More than 840 million people worldwide will suffer back pain by 2050, largely due to population increase and the ageing people, according to a modelling study published in the Lancet Rheumatology journal. The researchers analysed over 30 years of data to show that the landscape of back pain cases is set to shift, with the biggest increases in cases to be in Asia and Africa. The continued lack of a consistent approach to back pain treatment, and limited treatment options have researchers concerned that this will lead to a healthcare crisis, as low back pain is the leading cause of disability in the world, they said.


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"Our analysis paints a picture of growing low back pain cases globally, putting enormous pressure on our healthcare system," said study lead author, Professor Manuela Ferreira from the University of Sydney in Australia. "We need to establish a national, consistent approach to managing low back pain that is informed by research," Ferreira said in a statement.


The study found that since 2017, the number of low back pain cases has ticked over to more than half a billion people. In 2020, there were approximately 619 million cases of back pain. At least one-third of the disability burden associated with backpain was attributable to occupational factors, smoking, and being overweight. A widespread misconception is that low back pain mostly affects adults of working age. However, researchers said this study has confirmed that low back pain is more common among older people. Low back pain cases were also higher among females compared to males, they said.


The study analysed Global Burden of Disease (GBD) data from 1990 to 2020 from over 204 countries and territories to map the landscape of back pain cases over time. The GBD is the most comprehensive picture of mortality and disability across countries, time, and age. "Health systems need to respond to this enormous and rising burden of low back pain that is affecting people globally," said Professor Anthony Woolf, co-chair of the Global Alliance for Musculoskeletal Health which is calling for priority to be given to addressing the growing burden of musculoskeletal conditions. "Much more needs to be done to prevent low back pain and ensure timely access to care, as there are effective ways of helping people in pain," Woolf said.


In 2018, experts voiced their concerns in The Lancet journal and gave recommendations, especially regarding exercise and education, about the need for a change in global policy on the best way to prevent and manage low back pain to stop the rise of inappropriate treatments.
However, since then, there has been little change. Common treatments recommended for low back pain have been found to have unknown effectiveness or to be ineffective - this includes some surgeries and opioids, the researchers said.


Ferreira said there is a lack of consistency in how health professionals manage back pain cases and how the healthcare system needs to adapt."It may come as a surprise to some that current clinical guidelines for back pain treatment and management do not provide specific recommendations for older people," the researcher added.