Britain is facing a major health crisis fueled by a rise in back and neck problems, medical leaders have warned, caused by an increasingly sedentary, obese and aging population and the rise in remote working.
Almost a million people in Britain are too sick to work due to back or neck problems, according to official data, threatening to derail ministers’ efforts to expand the workforce and grow the economy.
According to a Guardian analysis based on publicly available figures, the social burden on people with back problems alone has tripled in 20 years to £1.4 billion per year, more than a quarter higher than before the pandemic.
Health leaders said the massive growth in back and neck problems caused by unhealthy lifestyles and seismic shifts in working patterns, among other things, was also accelerating rapidly as many affected could not access treatment.
In most cases, back or neck problems can be resolved or improved with prompt physiotherapy assessment, advice and rehabilitation.
However, the NHS is facing a shortage of physiotherapy staff, leaving thousands of patients on waiting lists. Some with severe pain are forced to wait so long that they develop other health problems, such as depression.
The crisis was so severe that emergency departments were seeing people with back or neck pain because they had no other options, health leaders said.
Prof. Kamila Hawthorne, president of the Royal College of GPs and Britain’s oldest GP, expressed concern that back pain has become “an all too common condition, affecting millions of people”.
GPs were increasingly seeing patients with “really debilitating” back and neck problems, she said. “In some cases, it’s so bad that they really can’t perform daily tasks without feeling terrible pain,” she added.
The latest figures from the Office for National Statistics (ONS) show that 2.9 million people had problems with their back or neck, up from 2.6 million in 2019.
About 995,000 people were classified as economically inactive for this reason between January and March last year, an increase of 28% compared to 779,000 in the same period in 2019.
An ONS spokesperson said: “In recent years we have seen a sharp increase in the number of people citing back or neck problems as the main reason for long-term retirement from the workforce.
“Our analysis has shown that a significant contribution to long-term absenteeism in general comes from the large number of ‘baby boomers’ nearing retirement. It is also possible that changing work practices during the pandemic, such as increased working from home, have contributed to the increase in back or neck complaints, as the largest increase in this category occurred between 2021 and 2022.”
Several factors likely explained the increase in back and neck problems, Hawthorne said. “People are working longer hours, and while they do so, they are living with multiple chronic conditions. There is also evidence that low back pain and obesity are linked.
“New ways of working, often without the right equipment and people waiting until problems are more serious before seeking treatment, could also be factors and something that would be interesting to investigate more deeply so that the problem can be properly addressed addressed.”
Sam Bhide, an experienced physiotherapist, has recently seen more and more people ‘walking out with chronic back pain’. “It is due to all kinds of factors, such as sedentary behavior, working from home without the right setup, but it can also be related to stress and physically demanding work or having an injury.
“The pandemic has made this worse and there are long waiting lists for people to get the support they need to manage their pain and enable them to function normally again.”
Ishmael Beckford, chairman of the board of the Chartered Society of Physiotherapy, said: “A major problem is that people cannot access the help they need… More and more people are presenting to A&E with neck and back pain.
“The fact that people are desperate for help is consistent with the latest NHS data: there are now almost 310,000 patients on a waiting list for community musculoskeletal services.”
The figure of almost 1 million people suffering long-term illness with back or neck pain was “alarming”, Beckford said.
“We can see the impact untreated back pain is having on patients, the NHS and the wider economy, with so many out of work. We urgently need more physiotherapy staff in the NHS and beyond.”
Government figures show that spending on people with back problems through the Disability Allowance (DLA) and its successor, the Personal Independence Allowance (Pip), has tripled over the past twenty years, even after adjusting for inflation.
The government spent £1.4 billion on people with back pain through these two benefits in 2022-23, up from £1.3 billion in 2019 and £405 million in 2002-03.
Rachel Suff, from the Chartered Institute of Personnel and Development, said the increase in back pain was deeply concerning.
“Our physical and mental health are interconnected, and employers must develop holistic strategies to help prevent ill health, such as MSK injuries. Long waiting times on the NHS for treatment are undoubtedly making the situation worse.”
Kate Shoesmith, deputy chief executive of the Recruitment and Employment Confederation, said ministers must also “address the real problems behind unsustainably long NHS waiting lists”.
“It should start with better support and more flexible working options for the staff currently working in the NHS, rather than talking about training and recruiting more staff for the NHS by 2030 – which seems a very distant target.”