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August 21, 2002

100 Million Americans Live with Aching Backs, 
but Most Don't Seek Medical Help

Increased Awareness Hasn't Dispelled Treatment Myths and Pain

CHICAGO, August 21, 2002 - Millions of Americans have low back pain so severe that it interferes with their daily activities. Yet, a significant percentage of them have not sought help from a medical doctor and many incorrectly believe surgery is the most effective cure for an aching back, according to a survey sponsored by the American Academy of Physical Medicine and Rehabilitation (AAPM&R).

The survey results show that more than one out of two respondents - which translates into more than 100 million adult Americans - have low back pain, and that more than half of them report the pain interferes with their activities. The survey also shows that back pain is not a condition caused only by aging; as many 18 to 24 year-olds reported back pain as did respondents age 55 and older.

Americans - those with back pain and those without - are knowledgeable about the condition, according to the survey. They understand that physical activity - and not bed rest as once believed - is the key to treating bouts of pain.

But this knowledge has not translated into relief for the millions of Americans who suffer from chronic low back pain, a condition that experts say will affect four out of five Americans at some point in their lives. Low back pain is the second most common reason for symptom-related visits to a physician, according to research published in the medical journals Spine and Lancet.

"Knowledge is half the battle," said Andrew Haig, M.D., Associate Professor, Physical Medicine and Rehabilitation and Surgery, University of Michigan. "But we have a long way to go in reducing the number of people who are letting low back pain diminish their quality of life. One reason may be that we doctors have not done a good job of working with our patients and explaining what we can do for them. This survey clearly shows that people in pain are seeking help, but not from us."

Almost two-thirds (62 percent) of those surveyed who experience back pain have sought help from the health care community. But the three most commonly consulted practitioners are chiropractors, physical therapists and massage therapists, and not medical doctors. And although Dr. Haig says that surgery is the best option for less than 5 percent of people with low back pain, almost half (48 percent) of the respondents said they think it's the only effective cure for about half of low back pain cases.

"Surgery is rarely the answer but many people associate doctors with surgery rather than exercise and other non-invasive therapies, which really are the most effective," Dr. Haig said.

When asked if they have or would see a physiatrist, a physician who specializes in physical medicine and rehabilitation, a quarter of respondents said they would.

"People want to take control of their health and they want health care professionals to work with them to do that," Dr. Haig said. "Physiatrists specialize in non-surgical, non-invasive treatments and help put patients in charge of their own care."

The survey results show that 3 out of 4 Americans know that regular exercise can help prevent back pain and most (71 percent) are choosing activity over bed rest to deal with episodes of pain. Most of those surveyed also are aware that an inactive lifestyle and emotional or psychological stress can cause or aggravate chronic back pain, in addition to traumatic injuries and age-related conditions such as arthritis and degenerative disc disease.

Dr. Haig said that while back pain sufferers are right to keep moving and to use exercise to relieve their pain, they might not be using the correct or most effective exercise.

"That old maxim, 'No pain, no gain' isn't true," said Dr. Haig. "Not every type of exercise is good for every person, especially for those who have medical conditions that limit their abilities."

Physiatrists have special skills and training in developing therapeutic exercise programs for various conditions, and in following through with their patients to make sure they can keep up the program and that it is effective.

"Many people are devising their own exercise plans, or getting advice from friends or people who don't have a medical background," said Dr. Haig. "Many people also are hanging on to myths, such as the belief that learning the correct way to bend, sit or lift can prevent back pain. Our survey found four out of five respondents believe that is an effective pain prevention strategy.

"While it is true that some types of movement can strain or aggravate your back, that knowledge is often misinterpreted," said Dr. Haig. "What the medical community now understands is that it is often better to tell our patients to do what feels right. Too often people stiffen up and force their bodies to move unnaturally in an effort to be 'correct;' they override their natural sense of what is physically comfortable and that can result in injury. Sometimes the best advice we can give is as simple as, 'Do what feels right, and if it hurts, don't do it.'"

According to the survey, which was conducted July 25-28, 2002, among 1,021 adults in the continental United States, back pain is a condition that crosses age boundaries, affecting as many people ages 18 to 24 as those ages 55 and older.

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) is the national medical society representing more than 7,000 physicians - called physiatrists - who are specialists in the field of physical medicine and rehabilitation. AAPM&R serves its members and their patients, other health professionals and society by advancing the field of physical medicine and rehabilitation, promoting excellence in physiatric practice and advocating on public policy issues related to disability.

Additional information, including a new online quiz on back pain treatments and prevention, is available to consumers on the AAPM&R Web site at www.aapmr.org. Consumers who take the online quiz, "Test Your Back Health IQ," will learn what they can do when pain knocks them on their backs and find out how their knowledge compares with the national average. Also available online is a physician locator page ("Find a PM&R Physician") to help consumers find a physiatrist in their area.

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