As part of National Spinal Health Week (20 - 26 May 2024), the Australian Chiropractors Association (ACA) released new findings on the prevalence of back pain due to spine related musculoskeletal disorders (MSDs), revealing a significant impact on the spinal health of Australian women and suggests overuse of prescribed and over-the-counter medications that are proven to be largely ineffective in treating back pain.
The survey Impact of Back Pain & Musculoskeletal Injuries in Australia, an independent national consumer survey conducted by Pureprofile, revealed of all back/spine related MSD's, 91.3% of female respondents experienced a back related MSD in their lifetime with 82% experiencing low back pain in the past 12 months.
According to a survey of 1,006 Australian respondents (506 female, 499 male, and 1 non-binary), a total of 6,368 MSDs were reported. Women experienced 52.1% of these MSDs, with the most common being low back pain (81.6%), sprains or strains (75.5%), and mid back pain (70.6%) with 93.7% of regional Australian women and 89.9% of metropolitan women experiencing a MSD.
Women were more likely than men to experience a higher number of MSDs; of the 462 female MSD sufferers, 12% experienced 1 or 2; 28.6% between 3 and 6; 33.8% between 7 and 9; and 27.3% experienced between 10 and 12 MSDs with women 22.5% more likely than men to experience 7-12 MSDs.
Of those, 82.2% of women reported low back pain, with 28% of female sufferers experiencing low back pain weekly; 12% daily; 18% monthly; 15% occasionally (one every few months) and 15% seldom, and 33.7% reported that their MSD affected their movement or their ability to carry out daily activities.
This past year, Australian women experienced higher rates of back pain than men. 25.5% more women suffered from upper back pain, 19.7% more from 'Chronic Primary Low Back Pain' (CPLBP), and 5% more from low or mid back pain. Regular pain was reported by 41% of women in the lower back, 34% of mid-back, and 32% of upper back. Additionally, 40% of female low back pain sufferers developed a chronic condition.
86% of female respondents reported experiencing low, mid and upper back pain, or 'Chronic Primary Low Back Pain' (CPLBP). Also known as non-specific low back pain, CPLBP is when people experience persistent symptoms beyond three months that often are not caused by any particular condition and are classified as having a non-sinister, non-pathological cause.
Dr Ali Young, a chiropractor, author, Chair of ACA's Women in Chiropractic, speaker, former Vice President (CAAWA), mother of two, with extensive experience treating and advocating for the spinal health of women.
Dr Young, said, "Significantly, the survey showed nearly half (49.4%) of all female MSD sufferers failed to seek a medical diagnosis. This issue was even more pronounced among women with low back pain (the most common MSD experienced by Australian women), with 61.1% not seeking a medical diagnosis. These figures suggest official data may underrepresent the true prevalence of MSDs affecting Australian women," she said.
The World Health Organisation (WHO) guideline for non-surgical management of chronic primary low back pain (CPLBP) in adults in primary and community care settings (Dec 2023), developed from in depth research by a world-wide range of neuro-musculoskeletal health practitioners including chiropractors; recommends optimising the clinical management of people with CPLBP as a priority for WHO Member States.
"Although the WHO research determined that in some cases, non-steroidal anti-inflammatory medications may assist sufferers in the short-term; in line with the University of Sydney's study (Lancet medical journal, 23 June 2023), the WHO recommends against the commonly prescribed use of opioids and paracetamol to treat low back pain as these medications have proven largely ineffective and come with a range of significant associated risks and side effects," said Dr Young.
"Alarmingly, what the survey revealed was that 81% of all low back pain sufferers opted to treat the symptoms with over the counter or prescription medications rather than seek drug-free treatment. While medication can be avoided with appropriate diagnosis and treatment, of concern, is that women reported the greatest use of pain relief medication for low back pain (82.2% compared to 79.0% of men) with 14% taking it daily, 13% frequently and 13.5% said they often used medication to relieve back pain," she said.
The top five triggers or causes reported for Australian women's back pain were aging (29.2%), lifting/pulling/pushing (27.9%), computer use at work (19.3%), desk/seated work (17.7%) and stress (16.6%).
The data also revealed that 95.5% of female workers who engaged in occupations that involve a combination of sitting and standing reported the highest prevalence of MSDs followed by 93.3% of women whose professions included a mix of sitting, standing, and physical activity.
Workers with seated or desk-only roles accounted for 91% of reported MSDs while female workers in sedentary occupations exhibited the highest prevalence of back pain at 89.1%, whereas women who were engaged in highly active roles reported a comparatively lower prevalence of 83.3%.
Of the women who are not part of the workforce, 82.6% reported experiencing back pain with 89.7% of full time mothers or homemakers and 86.8% of retired women all reported experiencing back pain.
Significantly, the survey results also reflect the importance of exercise in preventing low back pain with women who have a highly-active lifestyle outside work and who undertook daily exercise reporting the lowest prevalence of back pain (76%) compared to 87.4% of women who were 'somewhat active' and undertook only light physical activity - a mix of standing and walking.
The survey data also suggests that weight can influence the likelihood of men or women experiencing back pain with 95% of very overweight and 90% of underweight respondents suffering back pain compared to 81% of "ideal" weight respondents and 86% of "bit over weight".
Women reported 26% more adverse effects from their MSDs compared to men including sleep interference (32%), increased irritability (29%), significant pain (26%), loss of sleep (24%), reduced ability to exercise (23%), difficulty performing household chores, difficulty concentrating (20%) and impacts on mental health and wellbeing, (15%). Women were also 54% more likely to experience difficulty concentrating, 36% more likely to have mental health issues, and 28% more likely to suffer sleep disruption as a result of back pain.
"The implications of unresolved back pain for women of all ages can be debilitating, restricting their ability to participate in family, social, and work activities, and have a negative impact on their mental health and overall wellbeing so its vital sufferers seek appropriate healthcare options that not only limit the use of medications but treat the cause of their condition including recommending exercise to help prevent reoccurrence.
Of the 45% of female respondents who had consulted a chiropractor, 81% gained relief from back pain.
"The WHO's analysis shows that MSDs cause the most persistent pain, with low back pain being the leading cause of global disability across all ages and genders with prevalence and disability consistently higher in women and older people. Together, these survey results form a compelling case for a proactive, strategic response to how Australian women approach back pain," Dr Young said.
"With its findings focused on individualised holistic healthcare, the WHO's research aligns with the heart of ACA's chiropractic philosophy - that patient education and self-care strategies, tailored exercise programs and physical therapies including chiropractic spinal manipulative therapy, and massage; can provide effective, evidence-based holistic drug-free solutions for back pain sufferers," she said.
"With over 400,000 chiropractic healthcare consultations helping to create well-adjusted Australians every week, ACA chiropractors continue to play an important role in improving our spinal health," said Dr Young.
With prevention the best protection from back pain, women can
