INTRODUCTION: Low back pain (LBP) is a common symptom in Australian adults. In any six months period approximately 10% of Australian adults suffer some significant disability from low back pain METHODS: Data sources used in this study were the 2001 Australian adult low back pain prevalence survey RESULTS: We estimated the direct cost of low back pain in 2001 to be AUD$1.02 Billion. Approximately 71% of this amount is for treatment by chiropractors, general practitioners, massage therapists, physiotherapists and acupuncture. However, the direct costs are minor compared to the indirect costs of AUD$8.15 Billion giving a total cost of AUD$9.17 Billion. The sensitivity analysis showed very little change in results. DISCUSSION: The economic burden of low back pain in Australian adults represents a massive health problem. This burden is so great that it has compelling and urgent ramifications for health policy, planning and research. This study identifies that research should concentrate on the reduction of indirect costs. This is not to suggest excluding direct cost research, as it is likely that early, efficient and evidence-based management of low back pain in the first instance may lessen the indirect costs that often follow. These startling results advocate urgent Government attention to LBP as a disorder.
INTRODUCTION: There is no shortage of treatments for low back pain (LBP), including medication, injections, bed rest, physiotherapy, chiropractic, osteopathy, acupuncture, massage therapy, and surgery. In addition to this are a plethora of home and folk remedies. However, there is still doubt about the efficacy or effectiveness of even the most common forms of therapy METHODS: An age, gender and State stratified random sample of 2768 Australian adults was selected from the Electoral Roll. This sample were mailed a fully structured questionnaire that included a series of questions relating to care-seeking for LBP, choice of provider and types of treatment received. In addition a series of questions were asked relating to demographic characteristics, socioeconomic variables, and severity of LBP. Also asked was cigarette smoking status, anthropometric variables, perceived cause of low back pain, emotional distress, job satisfaction, physical fitness, past five year health status, and whether the subject feared LBP could impair their work capacity or life in the future. RESULTS: The survey response rate was 69.1%. The sample proved to be similar to the Australian adult population. The majority of respondents with LBP in the past six months did not seek care for it (55.5%). Factors that increased care seeking were higher grades of pain and disability, fear of the impact of pain on future work and life and female sex. Factors decreasing the likelihood for seeking care were identified as the cause of pain being an accident at home and also never being married. General medical practitioners and chiropractors are the most popular providers of care. DISCUSSION: High levels of pain and disability equating with higher levels of care-seeking would not surprise, however fear as a motivator for care-seeking has implications for clinical practice. Another important issue is the type of care selected for LBP. Using the best evidence available for the management of LBP is now seen as a responsibility for all practitioners. It would be useful to compare care-seeking with the evidence of the efficacy and effectiveness of the various therapies utilised.