Epidemiology

Lower back symptoms are one of the primary reasons for physician visits in the US.[5]​ In 2016, low back pain was the leading cause of years lived with disability among the US population.[6]​​ Considerable heterogeneity exists between low back pain epidemiological studies; estimates of incidence and prevalence should be interpreted with caution.

Annual incidence rates of 6.3% to 26% have been reported for first time lower back pain.[7][8] Estimates of 1-year incidence of any episode of lower back pain range from 1.5% to 36%.[8][9] The 3-year incidence of lower back pain of any severity or duration was 67% in a US Veterans Affairs outpatient population.[10]

Lower back pain has a lifetime prevalence of approximately 39% to 84%.[9][11][12] Prevalence appears to peak between 40 and 69 years, with a modest female preponderance, and progressively declines thereafter.[12] In the 2018 US National Health Interview Survey, 29.9% of Americans reported at least 1 day of lower back pain over the past 3 months.[13] Global data suggest a point prevalence of 12%, and 23% 1-month prevalence.[12]

The median global prevalence for hospital admissions for lower back symptoms has been estimated at 159 per 100,000 population, with the median length of hospital stay estimated as ranging from 5.4 days to 6.2 days.[14] Recurrence of lower back pain is very common. Estimates of recurrence at 1 year (including transformation of acute lower back pain into either recurrent or chronic pain) range from 24% to 80%.[8][15][16]​ Many patients with continued pain will, however, stop visiting their physician.

No ethnic predominance has been consistently demonstrated. In a 2018 US national health survey, the highest prevalence of lower back pain was in native Americans and native Alaskans and the lowest was in Asian Americans (46.5% versus 20.1%, respectively, for 3-month period prevalence).[13]​ However, the estimated prevalence of low back pain in India is 51% annually, and 66% lifetime, which is higher than in other populations.[17]

One of the main societal consequences of lumbar injury and chronic spine pain is disability. One review found that years lived with disability caused by low back pain (in developed countries) have increased by more than 50% since 1990.[18] Disability related to low back pain is projected to increase most in low-income and middle-income countries, where resources are limited, access to quality health care is generally poor, and sedentary work is becoming more common (as these countries develop service-based economies).[18]

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