Low back pain is the leading cause of disability worldwide, affecting an estimated 540 million people at any one time. Yet, a new Series of papers to be published in The Lancet highlights the extent to which the condition is mistreated, often against best practice treatment guidelines.

Low Back Pain (LBP) is extremely common, and is the largest single cause of years lived with disability in England (Global Burden of Disease 2013)

UK specific data shows that LBP was the top cause of years lived with disability in both 1990 and 2010, with a 12% increase over this time -- so the problem is getting worse.

LBP accounts for 11% of the entire disability burden from all diseases in the UK.

The cost of LBP to the NHS was estimated in 2008 to be £2.1 billion (and costs overall to UK society when we factor in work loss and informal care in region of £10.7 billion).

In the UK in 2006, one in seven of all recorded consultations with general practitioners were for musculoskeletal problems with complaints of back pain being the most common (417 consultations per year for low back pain per 10,000 registered persons)

Burden of back pain disability in UK has increased from 1510 disability adjusted life years /100,000 to 1634 DAlYs /100,000 -- an 8% increase in spite of massive investments in back pain research and treatment.

UK author additional quotes

Professor Nadine Foster, Keele University -- lead author of one of the papers, comments: "Funders should pay only for high-value care, stop funding ineffective or harmful tests and treatments, and importantly intensify research into prevention."

"The gap between best evidence and practice in low back pain must be reduced. We need to redirect funding away from ineffective or harmful tests and treatments and towards approaches that promote physical activity and function. We also need to intensify further research of promising new approaches such as redesigning patient pathways of care and interventions that support people to function and stay at work."

"There are examples of promising new solutions around the world but they need to be more rigorously researched to work out if they should be implemented."

Professor Martin Underwood, University of Warwick -- co-author on the papers comments: "Our current treatment approaches are failing to reduce the burden of back pain disability; we need to change the way we approach back pain treatment in the UK and help low and middle income countries to avoid developing high cost services of limited effectiveness."