What are back problems?

'Back problems’ describes a range of conditions related to the bones, joints, connective tissue, muscles and nerves of the back. These conditions can affect the neck (cervical spine), upper back (thoracic spine) and lower back (lumbar spine) as well as the sacrum and tailbone (coccyx).

Back problems reported on these web pages include:

  • Disc disorders (such as herniated discs or disc degeneration)
  • Sciatica and curvature of the spine
  • Back pain/problems not elsewhere classified.

Note back problems associated with another condition, such as osteoporosis are not included. For this reason, the total prevalence of back problems is likely to be underestimated.

Figure 1: Lateral view of spine

The diagram shows the 5 sections of the spine. The cervical spine is at the top of the spine, forming the neck. The thoracic spine sits underneath and attaches to rib cage. The lumber spine makes up the lower region of the back. Beneath that, the sacrum connects to the pelvis and the coccyx forms the bottom of the spine.

Back problems include:

  • episodes of ‘non-specific’ pain in the lower, middle and upper back that are sometimes associated with injury but often may arise and settle for no apparent reason
  • ‘sciatica’ a back problem with pain shooting down one leg often accompanied by tingling, numbness or weakness in that leg. A similar problem in the neck will cause arm symptoms
  • narrowing in the canal of the lumbar spine through which the spinal cord passes. This is more common in older people and causes difficulty walking as well as symptoms in both legs
  • less common conditions such as infection or fracture that are managed differently to the more common back problems
  • ‘whiplash’ following a motor vehicle accident.
     

Back problems can have many causes, relating to work, sport and lifestyle issues, injuries, diseases such as arthritis, disc disease and osteoporosis. Sometimes back pain is the result of a health condition beyond the spine such as a kidney stone or shingles. Factors that may increase the risk of developing back problems include age, physical fitness, smoking, being overweight, and the type of work a person does (ABS 2019).

Pain is the main symptom in most back problems. Back problems are a common reason for pain among younger and middle-aged adults, but can start in childhood (Raspe et al. 2004). Back problems are often recurrent and may need to be managed as a long-term health condition.

How common are back problems?

About 4.0 million Australians (16% of the total population) have back problems, based on self-reported data from the Australian Bureau of Statistics (ABS) 2017–18 National Health Survey (NHS).

Back problems are least common among people from birth to age 24 (Figure 2). The overall prevalence of back problems, after accounting for differences in age, is similar for males (16%) and females (15%).

Figure 2: Prevalence of back problems, by age group and sex 2017–18

The vertical bar chart shows that back problems are most common among males aged 55–64 (31%25) and females aged 65–74 (26%25). They are least common among people from birth to age 24 (3%25 in males and 4%25 in females). The prevalence of back problems for males and females is similar.

Note: refers to people who self-reported having back pain and problems (current and long term).

Source: AIHW analysis of ABS 2019a (Data table).

Aboriginal and Torres Strait Islander people

According to self-reported data from to the ABS 2018–19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), the prevalence of back problems among Aboriginal and Torres Strait Islander people was 13%, affecting about 102,000 people —including about 14,000 who live in remote areas (9.4% of the remote Indigenous population).

After adjusting for age, males and females had similar rates of back pain and problems (17% each). The proportion of Indigenous Australians (17%) and non-Indigenous Australians (16%) affected was also similar (Figure 3).

Figure 3: Prevalence of back problems by Indigenous status, 2018–19

The vertical bar chart shows that, after adjusting for age, the prevalence of back problems was relatively similar in Indigenous Australians (13%25 of males, 15%25 of females) compared with Total Australians (13%25 of males, 12%25 of females).

Note: Rates are age-standardised to the Australian population as at 30 June 2001.

Source: ABS 2019 (Data table).

Inequalities

According to self-reported data from the 2017–18 National Health Survey, prevalence of back problems was similar in Major cities (16%), Inner regional (17%) and Outer regional and Remote (15%) areas of Australia. Those living in the lowest socioeconomic areas were 1.4 times as likely to have back problems compared with those living in the highest socioeconomic areas (18% and 13%) (Figure 4).

Figure 4: Prevalence of back problems, by remoteness and socioeconomic area, 2017–18

The horizontal bar chart shows that the prevalence of back problems between Major cities, Inner regional areas, and Outer regional/Remote Australia was relatively similar. People living in the lowest socioeconomic areas were more likely to have back problems (19%25 in males and 18%25 in females) compared with those in the highest socioeconomic areas (14%25 in males, 13%25 in females).

Note: Rates are age-standardised to the Australian population as at 30 June 2001.

Source: AIHW analysis of ABS 2019b (Data table).