Wiener klinische Wochenschrift

, Volume 128, Issue 1–2, pp 6–13 | Cite as

Rising prevalence of back pain in Austria: considering regional disparities

  • Franziska Großschädl
  • Erwin Stolz
  • Hannes Mayerl
  • Éva Rásky
  • Wolfgang Freidl
  • Willibald J. Stronegger
original article



Back pain is the most common form of musculoskeletal conditions and leads to high health care costs. Information about geographic variations in highly prevalent diseases/disorders represents important implications for public health planning to face structural challenges. The present study aims to investigate regional trends in the prevalence of back pain and the role of obesity and social inequalities among Austrian adults.


A secondary data analysis based on five nationally representative cross-sectional surveys (1973–2007) was carried out (N = 178,818). Back pain was measured as self-reported presence. Obesity (BMI ≥ 30 kg/m²) was adjusted for self-report bias. For the regional analyses, Austria was divided into Western, Central and Eastern Austria. A relative index of inequality (RII) was computed to quantify the extent of social inequality.


A continuous rise in back pain prevalence was observed in the three regions and among all investigated subgroups. In 2007 the age-standardised prevalence was similar in Central (36.9 %), Western (35.2 %) and Eastern Austria (34.3 %). The absolute change in back pain prevalence was highest among obese subjects in Central Austria (women: + 29.8 %, men: + 32.5 %). RIIs were unstable during the study period and in 2007 highest in Eastern Austria.


Variation and trends in back pain are not attributable to geographic variation in Austria: an assumed East–West gradient in Austria has not been confirmed. Nevertheless our study confirms that back pain dramatically increased in all Austrian regions and investigated subgroups. This worrying trend should be further monitored and public health interventions should be implemented increasingly, especially among obese women and men.


