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Recurrent low back pain accounts for disproportionate healthcare costs in Polish working-age adults

Recurrent low back pain accounts for disproportionate healthcare costs in Polish working-age adults
Photo by Frankie Cordoba / Unsplash
Key Takeaway
Note that recurrent low back pain cases, though a minority, account for a disproportionate share of costs and services.

A 3-year (2019-2021) observational cohort study analyzed Polish National Health Fund and hospital data to estimate the direct costs of recurrent low back pain (LBP) in working-age adults (21-65 years) with LBP-related ICD-10 diagnoses. The study compared recurrent LBP cases to non-recurrent cases, with the primary outcome being estimated direct costs. The total sample size was not reported.

The analysis found the mean annual direct cost for all working-age LBP individuals in Poland was €184,986,519. Of this, recurrent LBP accounted for €13,699,529 (95% CI: €9,829,766–17,522,323). Although recurrent LBP cases comprised only 24.51% of all LBP cases, they accounted for 38.37% of total LBP costs and 54.28% of medical services. The median cost-per-visit was significantly higher for recurrent LBP compared to non-recurrent LBP. Patients over 35 years old accounted for 34.72% of total LBP expenses and two-fifths of all medical services, with physiotherapy services being the predominant type of outpatient visit.

Safety and adverse events were not reported. Key limitations include the observational design, which cannot establish causality, and the lack of reported sample size and specific effect sizes. The findings are specific to the Polish healthcare system and may not be generalizable to other settings.

For clinicians, this study quantifies the disproportionate resource use associated with recurrent LBP in a working-age population. The data suggest that recurrent cases, while a minority of patients, drive a large share of costs and service utilization, particularly in adults over 35. This underscores the potential clinical and economic importance of effective management strategies to prevent recurrence.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Health economic analysis is one of the solutions to optimize healthcare system management. Low back pain (LBP) appears to be increasing in both incidence and financial burden. According to the new pain definition, pain that recurs for more than 3 months should be classified as chronic. However, evidence on the prevalence and economic impact of recurrent LBP (rLBP) in the working-age population remains limited. The aim of this study was to estimate the approximate direct costs of the working-age population with rLBP. Additionally, analyze the cost-per-visit across different age groups and types of medical services. A bottom-up framework was used to estimate the national burden of rLBP in Poland, based on data from the Polish National Health Fund and representative hospital records from 2019 to 2021. The analysis included individuals aged 21–65 years with LBP-related ICD-10 diagnoses. Retrospective observational study. The mean annual direct cost of working-age LBP individuals in Poland was €184,986,519 including €13,699,529 from rLBP (95% CI: €9,829,766–17,522,323). 24.51% of LBP cases were classified as rLBP, covering 54.28% of medical services and 38.37% total LBP costs. The median cost-per-visit for rLBP was significantly higher compared to non-rLBP overall and specific age subgroups (p  Using the bottom-up framework, the estimated cost of rLBP in Poland was €13,699,529, representing 24.51% of cases in representative hospital data. rLBP showed higher per visit costs than overall LBP across all age groups. Patients over 35 years old accounted for 34.72% of total LBP expenses and two-fifths of all medical services. Moreover, outpatient visits to physiotherapy services were predominant.
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