🇪🇺 Back pain – One of the leading causes of disability and work absence in Europe

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Back pain is a common problem that affects people all over the world, and it is the leading cause of disability globally. In the EU, back pain is the most common reason for people to visit a doctor or take sick leave. This article will examine the costs, earning losses, and issues with work productivity associated with back pain in EU countries.

Back pain is proving to be a true European epidemic. In the article written for the HiNEWS project—Health Inequalities in European Welfare States, we can read that at the pan-European level, around 40% of all respondents reported back/neck pain, 22% hand/arm pain and 21% foot/leg pain.

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Source: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1409 

Studies have shown that back pain is a common cause of employee absenteeism and can result in significant costs for companies. According to a report by the European Agency for Safety and Health at Work, back pain accounts for approximately 50% of all chronic pain and is one of the leading causes of disability and work absence in Europe.

The biggest Europe-wide occupational health survey found 46% of European workers reporting back pain, while 43% had painful shoulder, neck and upper limb muscles.

In addition to the direct costs associated with absenteeism, back pain can also result in indirect costs such as reduced productivity, lower employee morale, and the need for workplace accommodations or modifications.

To address the issue of back pain and reduce its impact on employee absenteeism and company costs, many companies have implemented workplace ergonomics programs, provided employee education on proper lifting techniques and posture, and offered physical therapy or rehabilitation services.

Costs of Back Pain

Back pain is a significant cost to individuals, employers, and society. The direct costs of back pain include medical treatment, medication, and rehabilitation. The indirect costs include lost productivity, absenteeism, and early retirement. According to a study by the European Agency for Safety and Health at Work, the total cost of back pain in the EU in 2015 was estimated at €240 billion.

Earning Losses

Back pain can lead to earning losses for both employees and employers. For employees, back pain can result in sick leave, reduced working hours, and early retirement. For employers, back pain can lead to lost productivity, increased absenteeism, and higher insurance costs. A study by the European Foundation for the Improvement of Living and Working Conditions found that the average cost of back pain for employers in the EU was €6,600 per employee per year.

Issues with Work Productivity

Back pain can have a significant impact on work productivity. Employees with back pain may have difficulty concentrating, completing tasks, and meeting deadlines. This can lead to reduced productivity, lower quality of work, and increased errors. A study by the European Spine Journal found that employees with back pain were 1.5 times more likely to have reduced productivity at work than employees without back pain.


Prevention and Management

Prevention and management of back pain are critical to reducing the costs, earning losses, and issues with work productivity associated with this condition. Prevention strategies include workplace ergonomics, exercise, and education on proper lifting techniques. Management strategies include early intervention, physical therapy, and pain management.

  • Workplace ergonomics programs are initiatives implemented by employers to promote safe and healthy working conditions. These programs aim to reduce the risk of injury and illness by designing workspaces, equipment, and processes to fit the needs of the workers. Ergonomic programs can include the installation of adjustable chairs and desks, appropriate lighting, and the provision of ergonomic tools like keyboards and mousepads.
  • Employee education on proper lifting techniques and posture is another critical component of preventing back pain in the workplace. Proper lifting techniques can reduce the risk of strain and injury to the back muscles. Employees can be trained on the correct way to lift heavy objects, including keeping the back straight and using the legs to lift. Good posture, both while sitting and standing, can also help prevent back pain. Employees can be taught how to sit with their feet flat on the ground, shoulders relaxed, and back straight.
  • Physical therapy or rehabilitation services can also be offered to employees with back pain. These services can help individuals recover from back injuries, manage chronic pain, and improve mobility. Physical therapists can provide exercises to strengthen the back muscles, improve flexibility, and reduce pain. Rehabilitation services can also include massage therapy, chiropractic care, and acupuncture.

Employers can partner with a local physiotherapy clinic to provide on-site services for their employees. This can include assessments, treatment, and preventative exercises. Employers can also consider offering ergonomic assessments and training to prevent musculoskeletal injuries from occurring in the first place.

A Digital Transformation in Healthcare

A number of digital projects conducted under Horizon 2020 aim to help patients with back pain. Two of the projects featured here involve chiropractors working with physical therapists, other healthcare stakeholders, and researchers from nearly a dozen European countries.

The Back-Up Project aims to develop a new healthcare platform with a predictive model to support more effective and efficient treatment of neck and low back pain. Back- UP considers the multiple factors that influence the course of neck and low back pain, including the following dimensions: biological, musculoskeletal, psychological, behavioural, socioeconomic, workplace, and lifestyle. Based on patient-specific models using these data, Back- UP provides estimates of time to improvement, time to return to work in the case of ill workers, risk of recurrence, and musculoskeletal function, as well as direct and indirect economic costs of the chosen interventions.

The selfBACK project, on the other hand, is aimed at patients. It is a healthcare programme that focuses on self-management of low back pain to prevent chronicity, recurrence, and pain-related disability. The selfBACK consortium, coordinated by the Norwegian University of Science and Technology, has developed a decision support system that provides information and advice to patients via a smartphone app to support their personal self-management plan.


Implementing workplace ergonomics programs, providing employee education on proper lifting techniques and posture, and offering physical therapy or rehabilitation services can all help prevent and manage back pain in the workplace. These strategies can reduce the economic burden of back pain by reducing costs, earning losses, and issues with work productivity associated with this condition.

Healthcare in the workplace, specifically physiotherapy services, is crucial for long-term success. By providing employees with easy access to treatment, employers can improve productivity, job satisfaction, and overall well-being. Early intervention and treatment can prevent musculoskeletal conditions from worsening, leading to faster recovery times and reduced time off work.


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