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Chronic back pain is fuelling a cycle of mental ill-health and economic decline across Australia, with new research projecting that inaction on spinal health could strip 4.6 per cent from the nation’s gross domestic product over the next decade.
The Australian Chiropractors Association (ACA) is using the launch of its National Spinal Health Month in June to draw attention to the relationship between musculoskeletal disorders (MSDs), depression and long-term disability.
The campaign, themed “A Healthy Spine Supports A Healthy Mind,” marks the 30th anniversary of Australia’s longest-running national spinal health awareness initiative. It replaces the former Spinal Health Week format with a full month of activity throughout June.
The scale of the problem
According to the Australian Institute of Health and Welfare (AIHW) and the World Health Organisation (WHO), musculoskeletal disorders including back pain account for the largest proportion of persistent pain conditions in Australia. These conditions are frequently linked to depression and psychological distress.
Around 6.1 million Australians – almost one in three – are already affected by MSDs. Of those, 58 per cent are of working age between 25 and 64, placing the burden squarely on the workforce during peak income-earning years.
Four out of five Australians are expected to experience back pain at some point in their lives.
A $638 billion productivity gap
Research by Monash University’s School of Public Health and Preventive Medicine, published in August 2025, projected that without intervention to promote active lifestyles and appropriate care, 3.2 million working-age Australians will be living with chronic back pain by 2033.
The economic consequences are stark. Long-term chronic back disorders are projected to cost the Australian economy an estimated $638 billion in lost productivity over the next decade.
On an annual basis, MSDs already cost the economy around $55.1 billion in direct health costs, lost productivity and reduced quality of life. They limit mobility and dexterity, leading to early retirement, reduced socio-economic circumstances and social isolation.
A Deloitte Access Economics report has flagged the rising cost of MSDs in Australia as grounds for a strategic response to how the conditions are managed.
The back pain and mental health cycle
ACA President, Dr Billy Chow, pointed to a documented feedback loop between back pain and mental health deterioration.
“The coexistence of back pain and mental health conditions is associated with impaired quality of life, while the increased risk of developing a chronic back pain condition also poses a significant ongoing financial burden on sufferers and the economy as a whole,” Dr Chow explained.
A 2021 study by the International Association for the Study of Pain found that people living with chronic back pain face a heightened risk of experiencing mental health problems.
Dr Chow described the interaction as self-reinforcing. Chronic back pain can trigger psychological and social problems, while depressive symptoms can worsen back pain and increase the disability associated with the condition. That worsening disability, in turn, deepens the mental health impact.
“This vicious cycle, where back pain triggers a mental health problem that leads to the original back problem worsening, can continue accelerating unabated in the absence of interventions to break the pain cycle,” he warned.
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The Productivity Commission has estimated the direct economic costs of mental ill-health and suicide in Australia at between $43 billion and $70 billion annually in expenditure and lower economic productivity. A further $151 billion is attributed to the cost of disability and premature death due to mental ill-health, suicide and self-inflicted injury.
MSD cases set to grow 43 per cent
The projected growth of 43 per cent in MSD cases over the next two decades compounds the challenge. That figure sits alongside data showing 43 per cent of Australians have already reported experiencing a mental health disorder at some point in their lives.
Psychological distress in the form of anxiety or depression is common among acute back pain sufferers. Even when symptoms are short-term and not medically serious, without appropriate early treatment, acute back pain can progress to chronic back pain disorders that increase both physical and mental health disability risks.
Fear avoidance and the risk of doing nothing
Risk factors for developing long-term chronic back pain include avoidance behaviours, where sufferers ignore symptoms and avoid movements or activities due to fear of causing injury or increasing pain.
While limiting movement may be appropriate for some acute injuries during healing, if sufferers restrict or avoid activity in response to chronic pain – a pattern known as the Fear Avoidance Beliefs Model – it can increase pain and the risk of disability over the long term.
Opioids ineffective for acute back pain
Research from the University of Sydney has also raised concerns about the prescribing of opioids for back pain relief. The evidence indicates that opioids do not relieve acute low back pain lasting up to 12 weeks, and can result in patients experiencing worse pain. In some cases, opioids can cause harm.
The findings support a shift in chronic back pain treatment away from medication-based approaches toward integrated, holistic healthcare. Recommended care includes lifestyle support, advice to remain active and working, and tools to help patients self-manage pain to reduce disability, improve quality of life and boost workforce participation.
Holistic care in the treatment of back pain can also help reduce the need for medical interventions, lower hospital admissions and cut long-term healthcare costs for both MSD and mental health treatments.
Prevention and early intervention
Dr Chow urged Australians to take a proactive approach to spinal health.
“By taking an informed, proactive approach through preventative measures including making healthy lifestyle changes, remaining active and seeking early intervention when back problems do occur, back pain treatment can be effective and help limit the instances of mental health complications among sufferers,” he stated.
“Maintaining spinal health is essential to staying active, independent and feeling good at any age, so by tackling Australia’s very common back pain issue, we can improve the physical and mental health of society and aid in addressing stagnant productivity while reducing costs to the Australian economy.”
Growing demand for chiropractic care
According to Global Health Education Australia, over 300,000 Australians visit a chiropractor each week. Demand for chiropractic healthcare is increasing as more Australians seek holistic, non-invasive, drug-free healthcare to manage MSDs and minimise chronic back pain and its associated secondary implications.
The ACA, established in 1938, is the peak body representing chiropractors in Australia with around 3,000 members. It reports that 400,000 chiropractic healthcare consultations take place each week nationally.
ACA chiropractors are five-year university-educated healthcare professionals who use drug-free, evidence-based, non-surgical techniques including specific spinal adjustments to manage spinal health. They apply low-force intervention and use various manual therapies including soft tissue techniques while assessing lifestyle factors and providing relaxation methods to reduce reliance on medication.
National Spinal Health Month runs from 1 to 30 June 2026. Free back pain information resources are available at spinalhealth.org.au.
Last Updated on April 30, 2026 by Nick Ross
