Economic burden of recurrent low back pain among working-age adults in Poland: a 3-year retrospective observational analysis

Introduction 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. Methods 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. Results 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 < 0.001). rLBP accounted for 34.72% of total LBP costs in individuals aged over 35 years (over 50 years 23.65%), including 21.56% (over 50 years 14.43%) for inpatient admissions and 10.79% (over 50 years 7.69%) for physiotherapy. Conclusion 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.