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Is back pain killing us?

February 23, 2017

The 600,000 older Australians who suffer from back pain have a 13 per cent increased risk of dying from any cause, University of Sydney research has found.

Published in the European Journal of Pain, the study of 4390 Danish twins aged more than 70 years investigated whether spinal pain increased the rate of all-cause and disease-specific cardiovascular mortality.

Low back pain is a major problem, ranked as the highest contributor to disability in the world. Nearly four million people in Australia suffer from low back pain and the total cost of treatment exceeds $1 billion a year.

"Our study found that compared to those without spinal pain (back and neck), a person with spinal pain has a 13 per cent higher chance of dying every year. This is a significant finding as many people think that back pain is not life-threatening," said senior author Associate Professor Paulo Ferreira, physiotherapy researcher from the University's Faculty of Health Sciences.

"As this study was done in twins, the influence of shared genetic factors is unlikely because it was controlled for in our analysis.

"These findings warrant further investigation because while there is a clear link between back pain and mortality we don't know yet why this is so. Spinal pain may be part of a pattern of poor health and poor functional ability, which increases mortality risk in the older population," he said.

Lead author Dr Matthew Fernandez from the Faculty of Health Sciences, said: "With a rapidly growing ageing population, spinal health is critical in maintaining older age independence, highlighting the importance of spinal pain in primary health care as a presenting symptom."

"Back pain should be recognised as an important co-morbidity that is likely to impact people's longevity and quality of life."

Associate Professor Ferreira added: "Policy makers should be aware that back pain is a serious issue - it is an indicator of people's poor health and should be screened for, particularly in the elderly."

Recent research has also found that commonly prescribed medications for back pain such as paracetamol and anti-inflammatory drugs are ineffective in treating pain and have side effects.

"Medications are mostly ineffective, surgery usually does not offer a good outcome - the best treatment for low back is a healthy lifestyle, including physical activity. People need to get moving," Associate Professor Ferreira said.

Few studies have examined the potential reduced life expectancy associated with spinal pain in an ageing population, particularly after controlling for familial factors, including genetics.

This study follows previous research which found that people with depression are 60 per cent more likely to develop low back pain in their lifetime.

Fast facts:
    * Back pain effects approximately 700 million people worldwide

    * Back pain is the leading cause of disability globally

    * Back pain affects 4 million people in Australia

    * Total cost of treatment of back pain exceeds $1 billion a year in Australia

    * The lifetime prevalence of back pain is around 84 per cent.
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University of Sydney

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