• Bashir Bello Senior Lecturer, Physiotherapy Department, Faculty of allied Health Sciences, Bayero University Kano, Nigeria.
  • Tasiu Isah Muhammad Physiotherapist, Murtala Muhammad Specialist Hospital, Kano
Keywords: Low back pain, Economic cost, Direct cost, Indirect cost


The cost of treatment for patients with low back pain (LBP) has a noteworthy monetary effect around the world. In Nigeria documents indicating the cost of treatment of LBP are few or not in existence. The purpose of this study is to estimate the cost of low back pain management in Kano state. A total of 79 respondents (55 males,24 females) aged between 30 to 70 years receiving physiotherapy in secondary and tertiary hospitals consented to participate in the study. Data on economic cost of low back pain and socio demographic information were collected using a standardized economic cost questionnaire. Respondents functional disability level were assessed using Rolland Morris Disability Questionnaire. Results were analyzed descriptively using  statistics of proportions, means and standard deviation, inferential statistics of chi square.The overall estimated cost of annual low back pain mangement was averaged at 94389.57 naira ± 67270  with direct cost accounting for 84.80% (80045.57 ± 54287.02 naira ) and indirect cost accounting  for 15.20 % (14344 ± 12983.47 naira).There was no association between the cost of management of low back pain and gender (p=0.39). However, there was an association between the cost of low back pain mangement and functional disability score among respondents (p=0.004). This study concluded that management of low back pain constitutes a substantial cost burden which is  largely  attributed to direct cost and radiological investigation contributed greatly to the cost. 


Andersson, G. , 2000 .The Epidemiolical features of low back pain. The Adult Spine , Lancet 37 , 93–141.
Becker , A., Held , H. , Redelli , M. , 2010. Low back pain in primary care , Loss of care and prediction of future health care utilization. Spine 35 , 1714-1720.

Birabi, N.B .,Oke , K . , Dienye , P.O . , Okafor , U.A .C . , 2013. Cost Bbrden of low back pain among adults in southern Nigeria. International Journal Of Medical And Apllied Sciences 3 , 24-29.
Dagenais, S., Caro , J., Haldeman , S ., 2007 . A Systematic review of low back pain cost of illness studies in the United States and internationally. American Journal of Medical Science 8 , 8-20.
JAMA., 1999. Centers for disease control and prevention: Prevalence of disabilities and associated health conditions among adults United States, 285,1571-1572.

Katz, J.N. 2006. Lumbar disc disorders and low-back pain: socioeconomic factors and
consequences. American Journal of Bone & Joint Surgery, 88(suppl 2):21-24.

Koes, B.W., van Tulder, M., Lin, CW.C. et al. 2010. An updated overview of clinical guidelines
for the management of non-specific low back pain in primary care European spine journal, 19: 2075.

Maniadakis, N., and Gray, A., 2000. The economic burden of back pain in the UK. Pain,

NER, 2014. Nigeria economic report: Document of the World Bank. Retrieved from on 23rd May, 2016.

Odole, C.A. , Babatunde, A.A ., Olatunji, B.O. , 2011. Economic burden of low back pain on patients seen at the outpatient clinics of secondary and tertiary health institutions in
Ibadan. Journal Of The Nigeria Society Of Physiotherapy 18 &19 ,43-48.

Omokhodion , F.O., Umar, U.S. , Ogunnowo, B.E., 2000 . Low back pain in Nigerian university. Journal of Occupational Medicine 53, 287-289.

Shekelle, P.G., 2009.Cost of health estimation. Annals of European Economics 12, 9-17.
Stewart, W.F., Ricci, J.A., Chee, E., Leotta, C., Foley, K., Hochberg, M.C. , 2006 .Back pain
exacerbations and lost productive time costs in United States workers. Journal of Spine 31, 3052-3060.

Van tudler, M.W., Koes, B.W., Boutler, L.M., 1997. Conservative treatment of acute and chronic low back pain. A systematic review of randomized control trials of the most common interventions. Journal of Spine 22, 2128-56.

Watson, K.D., Papageorgiou, A.C ., Jones, G.T. , 2002 . Low back pain in school children, Occurance and characteristics. Journal of Pain 97, 87–92.

Wenning, I., Schmid, T., Kohlman, S. , and Skewith, R., 2008 . The burden of NCDs internationally. American Journal of Public Health 16 , 40-46.

Whitehursrt, T., Bryan , M., Lewis , J., Hill , R., and Hay, S ., 2011. Cost of Non-communicable
disease in Germany and Internationally. European Journal of Public Health 12 , 20-24.

Williams, J.H., Money, J.K., and Kristina , S.B., 2009. Implications for physical activity in the
population with low back pain. American Journal of Lifestyle and Medicine 3 , 63-70.

WHO, 2013. Global action plan for the prevention and control of non-communicable diseases
2013-2020. Retrieved from September, 2014.

Woolf, A.D., and Pfleger, B., 2003. Burden of major musculoskeletal conditions. Bulletin of the World Health Organization 81,646–56.