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Lower back pain remains one of the most challenging public health issues.

The statistics are eye-opening. According to the American Chiropractic Association:

• “31 million Americans experience low-back pain at any given time”
• “Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.”
• “Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.”
• “One-half of all working Americans admit to having back pain symptoms each year.“
• “Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.“
• “Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.”
• “Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.“

Several components of a well-run workplace wellness program may help address symptoms — and potentially causes — of some lower back pain, including exercise, stress management, diet and more.

And now a new series in The Lancet is addressing the topic.

The medical journal writes: “Almost everyone will have low back pain at some point in their lives. It can affect anyone at any age, and it is increasing—disability due to back pain has risen by more than 50% since 1990. Low back pain is becoming more prevalent in low-income and middle-income countries (LMICs) much more rapidly than in high-income countries. The cause is not always clear, apart from in people with, for example, malignant disease, spinal malformations, or spinal injury. Treatment varies widely around the world, from bed rest, mainly in LMICs, to surgery and the use of dangerous drugs such as opioids, usually in high-income countries.”

Workplace Insight breaks down some of the authors' findings:

• “The series provides evidence that back pain should be managed with activity, in the workplace and in primary care.”
• “However, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are referred for scans and surgery or prescribed pain killers including opioids.”
• “The authors claim this is at best pointless and at worst harmful. Exercise and psychological therapy are the only things that work for the majority of cases of chronic back pain but too many people wrongly believe the idea that rest is best for the condition, according to the authors.”
• “The series of papers also concludes that job satisfaction and a positive attitude are among the strongest indicators of how well people will overcome chronic back pain and related issues.”

For workplace wellness program design, these insights may provide impetus to review opportunities to address lower back pain concerns among employees.