Study finds 87.5 million low back pain cases in India; doctors say surgery not only solution

“This number is likely to be an undercount due to less availability of data on musculoskeletal conditions and because these estimates have not taken into consideration the impact of Covid-19,” says Dr Rakhi Dandona, Professor at Public Health Foundation of India (PHFI), who was part of the study.

“Low back pain can start with a niggling ache to shooting pain. At our spine unit, the daily load is approximately 60-70 patients,” says Dr Shailesh Hadgaonkar, chief spine surgeon at Sancheti Hospital. According to the latest report, there were more than 500 million prevalent cases of low back pain worldwide in 2020 and the number is likely to cross 800 million by 2050. “On top of absenteeism from work, low back pain might force workers to retire prematurely. Prevalence and years lived with disability due to low back pain increase with age, peaking at 85 years, and compromise the prospect of healthy aging. Emphasis should be given to integrated and early return to work interventions,” say experts in the report.

“Surgery can be useful in selective cases, but it is not always the solution. Chronic back pain is often also related to increasing age, and common causes include arthritis of the spine, spinal stenosis and disc problems like a bulging disc. Non-surgical management is often advised in a majority of cases,” says Hadgaonkar.

According to The Lancet report, low back pain remains the leading cause of Years of Living with Disability (YLDs) globally, and is caused by three modifiable risk factors: occupational risk, smoking and high BMI.

It attributed nearly one-quarter of YLDs due to low back pain to occupational factors, including prolonged sitting or standing, bending or lifting. Despite being among the leading causes of disability worldwide, and a substantial societal and economic burden, low back pain does not feature on the global health agenda, says Dandona of PHFI.

“In India, we need to invest in documenting the prevalence of low back pain, its risk factors, and the means people adopt to manage the pain. All this can facilitate the formulation of prevention strategies at the population level, mitigation of low back pain in the workplace, along with the availability of appropriate rehabilitation services,” she says.