Chronic pain cases in Australia are soaring. There are three reasons why

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The number of Australians suffering from pain is on the rise. An estimated 3.2 million people had chronic pain in 2018, with that figure projected to increase to 5.2 million by 2050.

Over-the-counter pain medication manufacturing is projected to pull in $785.5 million of revenue this year, while a new study has estimated there to be an almost 50 per cent increase in the number of cases of lower back pain in Australia by 2050.

But what’s causing this pain?

Study author and principal research fellow at the Sydney University Institute of Bone and Joint Research Professor Manuela Ferreira said her lower back pain research identified three main risk factors: obesity, smoking and occupational factors such as heavy lifting, coupled with Australia’s ageing population.

“The unhealthier we get, the more likely we are to develop back pain,” she said.

Two-thirds of Australian adults are overweight or obese, according to the Australian Institute of Health and Welfare – 12.5 million adults – while 12 per cent are living with severe obesity.

Australia is a world leader in anti-tobacco legislation, but we’re still not on track to drop smoking rates to 5 per cent by 2030, new research has revealed. An estimated 13.7 per cent of adults were daily smokers in 2019.

While cigarettes haven’t been proven to cause back spasms, Ferreira said both extra weight and smoking were associated with an unhealthy lifestyle.

“We need to invest in improving knowledge and beliefs around back pain and change that belief that if you have that pain, you have to stay home, you have to stay off work, you have to lie down in bed rest,” she said. “What works with back pain is being active.”

More than half of Australian adults don’t participate in sufficient physical activity. Meanwhile, a study from Norway, also released this week, has found people who are more physically active have a higher pain tolerance.

Back pain is the third leading cause of the total burden of disease in Australia, and the leading cause of non-fatal burden in 2022. It’s also the top reason for lost work productivity and early retirement in Australia, costing the health system $4.8 billion every year.

From 2020 to 2021, seven in 10 Australians experienced pain within the four weeks before the survey, two-thirds of whom said it had interfered with their work.

Sydney Pain Management Clinic medical director Dr Vahid Mohabbati said the clinic had seen a surge in patients in the past several years, mostly presenting with spinal pain.

He attributes some increase to people who already had pain that was exacerbated by COVID-19 or an adverse reaction to the vaccine, along with people presenting with symptoms of long COVID-19, including chronic pain and chronic fatigue.

Mohabbati said there were also lifestyle factors at play: “I think it was more multifactorial, with social issues … and change in lifestyle with people being more sedentary by working from home.”

He’s also seen an increase in patients suffering from diabetic neuropathy, a painful form of nerve damage driven by high blood sugar.

The proportion of Australians diagnosed with diabetes nearly doubled between 2000 and 2020, with 4.3 per cent of Australians diagnosed with the disease.

Fellow at Sydney University’s Institute for Musculoskeletal Health Dr Giovanni Ferreira said socioeconomic factors in lifestyle and pain shouldn’t be ignored.

“Back pain and pain in general [are linked to] complex social problems that need complex solutions not just at the individual level,” he said.

Poor mental health can also play a role, Ferreira said, with a link between anxiety, depression, and an increased risk for persistent back pain. Asking someone to lose weight or exercise more doesn’t address broader issues around lifestyle and health, he said.

“We’re learning a lot more about risk factors, things that predispose people to develop pain and to develop disabling pain, but we are not very good yet coming up with great solutions to help people at a societal level,” he said.

“Finding out what the effective treatments are to reduce the burden of pain is a big challenge for the future.”

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