Britain is facing a major health crisis fuelled by a surge in back and neck problems, medical leaders have warned, caused by an increasingly sedentary, obese and ageing population and the rise in remote working.
Almost a million people in the UK are too sick to work because of back or neck ailments, according to official data, which threatens to derail ministers’ efforts to expand the workforce and grow the economy.
According to a Guardian analysis of publicly available figures, the welfare bill for people with back problems alone has tripled in two decades to £1.4bn a year, and is up by more than a quarter compared with before the pandemic.
Health leaders said the enormous growth in back and neck problems, driven by unhealthy lifestyles and seismic shifts in working patterns among other factors, was also accelerating rapidly because many affected could not access treatment.
In most cases, back or neck issues may be resolved or improved with prompt physiotherapy assessment, advice and rehabilitation.
However, the NHS faces a shortage of physiotherapy staff, with thousands of patients stuck on waiting lists. Some in severe pain have been forced to wait so long that they are developing other health conditions, such as depression.
The crisis was so severe that A&E units were seeing people present with back or neck pain because they had no other options, health leaders said.
Prof Kamila Hawthorne, the chair of the Royal College of GPs and Britain’s most senior family doctor, expressed concern that back pain had become “an all too common condition, affecting millions”.
GPs were increasingly seeing patients present with “really debilitating” back and neck problems, she said. “In some cases to the extent they really can’t undertake everyday tasks without feeling terrible pain,” she added.
The most recent figures compiled by the Office for National Statistics (ONS) showed 2.9 million people had problems linked to their back or neck, up from 2.6 million in 2019.
About 995,000 were classed as economically inactive for that reason between January and March last year, up 28% from 779,000 during the same period in 2019.
An ONS spokesperson said: “In recent years we’ve seen a sharp rise in the number of people citing back or neck problems as the main reason for being out of the workforce long-term.
“Our analysis has shown that an important contribution to long-term sickness in general has come from the large number of ‘baby boomers’ who are approaching retirement. It’s also possible that changing work practices during the pandemic, such as increased home working, may have contributed to the increase in back or neck complaints, as the biggest increase in this category was between 2021 and 2022.”
Several factors were likely explanations for the rise in back and neck problems, Hawthorne said. “People are working for longer, and as they do they are living with multiple chronic conditions. There is also evidence that links lower back pain and obesity.
“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 explore more deeply, so the issue can be addressed properly.”
Sam Bhide, an advanced practice physiotherapist, has seen more people “come through the doors with chronic back pain” recently. “It’s due to a range of factors such as sedentary behaviour, working from home without the right set-up, but also can be related to stress and physically demanding jobs or having suffered an injury.
“The pandemic has further compounded this and there are long waiting lists for people to get the support they need to both manage their pain and enable them to get back to their normal function.”
Ishmael Beckford, the chair of council at the Chartered Society of Physiotherapy, said: “A major problem is that people are unable to access the help they need … More people are presenting in A&E with neck and back pain.
“The fact that people are desperately looking for help correlates with the latest NHS data: there are nearly 310,000 patients on a wait list for community musculoskeletal (MSK) services now.”
The figure of almost 1 million people signed off long-term sick 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 now out of work. We urgently need more physiotherapy staff in the NHS and beyond.”
Government figures show spending on people with back problems through the disability living allowance (DLA) and its successor benefit the personal independence payment (Pip) has tripled in the past 20 years, even after adjusting for inflation.
The government spent £1.4bn on people with back pain in 2022-23 via those two benefits, up from £1.3bn in 2019, and £405m in 2002-03.
Rachel Suff, of the Chartered Institute of Personnel and Development, said the surge in back pain was very concerning.
“Our physical and mental health are interrelated, and employers need to develop holistic strategies to help prevent ill health such as MSK injuries. Long NHS waiting times for treatment are no doubt exacerbating the situation.”
Kate Shoesmith, deputy chief executive of the Recruitment and Employment Confederation, said ministers must also “address the real issues behind untenably long NHS waiting lists”.
“It should start with better support and more flexible working options for the staff working in the NHS right now, rather than talk about training and recruiting more staff to the NHS for 2030 – which feels a very distant goal.”
