The staggering cost of neck and back pain to the US economy in 2023

If you're an American adult, there's an 80% chance that you've experienced pain so debilitating that you've had to adjust your work, hobby or family activities to accommodate. This according to Harvard Medical School.

And despite the severe repercussions of pain, according to a survey of 13,000 adults, 58% of adults never seek treatment for this type of pain.

We're talking, of course, about back pain.

This all adds up to untold suffering by millions of people in the United States, and costs the US economy hundreds of billions each yeah in lost productivity — we'll get to exactly how much later on.

How can neck and back pain cost billions to the US economy?

Neck and back pain is the discomfort and stiffness felt in the area from the base of your skull to your lower back, stemming from various issues like poor posture, ongoing stress, or medical conditions.

It's a common physical setback that interrupts our daily lives. Career, exercise, hobbies, family life and much more can be heavily impacted. Indeed, 40% of all sick days in the US are due to back pain, according to Pain Physician Journal.


40% of all sick days taken in the United States are due to back pain, according to Wikipedia

Source: Pain Physician Journal, p. E46

Understanding the anatomy of the neck and back is crucial for recognizing the origins of pain in these areas.

Locating discomfort: the 4 regions of the spine

The neck, or the cervical spine, comprises seven small vertebrae, beginning at the base of the skull and running down to the upper back. The back, which encompasses the thoracic and lumbar spine, extends from the base of the neck down to just above the tailbone. The last region of our spine is known as the pelvic spine.

The various areas of the neck, back, lumbar and pelvic areas of the back, from Wikipedia

Image courtesy the Wikipedia page on back pain

Each section of the spine protects the spinal cord while providing structural support and enabling movement.

Muscles and ligaments throughout the neck and back contribute to posture and motion but can also be sources of pain when strain or injury occurs. 

The vast majority of injuries and causes of pain can't be diagnosed by current medical technology

According to Wikipedia, back pain is rarely linked to a specific cause. 

In as many as 90 percent of cases, no physiological causes or abnormalities on diagnostic tests can be found. 

And while doctors can't find abnormalities, the pain for sufferers is very real.

Several common causes contribute to neck and back pain, spanning from the temporary to the persistent.

A prevalent cause of neck and back pain is thought to be strain and tension, often resulting from poor posture, improper lifting techniques, or sporadic movements that exert undue stress on the muscles and ligaments.

Injuries, whether sudden or accumulated over time, like whiplash or herniated discs, directly impact the structural integrity and function of the neck and back, resulting in pain.

Chronic conditions, such as osteoarthritis or degenerative disc disease, introduce persistent pain by altering the natural anatomy and causing inflammation or nerve impingement. Diagnosable causes are less than 4% of total diagnoses. 

Symptoms of neck and back pain may manifest in various ways, including stiffness, sharp or dull aches, and potentially, pain that radiates to other regions like the arms or legs.

Given the literal centrality of our spinal system to our overall health, it's easy to see how dysfunction in the back can lead to spiraling health issues, discomfort and debilitating pain.

A woman rubbing her neck and shoulders, illustrating that she's experiencing pain in her neck, shoulders and back

How back pain leads to so many lost days: downstream impacts

If you've ever experienced chronic pain — or even pain that persists for more than a few days — then you can start to understand why ongoing back pain creates a litany of other problems.

Indeed, neck and back pain can limit mobility, reduce flexibility, and make routine activities like lifting, bending, or even simply sitting, an ordeal.

The persistent pain or discomfort might modify postures and movements, which sometimes further exacerbate the condition by straining other parts of the body. Consequently, this can hinder participation in physical activities and impact overall wellness and fitness levels.


62% of patients with back pain also display symptoms of depression


Moreover, the persistence of neck and back pain is not just a physical battle but it permeates into mental and emotional well-being as well.

Individuals dealing with chronic pain may experience feelings of frustration, irritability, or depression due to the persistent discomfort and limitations it places on daily activities and life enjoyment. From

Depression is the most common emotional feeling associated with neck and back pain, and major depression is four times more likely in patients suffering from chronic back pain.

This can also disrupt sleep, leading to fatigue and further taxing emotional resilience, sometimes establishing a challenging cycle of pain and emotional stress to manage and navigate through.

The repercussions of neck and back pain also cascade into one’s professional life, affecting productivity and occupational efficacy. Imagine being unable to work (as so many people are) — the impact to wealth, autonomy and self esteem can be challenging for even the most optimistic and resilient among us. 

Persistent pain might necessitate taking breaks, modifying workstations, or even taking sick leave, which can disrupt work output.

In certain professions, particularly those that demand physical labor or prolonged sitting, neck and back pain can be particularly detrimental, potentially impeding the ability to perform tasks optimally and affecting career longevity and progression.

The cost of all this? Millions suffering from pain. And an estimated $230 billion hit to the US economy in lost productivity each year.

Back pain costs the US economy over $230 Billion in lost productivity

It's a staggering number, and hard to reconcile. Getting here took some research, and a little math (it's basic, I promise).

According to the Integrated Benefits Institute a non-profit health research and analytical firm, the cost of sick days is $576 billion each year to the US economy. The Pain Physicial Journal (page E46 of the report) cites a statistic that up to 40% of sick days are attributed to back pain each year. Doing some simple math, 40% of 576 billion is roughly $230 billion annually lost due to sick days from workers experiencing back pain.

The sheer magnitude of the economic implications stemming from back pain emphasizes a crucial need to address this health concern, both from a personal and an economic perspective. These numbers reveal the depth and breadth of the issue, suggesting that back pain isn't just a personal health challenge but a significant economic burden that affects workforce productivity and, by extension, the nation's economy.

Furthermore, when considering the broader ramifications of such widespread pain, it becomes clear that there is an urgent necessity for more effective interventions and solutions. As the numbers of affected individuals grow, so does the strain on businesses, healthcare systems, and families.

Learn more about DIY, alternative and non-intervention treatments for some forms of back pain.

If pain is serious or persistent, please see your physician.

This escalating situation calls for innovative approaches to prevention, management, and treatment, highlighting the need for multi-faceted solutions that address the root causes and provide relief to those affected.