Back pain is a symptom experienced by a large proportion of the population. It causes personal discomfort and national economic loss of a magnitude wholly misrepresented by that which might be inferred from its characterisation as the malingerer’s complaint and its adoption as a target for humour. Indeed such are the consequences of back pain that in 1976 the then Minister of State for Health, Dr David Owen, established a multi-disciplinary Working Group to investigate the problem. The Group’s report (DHSS 1979) was published at the end of the decade and contained recommendations flowing from the identification of several unresolved issues. Of particular significance among the latter were the means of ‘improving understanding so as to provide a basis for developing more effective remedies’.

Today back pain continues to generate considerable economic and social burdens. It also remains a subject of parliamentary interest, giving rise to members’ questions akin to those which triggered the official investigation in the second half of the 1970s. Against a background of therefore seemingly little success in reducing the impact of back pain, this paper attempts a detailed quantification of its present costs to the community and explores the potential for diminishing this expense in the future.