Six million Britons living with undiagnosed back pain

Over a quarter of Britons (27 per cent) suffering from debilitating lower back pain – estimated to be around six million people – do not have a diagnosis for their symptoms. This is leading to widespread anxiety, depression and avoidable time off work, new research suggests.

The figures out today from Nuffield Health reveal that the combination of a lack of access to treatment and diagnostics, poor guidance for doctors, as well as sedentary lifestyles, are causing a large population in the UK to live with painful symptoms which could be avoided with early treatment and good advice. Nuffield Health questioned 3,322 people across the UK; 1,203 (36 per cent) said they suffer lower back pain which impacts on their daily life. Of these:

  • Over a quarter of people (27 per cent) have never had diagnosis and do not understand why they have pain or how it could be treated.  
  • Half of those with pain – up to 11 million based on today’s snapshot – have been told that a referral to a spinal specialist is pointless as there is no treatment for lower back pain.
  • Over a third (35 per cent) have not had access to any form of diagnostic scan – MRI /CT or X-ray to investigate the symptoms. 
  • Over half have self-diagnosed using the internet in order to help improve their pain.
  • Over 80 per cent have been managing the pain with drugs for more than six weeks; almost two thirds (64 per cent) for more than three months; and nearly a third (31 per cent) for over five years.

Back pain is the UK’s leading cause of long term sickness, responsible for more than 15 million sick days in 2013. One in seven (14 per cent) questioned with lower back pain said they are on long term sickness benefit or cannot work due to their symptoms, while the same number (14 per cent) have taken at least a month off in the past 12 months. Over a quarter (27 per cent) of people say that the lack of diagnosis or knowledge is causing depression, while one in six (17 per cent) are anxious they are suffering from a more serious health condition.

Mr Almas Khan, Specialist Consultant Spinal Surgeon for Nuffield Health in Leeds said:  

“Once serious conditions, like cancer, nerve conditions and infections have been ruled out there is a tendency to group every other patient together in one category. Confusing central guidance often means GPs are reluctant to make referrals to specialists, or to send patients for scans or X-rays to obtain a diagnosis. This leads to huge numbers of people left without any real knowledge about what their problem is and how they are supposed to deal with it. For most, early exercise, physiotherapy and pain management will usually help, but if symptoms persist for more than 3 months then further investigation is warranted. By ruling out early scanning, there is also the danger that a very small number of patients with serious conditions will be missed and this can also lead to extreme anxiety for some people.” 

The research also shows that patients are twice as likely to be guided towards painkillers (60 per cent) than to exercise (25 per cent), despite exercise being considered a vital part of recovery and treatment for many patients with lower back pain. Conversely, more than a third (38 per cent) of back pain sufferers said they are fearful of doing any kind of physical activity or exercise. Nuffield Health doctors say that for the vast majority of patients, early pain management combined with exercise or physiotherapy could be vital in preventing long-term problems.

The lifestyle choices of Britons also appear to be exacerbating lower back pain prevalence. Although over a third of Britons suffer pain, just over half (53 per cent) regard exercise as an important part of keeping fit and healthy, while 57 per cent say they lead a completely sedentary life - mostly sitting, reading, playing video games, watching TV or using a computer for most of the day, with little or no vigorous exercise, including walking.   The figures show that people who lead sedentary lifestyles are more than twice as likely to suffer back pain (22 per cent compared with 47 per cent); once they have pain, nearly three quarters resign themselves to a sedentary lifestyle.

Consultant Spinal Surgeon at Nuffield Health Wessex Hospital, Mr Christopher Dare, said:  

“Although many people suffer from debilitating lower back pain, there is still a lack of understanding about how to prevent and treat it. We do know that delaying a diagnosis can be harmful due to the impact it can have in the long term on careers, families and psychological welfare. There may not be a medical or surgical solution, and doctors should be honest about what can be achieved, but if a patient is empowered with knowledge then they can use the information to help themselves. Wherever possible people need to keep moving and exercising, while early physiotherapy and scanning can both help prevent people spending years in pain, with cupboards full of drugs and an increasingly diminishing chance of recovery.”   

Nuffield Health Doctors are also urging patients to help themselves, given the findings of the research.

  1. Build regular exercise into your daily routine:  ‘Couch potatoes’ – Britons who lead a sedentary lifestyle - primarily watching TV or playing video games, with little or no exercise - are more than twice as likely to suffer back pain (22 per cent compared with 47 per cent);  while 74% of back pain sufferers lead sedentary lifestyles once they have pain. Those who don’t exercise tend to suffer more from severe back pain (56 per cent) than those who do and have always done so (44 per cent)
  2. Make sure you are taking regular breaks at work: 36 per cent of back pain sufferers do not take regular short breaks at work.   Nearly two thirds (64 per cent) of the people surveyed said that their workplace doesn’t provide any kind of support or advice to help them with their problem.  In fact, employers are legally obliged to minimise the risk of employees developing back pain or making existing back pain worse. Talking to managers about how they can help you through risk assessment and making changes where needed, can be beneficial.

    This short film looks into how to look after your back whether you’re working from the office or from home. In a step-by-step guide, our Nuffield Health Physiotherapist, Joanne Gough, explains the importance of posture and correct spinal alignment and adds some handy tips for supporting your posture if you have to work from home without a desk.

  3. Pay attention in high risk jobs: Over three quarters (77 per cent) who drive long distances for work suffer back pain – the highest in the UK – while 54 per cent of manual labourers and almost four out of ten people (37 per cent) with desk jobs have lower back pain.

Steve Nawoor, Professional Head of Physiotherapy, Nuffield Health, said:

“Back pain is often a combination of factors, which in the first instance requires detailed assessment from an appropriate level of practitioner that can take into account all aspects of the condition and offer advice accordingly. Early intervention is the key and physiotherapists are well placed to signpost patients appropriately with the correct information, whether that be strategies and advice for self-management, exercise and lifestyle planning or onward referral for further investigation.”

Last updated Friday 13 October 2017

First published on Thursday 28 May 2015