Australian Institute of Health and Welfare 2020. Back problems. Cat. no. PHE 231. Canberra: AIHW. Viewed 17 October 2021, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
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 2021 Oct. 17]. Available from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Australian Institute of Health and Welfare (AIHW) 2020, Back problems, viewed 17 October 2021, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
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Back problems are a range of conditions related to the bones, joints, connective tissue, muscles and nerves of the back. Back problems are a significant cause of disability and lost productivity.
In 2017–18, there were 181,000 hospitalisations for back problems
Pain at least "moderately" interfered with daily activities for almost 2 in 5 (38%) people with back problems in 2017–18
About 4.0 million people or 1 in 6 Australians (16%) had back problems in 2017–18
In 2015, back pain was the 2nd leading cause of disease burden, accounting for 4.1% of Australia’s total disease burden
Pain is the main symptom of most back problems and treatment can be complex. This can be further complicated by comorbid conditions. Some general treatment strategies for chronic diseases, for example, lifestyle modifications such as diet, exercise, weight control, and reducing smoking, can benefit people with back problems (Bauer et al. 2014).
The most recent Australian clinical practice guidelines for management of non-specific low back pain encourages reassurance, self-management and physical therapy as first line care, supplemented by non-pharmacological therapies such as heat, massage, acupuncture and mindfulness where appropriate (Almeida et al. 2018). Medications are discouraged except where first and second-line non-pharmacological interventions are unsuccessful, and when they are prescribed, the lowest effective dose for the shortest amount of time possible is advised (Almeida et al. 2018).
Non-steroidal anti-inflammatory drugs (NSAIDS) should be the first-line medication when non-pharmacological management is inadequate (Almeida et al. 2018). Opioids should only be used when other treatments have failed after cautious assessment of risk versus benefits for the individual (Almeida et al. 2018). Paracetamol and surgery are no longer recommended (Almeida et al. 2018).
Reliable and up to date information on how to manage back pain is provided at mybackpain.org.au, a resource funded by Australia’s National Health and Medical Research Council, and developed by Arthritis Australia, the University of Queensland and Cochrane Back and Neck.
General practitioners (GPs) are usually the first point of contact with the health care system for people with back problems. Back problems are among the most commonly managed conditions in general practice (Almeida et al. 2018). In 2015–16, 3.1 of every 100 GP-patient encounters for chronic conditions were for the management of back problems. This has increased significantly from 2.6 of every 100 GP-patient encounters in 2006–07 (Figure 1).
There is currently no nationally consistent primary health care data collection monitoring provision of care by GPs. The statistics on general practice activities are based on Bettering the Evaluation and Care of Health (BEACH) data, which are derived from a sample survey of GPs and their encounters with patients and should be interpreted with caution.
Source: Britt et al. 2016 (Data table).
Data from the AIHW National Hospital Morbidity Database (NHMD) show that in 2017–18:
Source: AIHW National Hospital Morbidity Database (Data table).
The top 3 main reasons for back problem hospitalisations were:
From 2015–16 to 2017–18, the age-standardised hospitalisation rate for back problems among Australians remained relatively stable and was higher for females compared with males (Figure 3). Data prior to 2015–16 are not presented because rehabilitation hospitalisations were coded differently before this year.
Note: Age-standardised to the 2001 Australian population.
Almeida M, Saragiotto B, Richards B & Maher CG 2018. Primary care management of non-specific low back pain: key messages from recent clinical guidelines. The Medical Journal of Australia 2018(6):272–275.
Bauer UE, Briss PA, Goodman RA & Bowman BA 2014. Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. Lancet 384:45–52.
Britt H, Miller GC, Bayram C, Henderson J, Valenti L, Harrison C et al. 2016. A decade of Australian general practice activity 2006–07 to 2015–16. General practice series no. 341. Sydney: Sydney University Press.
Gore M, Sadosky A, Stacey BR, Tai KS & Leslie D 2012. The burden of chronic low back pain: clinical comorbidities, treatment patterns, and health care costs in usual care settings. Spine (Phila Pa 1976) 37(11):E668–E677.
Kozma CM, Provenzano DA, Slaton TL, Patal AA & Benson CJ 2014. Complexity of pain management among patients with nociceptive or neuropathic neck, back, or osteoarthritis diagnoses. Journal of Managed Care and Speciality Pharmacy 20(5):455–466b.
Summary: Low back pain and radicular pain: assessment and management. KCE report 287Cs. Brussels: Belgian Health Care Knowledge Centre (KCE), 2017.
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