Regular Article
The economic burden of low back pain: a review of studies published between 1996 and 2001

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Abstract

Low back pain (LBP) poses an economic burden to society, mainly in terms of the large number of work days lost by a small percentage of patients who develop chronic LBP. The object of this review is to gain a better understanding of the societal costs of LBP and to see whether current clinical management follows evidence-based guidelines and is economically attractive, by reviewing studies on LBP with economic implications. To this end, the Medline database was searched between 1996 and 2001 using appropriate keywords, broadly defined. A total of 372 abstracts were screened and paper copies of 73 potentially relevant articles were obtained.

It was found that the cost of LBP illness was high and was comparable to other disorders such as headache, heart disease, depression or diabetes, but actual cost estimates varied depending on the costing methodology employed. A small percentage of patients with chronic LBP accounts for a large fraction of the costs. Excessive and inappropriate use of diagnostic or therapeutic services can be documented but varied by region and provider type. Management according to evidence-based guidelines was not necessarily economically attractive. Interventions for acute or chronic LBP failed to show economic benefits, but demonstrated modest clinical benefits, which suggested a weak relationship between clinical and economic outcomes. The conclusion was that common definitions and costing methodologies need to be found to gain a better understanding of the true costs to society and to make studies comparable. A better definition is needed for the type for patient with LBP for whom therapeutic management is most likely to have a long-lasting economic benefit.

References (35)

  • HR Guo et al.

    Back pain prevalence in US industry and estimates of lost workdays

    American Journal of Public Health

    (1999)
  • KB Hagen et al.

    Work incapacity from low back pain in the general population

    Spine

    (1998)
  • N Krause et al.

    Alternative approaches for measuring duration of work disability after low back injury based on administrative workers' compensation data

    American Journal of Industrial Medicine

    (1999)
  • JA Rizzo et al.

    The labor productivity effects of chronic backache in the United States

    Medical Care

    (1998)
  • BG Druss et al.

    Health and disability costs of depressive illness in a major U.S. corporation

    American Journal of Psychiatry

    (2000)
  • JF Dartigues et al.

    Comparative view of the socioeconomic impact of migraine versus low back pain

    Cephalalgia

    (1998)
  • MR Underwood

    Crisis: what crisis?

    European Spine Journal

    (1998)
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    All correspondence to: Andreas Maetzel. Tel: 001(416) 946 4501; Fax: 001(416) 946 2291; E-mail: [email protected]

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