Back pain Geographic variation Long-term trend Obesity Social inequality 


  1. 1.
    Hoy D, Bain C, Williams G, March L, Brooks P, et al. Global prevalence of low back pain. Arthritis Rheum. 2010a;64:2028–37.CrossRefGoogle Scholar
  2. 2.
    Hoy D, March L, Brooks P, Woof A, Blyth F, et al. Measuring the global burden of low back pain. Best Pract Res Clin Rheumatol. 2010b;24:155–65.CrossRefPubMedGoogle Scholar
  3. 3.
    Buchbinder R, Blyth FM, March LM, Brooks P, Woolf AD, et al. Placing the global burden of low back pain in context. Best Pract Res Clin Rheumatol. 2013;27:575–89.CrossRefPubMedGoogle Scholar
  4. 4.
    Pedisic C, Pranic S, Juraic D. Relationship of back and neck pain with quality of life in the Croatian general population. J Manipulative Physiol Ther 36(5):267–275.Google Scholar
  5. 5.
    Manchikanti L, Singh V, Falco FJE, Benyamin R, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation. 2012;17:3–10.CrossRefGoogle Scholar
  6. 6.
    Nilsen TIL, Holtermann A, Mork PJ. Physical exercise, body mass index, and risk of chronic pain in the low back and neck/shoulders: longitudinal data from the Nord-Trondelag Health Study. Am J Epidemiol. 2011;174:267–73.CrossRefPubMedGoogle Scholar
  7. 7.
    Großschädl F, Freidl W, Rásky E, Burkert N, Muckenhuber J, Stronegger WJ. A 35-Year trend analysis for back pain in Austria: the role of obesity. PLoS One. 2014;9(9):e107436–e6.PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Van der Windt DA, Dunn KM. Low back pain research—future directions. Best Pract Res Clin Rheumatol. 2013;27:699–708.CrossRefPubMedGoogle Scholar
  9. 9.
    Volinn E. The epidemiology of low back pain in the rest of the world. A review of surveys in low- and middle-income countries. Spine. 1997;22:1747–54.CrossRefPubMedGoogle Scholar
  10. 10.
    Berlin C, Busato A, Rosemann T, Djalali S, Maessen M. Avoidable hospitalizations in Switzerland: a small area analysis on regional variation, density of physicians, hospital supply and rurality. BMC Health Serv Res. 2014;14:289. doi:10.1186/1472-6963-14-289.PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Laut KG, Mocroft A, Lazarus J, Reiss P, Rockstroh J, Karpov I, Rakhmanova A, Knysz B, Moreno S, Gargalianos P, Lundgren J, Kirk O; Eurosida in Eurocoord. Regional differences in self-reported HIV care and management in the EuroSIDA study. J Int AIDS Soc. 2014;17(4 Suppl 3):19504. doi:10.7448/IAS.17.4.19504.PubMedGoogle Scholar
  12. 12.
    Li P, Znaor A, Holcatova I, Fabianova E, Mates D, Wozniak MB, Ferlay J, Scelo G. Regional geographic variations in kidney cancer incidence rates in European countries. Eur Urol. 2015;67:1134–41. doi:10.1016/j.eururo.2014.11.001.CrossRefPubMedGoogle Scholar
  13. 13.
    Tamayo T, Schipf S, Meisinger C, Schunk M, Maier W, Herder C, Roden M, Nauck M, Peters A, Völzke H, Rathmann W. Regional differences of undiagnosed type 2 diabetes and pre-diabetes prevalence are not explained by known risk factors. PLoS One. 2014;9(11):e113154. doi:10.1371/journal.pone.0113154.PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Großschädl F, Stronegger WJ. Regional trends in obesity and overweight among Austrian adults between 1973 and 2007. Wien Klin Wochenschr. 2012;124(11–12):363–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Stein KV, Rieder A, Dorner T. East-West gradient in cardio-vascular mortality in Austria: how much can we explain by following the pattern of risk factors? Int J Health Geographics. 2011;10:59.CrossRefGoogle Scholar
  16. 16.
    Dorner T. Public Health Herausforderungen in Bezug auf körperliche Aktivität. Sport Präventivmed. 2009;39(4):36–42.Google Scholar
  17. 17.
    Dorner T, Leitner B, Stadlmann H, Fischer W, Neidhart B, et al. Prevalence of overweight and obesity in Austrian male and female farmers. Soz Präventivmed. 2004;49:243–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Hershkovich O, Friedlander A, Gordon B, Arzi H, Derazne E, et al. Associations of body mass index and body height with low back pain in 829,791 adolescents. Am J Epidemiol. 2013;178:603–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010;171:135–54.CrossRefPubMedGoogle Scholar
  20. 20.
    Shiely F, Perry IJ, Lutomski J, Harrington J, Kellehr CC, et al. Temporal trends in misclassification patterns of measured and self-report based body mass index categories—findings from three population surveys in Ireland. BMC Public Health. 2010;10:560.PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Großschädl F, Haditsch B, Stronegger WJ. Validity of self-reported weight and height in Austrian adults: socio-demographic determinants and consequences for the classification of BMI categories. Public Health Nutr. 2012;15:20–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Espelt A, Goday A, Franch J, Borrell C. Validity of self-reported diabetes in health interview surveys for measuring social inequalities in the prevalence of diabetes. J Epidemiol Community Health. 2012;66:e15.CrossRefPubMedGoogle Scholar
  23. 23.
    Harkness EF, Macfarlane GJ, Silman AJ, McBeth J. Is musculoskeletal pain more common now than 40 years ago? Two population-based cross-sectional studies. Rheumatology. 2005;44:890–5.CrossRefPubMedGoogle Scholar
  24. 24.
    Fernández des Las Penas C, Alonso-Blanco C, Hernández-Barrera V, Palacios-Cena D, Jiménez-Garcia R, Carrasco-Garrido P. Has the prevalence of neck pain and low back pain changed over the last 5 years? A population-based national study in Spain. Spine J 13(9):1069–1076.Google Scholar
  25. 25.
    Farioli A, Mattiolo S, Quaglieri A, Curti S, Violante F, Coggon DM. Musculoskeletal pain in Europe: role of personal, occupational and social risk factors. Scand J Work Environ Health. 2014;40:36–46.PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Garragee E, et al. Report of the NIH Task Force on Research Standards for chronic low back pain. Pain Med. 2014;15:1249–67.CrossRefPubMedGoogle Scholar
  27. 27.
    Austria S. Regionale Unterschiede in der Sterblichkeit. 2008.
  28. 28.
    Lidegaard M, Jensen RB, Andersen CH, et al. Effect of brief daily resistance training on occupational neck/shoulder muscle activity in office workers with chronic pain: randomized controlled trial. BioMed Res Int. 2013;2013. doi: 10.1155/2013/262386Google Scholar
  29. 29.
    Steffens D, Maher CG, Li Q, Ferreira ML, Pereira LSM, Koes BW, Latimer J. Weather does not affect back pain: results from a case-crossover study. Arthritis Care Res. 2014;66:1867–72.Google Scholar
  30. 30.
    McDonald DC, Carlsson K, Izrael D. Geographic variation in opioid prescribing in the U.S. J Pain. 2012;13:988–96.PubMedCentralCrossRefPubMedGoogle Scholar
  31. 31.
    [Evidence and consensus based Austrian guidelines for management of acute and chronic nonspecific backache]. Wien Klin Wochenschr. 2007;119(5–6):189–97.Google Scholar
  32. 32.
    Breivik H, Collett B, Ventafridda V, Cohen R, Galacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Franziska Großschädl
    • 1
  • Erwin Stolz
    • 2
  • Hannes Mayerl
    • 2
  • Éva Rásky
    • 2
  • Wolfgang Freidl
    • 2
  • Willibald J. Stronegger
    • 2
  1. 1.Institute of Nursing ScienceMedical University of GrazGrazAustria
  2. 2.Institute of Social Medicine and EpidemiologyMedical University of GrazGrazAustria

Personalised recommendations