What is the average age at which people begin to experience back pain? And what are the main causes?

What is the average age at which people begin to experience back pain? And what are the main causes?

Today, what is the average age of people who start to experience back pain?

It is estimated that 8 out of 10 individuals will suffer an episode of low back pain (also known as lumbago) during their lifetime (reference 1). Low back pain is therefore a common condition that can affect the entire population, regardless of gender, age or socio-economic status. However, the prevalence (i.e. number of cases in a given population) of low back pain can vary according to a number of factors, including age and gender. Indeed, the prevalence of low back pain tends to increase with age, ranging from around 5% in children, to 20% in teenagers, and peaking at 25-45% in individuals aged between 40-69 years (reference 2). Finally, for all age groups, the prevalence of low back pain tends to be higher in females than in males (reference 2).

And what are the main causes?

Low back pain is a multifactorial condition, meaning that it involves not only physical factors, but also the interaction of several biological, psychological and socio-environmental factors (reference 3). In around 85% of patients suffering from low-back pain, no specific cause can be identified. However, there are various classification systems for characterizing the different types of low-back pain. Three categories of low back pain are commonly identified in the scientific literature: (1) non-specific low back pain; (2) radicular syndrome; and (3) specific low back pain.

Non-specific low back pain, commonly referred to as simple low back pain, common low back pain, mechanical low back pain or, is the most frequent type of low back pain (reference 3). This pain cannot be explained by any identifiable underlying disease or pathology. It is therefore the result of biomechanical damage to one or more anatomical structures in the back, such as joints, ligaments and muscles. Non-specific low back pain is more commonly characterized by pain predominantly in the lumbar region, without pain or neurological signs or symptoms in the lower limb (reference 3). Note that the World Health Organization has recently officially adopted the term “Primary Low Back Pain” in reference to this category of low back pain.

Root syndrome is a group of conditions involving compression, irritation or inflammation of a nerve root (reference 4). This nerve root damage can lead to a variety of symptoms in addition to low-back pain, including dominant leg pain (sciatica), with or without loss of sensation and/or strength in the lower limb (reference 4). Lumbar disc herniation is the main cause of radicular syndrome in individuals aged between 30 and 50 (reference 5). Generally speaking, this condition appears suddenly, following a precise movement or lifting of a load. Lumbar spinal stenosis (reference 6) is the main cause of radicular pain in people over 60. This condition usually appears gradually, as it is most commonly caused by degenerative changes associated with aging. Important: It is quite possible for structural changes to be present, without the patient showing any symptoms.

Specific low back pain, also known as symptomatic low back pain or secondary low back pain, accounts for 1 to 5% of cases of low back pain. This type of low back pain is caused by the presence of an identifiable underlying pathology affecting one or more components of the lumbar spine. Causes of specific low back pain include fracture, infection, spinal tumors, axial spondyloarthritis and cauda equina syndrome (reference 3). This type of low-back pain is usually accompanied by systemic symptoms (e.g. fever, night sweats, pain that wakes you up at night).

If your back pain is accompanied by one or more of the following signs and symptoms (reference 7), it’s important to consult a healthcare professional without delay:

Urinary or fecal incontinence (difficulty retaining urine or stool), urinary retention (inability to completely empty the bladder)
Sudden pain following trauma
Personal history of cancer, unexplained or unintentional weight loss, pain at night or at rest, malaise or extreme fatigue
Fever
Chronic symptoms (> 3 months) appearing before the age of 45, associated with one or more of the following characteristics: absence of a specific mechanism of injury (insidious onset of pain), improvement of symptoms with movement, absence of improvement of symptoms with rest, morning stiffness (> 30 minutes), pain that wakes up in the second half of the night, alternating gluteal region pain, history of inflammatory arthritis, favorable response to anti-inflammatory drugs in less than 48 hours, or worsening of symptoms in less than 48 hours if anti-inflammatory drugs are discontinued.

Janny Mathieu DC, Étudiante au doctorat en sciences biomédicales

References

Buchbinder R, van Tulder M, Öberg B, Costa LM, Woolf A, Schoene M, et al. Low back pain: a call for action. Lancet. 2018;391(10137):2384-8.
Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67.
Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. Lancet (London, England), 398(10294), 78–92. https://doi.org/10.1016/S0140-6736(21)00733-9
Jordan, J. L., Konstantinou, K., & O’Dowd, J. (2011). Herniated lumbar disc. BMJ clinical evidence, 2011.
Bagley C, MacAllister M, Dosselman L, Moreno J, Aoun SG, El Ahmadieh TY. Current concepts and recent advances in understanding and managing lumbar spine stenosis
Mathieu, J., Pasquier, M., Descarreaux, M., & Marchand, A. A. (2023). Diagnosis Value of Patient Evaluation Components Applicable in Primary Care Settings for the Diagnosis of Low Back Pain: A Scoping Review of Systematic Reviews. Journal of Clinical Medicine, 12(10), 3581.