How do back problems affect quality of life?

The chronic and widespread nature of back problems often lead to poorer quality of life, psychological distress, bodily pain, and disability.

Back problems reported on these webpages include:

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

Note, back problems that are caused by another condition, such as osteoporosis or osteoarthritis, are not included.

Burden of disease

Back pain and problems is a large contributor to illness, pain, and disability in Australia. Based on data from the Australian Burden of Disease Study 2015, back pain and problems were the second leading cause of burden overall, accounting for 4.1% of Australia’s total disease burden.

Back pain and problems were the third leading cause of disease burden for both males and females, representing 3.9% and 4.4% of total disease burden, respectively [1].

Among males, back pain and problems is the second leading cause of disease burden for those aged 25–44 and 45–54 and the third leading cause for those aged 55–64. Among females, it was the leading cause for those aged 45–54 and the second leading cause for those aged 25–44.

Almost all of the burden caused by back pain and problems was non-fatal burden, where back pain and problems was the number one leading cause of non-fatal disease burden among males, females and overall, accounting for 8.1% of total non-fatal disease burden in Australia.

Additionally, in 2015–16, Back pain and problems cost the Australian health system an estimated $2.8 billion, representing 23% of disease expenditure on Musculoskeletal conditions and 2.4% of total health expenditure [2].

Perceived health status

People aged 15 and over with back problems are less likely to perceive their health as excellent than those without the condition according to the 2017–18 National Health Survey (NHS). After adjusting for age, people with back problems were 2.4 times as likely to rate their health as poor (6.5%) compared to with those without back problems (2.7%) (Figure 1).

Figure 1: Self-assessed health of people aged 15 and over with and without back problems, 2017–18

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

Source: AIHW analysis of ABS Microdata: National Health Survey, 2019 [3] (Data table).

Psychological distress

Overall, people aged 18 and over with back problems were 2.5 times as likely to report experience very high levels of psychological distress (8.1%) than those without the condition (3.2%) after adjusting for age (Figure 2).

Figure 2: Psychological distress(a) experienced by people aged 18 and over with and without back problems, 2017–18

The vertical bar chart shows that people aged 18 and over with back problems were more likely to report levels of psychological distress that were moderate (28%25), high (16%25) or very high (8%25) compared with people without back problems (22%25, 8%25, and 3%25 respectively). People with back problems were less likely to report low levels of psychological distress (48%25) compared with people without back problems (67%25).

a. Psychological distress is measured using the Kessler Psychological Distress Scale (K10), which involves 10 questions about negative emotional states experienced in the previous 4 weeks. The scores are grouped into Low: K10 score 10–15, Moderate: 16–21, High: 22–29, Very high: 30–50.

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

Source: AIHW analysis of ABS Microdata: National Health Survey, 2014–15 (Data table).

Pain

People with back problems were 2 times as likely to experience severe (11%) and very severe (3.1%) bodily pain compared with those without the condition (4.6% and 1.0%, respectively) according to self-reported data from the 2017–18 NHS (Figure 3).

Figure 3: Pain(a) experienced by people aged 18 and over with and without back problems, 2017–18

The vertical bar chart shows that people aged 18 and over with back problems were twice as likely to report moderate (34%25) or severe (11%25) bodily pain and three times as likely to report very severe (3%25) bodily pain compared with those without the condition (15%25, 5%25 and 1.0%25 respectively). People with back problems were less likely to report their levels of bodily pain as very mild (20%25) or none (11%25) compared with people without back problems (26%25 and 37%25 respectively).a

 a. Bodily pain experienced in the 4 weeks prior to interview.

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

Source: AIHW analysis of (ABS 2019) [3] (Data table).

Impact on activity

In 2017–18, 38% of people with back problems said that bodily pain interfered with their daily activities at least 'moderately', compared with 17% of people without back problems. Of people with back problems, 5.8% said bodily pain had an 'extreme' impact on their activity, compared with 2.4% of people without back problems (Figure 4).

Figure 4: Extent that bodily pain interferes in daily activities in people with and without back problems, 2017–18

The vertical bar chart shows that people with back problems were more likely to describe their bodily pain as interfering with their daily activities ‘a little bit’ (29%25), ‘moderately’ (20%25), ‘quite a bit’ (13%25), and ‘extremely’ (5.8%25) compared with people without back problems (19%25, 9.6%25, 4.6%25 and 2.4%25, respectively). People with back problems were less likely to describe no interference in daily activities (22%25) or no bodily pain (11%25) compared with people without back problems (27%25 and 37%25, respectively).

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

Source: AIHW analysis of (ABS 2019) [3] (Data table).

Workforce participation

According to self-reported data from the 2017–18 NHS, people aged 15–64 with back problems are less likely to be employed (73%) compared with people without back problems (77%) and more likely to not be in the labour force (22% compared with 19%). There is little difference in the proportion of people who were unemployed with (5%) and without (4%) back problems (Figure 5).

Figure 5: Workforce participation of people aged 15–64 with and without back problems, 2017–18The vertical bar chart shows that there was very little difference in the workforce participation of 15–64 year olds with and without back problems. Slightly less people with back problems were employed (73%25) compared with people without back problems (77%25), and a similar proportion of people with back problems were unemployed (5%25) or not in the labour force (22%25) compared with people without back problems (4%25 and 19%25 respectively).

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

Source: AIHW analysis of ABS 2019 [3] (Data table).

References

  1. AIHW (Australian Institute of Health and Welfare) 2019. Australian Burden of Disease Study 2015: Interactive data on disease burden. Cat. no. BOD 24. Canberra: AIHW. Viewed 13 June 2019.
  2. AIHW 2019. Disease expenditure in Australia. Cat. no. HWE 76. Canberra: AIHW. Viewed 13 June 2019.
  3. ABS (Australian Bureau of Statistics) 2019. Microdata: National Health Survey, 2017–18, detailed microdata, DataLab. ABS cat. no. 4324.0.55.001. Canberra: ABS. Findings based on AIHW analysis of ABS microdata.