Media release

From: University of Technology Sydney (UTS)

Back pain isn’t just a debilitating condition, it may be a flag for other major health issues. New research shows the incidence of conditions such as heart disease, arthritis, diabetes and cancer is higher in people with back pain than in those without back pain.

Chronic back pain is a leading cause of disability worldwide, and a major burden on healthcare systems and economies. It keeps millions of people from work and, for many, the simple act of sitting, standing or sleeping is a daily struggle.

The study, led by Associate Professor Rafael Zambelli Pinto, a physiotherapist and researcher specialising in musculoskeletal conditions from the University of Technology Sydney (UTS), was recently published in Brazilian Journal of Physical Therapy.

The international team also included researchers from the Universidade Federal de Minas Gerais, Universidade Estadual Paulista and University of Sao Paulo in Brazil and the University of Sydney, UNSW, NeuRA in Australia.

The study used data from the 2019 National Health Survey in Brazil, which covered nearly 90,000 people. Approximately one in five people reported chronic back pain, a finding similar to higher-income countries, indicating the research has global relevance.

It found that a range of diseases were more prevalent in people with chronic back pain than in those without chronic back pain.

Cardiovascular disease, arthritis and depression were the top three most prevalent comorbidities in people with chronic back pain. Diabetes, cancer, asthma and other lung diseases were also higher in this population than those without back pain.

Those with back pain were 17 per cent more likely to report cardiovascular disease, 15 per cent more likely to report arthritis, and 12 per cent more likely to have clinical depression than those without back pain.

Around four million Australians are estimated to be living with back problems, according to the Australian Institute of Health and Welfare, with nearly 3 in 4 of those with back pain aged over 45 classified as having a comorbidity.

Patients with chronic back pain who also have comorbidities are more likely to report severe activity limitations, particularly those who have arthritis, depression and cardiovascular disease, the research found.

“While more research is needed to understand the link between chronic back pain and other non-communicable diseases, they often share underlying risk factors such as physical inactivity, obesity, stress and poor sleep,” Dr Zambelli Pinto said.

“When these conditions occur together, the impact on daily life is significant. Adults with both back pain and arthritis, for example, are more than twice as likely to report serious limits on their ability to carry out everyday activities compared to those without this specific comorbidity,” he said.

Back pain is one of the most common reasons people visit their GP, and the study suggests a wider, more integrated approach to care could reduce suffering and ensure other chronic diseases are properly managed.

“The findings highlight the urgent need for doctors to look beyond pain management when treating patients with chronic back pain. It’s not just about the spine. These patients are carrying a heavier overall health burden that affects their independence and quality of life,” Dr Zambelli Pinto said.

The research suggests the need to develop comprehensive care pathways and interdisciplinary approaches to manage these patients effectively.