Prevalence of low back pain in the community: Implications for service provision in Bradford, UK

Study objective - To assist a purchasing district in the planning of services for low back pain by assessing the prevalence of symptoms and the current involvement of primary, secondary, and complementary care in the treatment of low back pain. In the light of these findings, to assess further the potential impact of a new system of open access to physical therapy, as recommended by the British Clinical Standards Advisory Group (CSAG). Design - A two-stage cross sectional survey approach using postal questionnaires. Subjects - Altogether 1437 men and 1747 women aged 25-64 years, randomly selected from the family health services association register in Bradford. Main results - An annual incidence of 4.7% for low back pain was found, with Lifetime, 12 month period, and point prevalences of 59%, 39%, and 19% respectively. Over a one year period, 50.3% of episodes were acute (<2 weeks), 21% were subacute (2 weeks-3 months), and 26% were chronic (over 3 months) in duration. Altogether 17.8% of the population in this age range experienced referred pain, numbness, or tingling, and 6.4% took time off work as a result of low back pain. In the same year, 20% of the population in the same age range consulted no-one about their pain, 13.7% were treated at the primary care level, 4% received secondary care, and 3% visited a complementary therapist. One fifth of those who did not consult a professional experienced severe pain during episodes. Prevalence estimates indicate that an emphasis on early intervention and primary care management of simple low back pain as recommended by the CSAG could generate a 131% surge in demand for physical therapy. Conclusions - Local prevalence estimates may allow purchasers to estimate the potential effects of a shift in management policy for low back pain and to highlight areas of unmet need in terms of resources and patient education.