Australian Institute of Health and Welfare (2020) Back problems, AIHW, Australian Government, accessed 04 February 2023.
Australian Institute of Health and Welfare. (2020). Back problems. Retrieved from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Back problems. Australian Institute of Health and Welfare, 25 August 2020, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Australian Institute of Health and Welfare. Back problems [Internet]. Canberra: Australian Institute of Health and Welfare, 2020 [cited 2023 Feb. 4]. Available from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Australian Institute of Health and Welfare (AIHW) 2020, Back problems, viewed 4 February 2023, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
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Back problems often lead to poorer quality of life, psychological distress, bodily pain, and disability.
Back pain and problems are 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 (AIHW 2019a).
Among males, back pain and problems were 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, they were 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 were 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 (AIHW 2019b).
People aged 15 and over with back problems were less likely to perceive their health as excellent compared with 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 with those without back problems (2.7%) (Figure 1).
Note: Rates are age-standardised to the Australian population as at 30 June 2001.
Source: AIHW analysis of ABS 2019 (Data table).
People with back problems were 2.6 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 2).
(a) Bodily pain experienced in the 4 weeks prior to interview.
Source: AIHW analysis of ABS 2019 (Data table).
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 3).
Overall, people aged 18 and over with back problems were 2.5 times as likely to report experiencing very high levels of psychological distress (8.1%) than those without the condition (3.2%) after adjusting for age (Figure 4).
(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.
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).
People with back problems often have other chronic diseases and long-term conditions. These are referred to as 'comorbidities' – two or more health problems occurring at the same time. Comorbidities often share common risk factors, and may interact to determine the health status of individuals. As people age, they are more likely to develop more than one chronic condition.
This information is based on self-reported data from the Australian Bureau of Statistics (ABS) 2017–18 National Health Survey (NHS), and was last updated in March 2019.
An estimated 2.5 million Australians aged 45 and over have back problems, based on self-reported data from the 2017–18 National Health Survey. Of these, almost 3 in 4 of those people (74% of the total population of people with back problems) report also having one or more of the following selected chronic conditions (Figure 6):
In addition, almost 1 in 2 (46%) have two or more other chronic conditions (Figure 6).
Note: the 9 other selected chronic conditions are heart, stroke and vascular disease, asthma, arthritis, cancer, COPD, diabetes, kidney disease, mental and behavioural conditions, and osteoporosis.
Among people aged 45 years and over with back problems:
These proportions remained similar even after accounting for differences in the age structure of the populations (Figure 7; Data tables - Table 5.2).
The National Health Survey (NHS) uses three factors to determine whether or not a person is counted as having a particular condition: whether the condition is current, whether it is long term and whether it was medically diagnosed. The combination of these factors required for a person to count as having the condition varies according to the nature of the condition. For example, some conditions, such as diabetes and HSVD, once diagnosed, are seen to be lifelong. Even if a person no longer reports symptoms, they still count as having the condition. While other conditions, such as depression, asthma, cancer or back problems, can be lifelong, episodic or in complete remission.
Most conditions do not need the respondent to have been diagnosed by a doctor or nurse. The respondent is counted if they said they have the condition. However, in cases where the respondent said they had diabetes or HSVD and that the condition was not current, they need to have received a diagnosis to be counted.
Has the condition been diagnosed by a doctor or nurse?
no diagnosis required
not long term
Heart, stroke and vascular disease (HSVD)
Mental and behavioural conditions
Note: Please see the 2017-18 NHS User Guide for more information on the definitions of the conditions.
ABS (Australian Bureau of Statistics) 2018a. National Health Survey: First Results, 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS.
ABS 2018b. National Health Survey: Users’ Guide, 2017–18. Viewed 1 May 2019. Canberra: ABS.
ABS 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.
AIHW (Australian Institute of Health and Welfare) 2019a. Australian Burden of Disease Study 2015: Interactive data on disease burden. Cat. no. BOD 24. Canberra: AIHW. Viewed 13 June 2019.
AIHW 2019b. Disease expenditure in Australia. Cat. no. HWE 76. Canberra: AIHW. Viewed 13 June 2019.
Bollegala D, Perruccio AV & Badley EM 2011. Combined impact of concomitant arthritis and back problems on health status: Results from a nationally representative health survey. Arthritis Care & Research 63.
Ha IH, Lee J, Kim MR, Kim H & Shin JS 2014. The association between the history of cardiovascular diseases and chronic low back pain in South Koreans: a cross-sectional study. PLOS ONE 9(4):e93671.
Schofield DJ, Callander EJ, Shrestha RN, Passey ME, Percival R & Kelly SJ 2012. Association between comorbidities and labour force participation amongst persons with back problems. Pain 153:2058–2072.
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