News Release

Back pain under-recognised in less-developed countries

NB. Please note that if you are outside North America, the embargo for LANCET press material is 0001 hours UK Time Friday January 17, 2003.

Peer-Reviewed Publication

The Lancet_DELETED

Authors of a research letter in this week's issue of THE LANCET highlight how lower back pain is a serious and poorly recognised health burden for rural communities in less-developed countries.

Damian Hoy and colleagues from the Burnet Institute, Melbourne, Australia, did a cross-sectional study of the prevalence of low back pain and related functional disability among 500 adults from 19 villages in Tibet. A third of those sampled reported lower back pain at the time of interview, and around 40% reported that they had experienced lower back pain over the previous 12-month period. 20% of people reporting back pain had associated functional disability.

The people surveyed reported that low back pain prevented them from doing key activities important in maintaining their homes and livelihoods. Common activities such as collecting water, harvesting, and carrying heavy objects, including children, increased the risk of low back pain. However the investigators observed that the villagers did not bend their knees when doing ground-level tasks. The survey prompted township doctors to train local health workers about safer back positioning and flip-charts and posters were introduced into local health clinics to promote back-pain management. A 'back-happy' tap-stand was installed to ensure that water containers could be filled without bending of the back (see illustrations).

Damian Hoy comments: "Low back pain is a significant, under recognised problem in central Tibet, impairing health and productivity, and is likely to be a problem in many rural societies combining poor economic conditions with subsistence farming. Longitudinal studies are needed to assess the effect of cost-effective and sustainable interventions to reduce the burden of low back pain. Health and development assistance projects should expand beyond communicable diseases to include conditions such as low back pain."

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