There is no debating that back pain is on the rise. It is a great leveler though, assailing people of all age groups, gender, and socioeconomic classes and causing a burden on the economy. In the United States, an approximate 7 million people join the league of back pain sufferers every year and contribute to the 19 to 25 percent of workers claiming compensation for back pain and to the loss of approximately 170 million working days annually.1
Back Pain And Gender
[pullquote]More women suffer from low back pain, and this could be because of a gene variant that promotes pain in women.[/pullquote]
Gender is a factor in back pain, with more women complaining of back pain than men.2 While some hold the lower pain threshold in women as a differentiating factor,3 a 2012 study suggests that a certain gene variant that is responsible for the body’s pain regulation suppresses chronic low back pain in men and promotes it in women.4
Researchers also suggest looking into social factors like gender role expectation, ethnicity, stress and anxiety, and family history.5
But this is hardly to say men don’t suffer from back pain at all. Statistics show that from 1997 to 2014, at least 23 percent of the adult male population in the United States suffered from low back pain.6 We wanted to explore the common causes of back pain in men. So we looked at some of the anatomical differences, but here’s what we found.
Being Overweight May Not Affect Men So Much
[pullquote]Men with higher BMI have better trunk movement, which ensures lesser back pain.[/pullquote]
A commonsensical reason for back pain would be body weight, because when you are overweight and are carrying excess weight in the abdominal area, the bulging abdomen puts pressure on the lumbosacral curve in the lower back, the area where the lumbar vertebrae meet the sacral bones. This could result in biomechanical changes in the lumbar spine and even spinal misalignment.7.
In which case, more men would be suffering from back pain than women, as men tend to gain fat around their waist as opposed to women, who gain it around the hips and thighs. However, a study showed that while women with larger waist circumference suffered from back pain, this parameter did not apply to men.8
One possible explanation for this lies in the gender difference in the isokinetic strength of the trunk muscles, or the ability of the trunk muscles to contract constantly at a consistent speed, which is a factor in back pain. Men with higher BMI have been seen to have more isokinetic strength, which leads to less back pain. This, however, is not the case in women where the trunk muscle loses its isokinetic strength with increased BMI and age. Obesity and inactivity affect women more adversely when it comes to lower back pain than they affect men.9
So, if body weight is not really the cause of back pain in men, what are the real causes?
Common Causes Of Back Pain In Men
The common causes are diseases that affect only men or are more prevalent among them, certain socioeconomic factors that impact men, and lifestyle factors that are adopted more by men than women.
[pullquote]Inflammation of the prostate gland, arthritis of the spine, abnormal enlargement of the aorta, and disk rupture, seen mostly in men, can cause back pain.[/pullquote]
The health conditions that contribute to back pain primarily in men include:
This inflammatory arthritis of the spine where it joins the pelvis, eventually making the vertebrae fuse with each other, affects men more and can start as early as when they are 17.
Men are more prone to disc rupture as they are predominantly involved in work that requires manual labor such as heavy lifting, pushing, and pulling.10
Abdominal Aortic Aneurysm
This condition, in which the lower part of the aorta becomes enlarged, has back pain as the first indicator. It is more common in men, reveals a study in which ultrasonography screening done on brothers and sisters who had abdominal aortic aneurysm but showed no symptoms. The study found that most of the brothers suffered from it.11
Back pain occurs frequently in individuals with a family history of kidney stones, and nearly 95 percent of the male population with a family history is at risk for kidney stones.12.
Chronic prostatitis, a swelling of the prostate gland, can often cause pain in the lower back.
[pullquote]Manual machine handling jobs, low educational status, and job dissatisfaction may all lead to pain.[/pullquote]
Strenuous Physical Job
People in occupations that involve manual material handling are more prone to back pain.13 These physically strenuous jobs are often handled by men. Being physically active increases fitness levels, but studies have found that extreme and strenuous physical activity can lead to back pain just as inactivity does.14
Socioeconomic factors, which include job dissatisfaction, physically strenuous work, psychologically stressful work, and low educational status, play a major role here.15 Men from lower socioeconomic backgrounds with lower educational status are more commonly engaged in strenuous physical activities and have less access to healthcare facilities or pain management techniques and suffer from recurring pain.
Women from similar backgrounds, on the other hand, are engaged more in household chores and childcare, which are no less strenuous and can have similar effects on their body.
On the other hand, people of both genders from a higher socioeconomic status who are engaged in desk jobs that involve little physical activity are equally at risk for back pain. Posture also becomes an important factor here.
[pullquote]Smoking and drinking too much alcohol can trigger low back pain. Men smoke five times more than women do.[/pullquote]
Other lifestyle factors such as smoking or excessive alcohol consumption also play a major role in making one vulnerable to pain.16 Studies have shown that nearly 23 percent of smokers and 15 percent of nonsmokers suffer from back pain.17
A 2010 WHO report estimates that worldwide, men smoke about five times more than women do, though the ratio varies across countries on the basis of their level of socioeconomic development and women in developed nations are not far behind men in this aspect.18
Similarly for drinking, while men are more likely than women to drink excessively,19 a study on drinking patterns related to gender in the United States from 2002 to 2012 found that the gap is closing fast.20
You can see that apart from the diseases that affect men, the socioeconomic and lifestyle-related causes of back pain in men can also affect women, and perhaps more adversely.
|↑1||Nag, P.K. and Hsiang, S., 2000. Ergonomics in manual materials handling tasks. ICMR Bulletin, 30, pp.67-76.|
|↑2, ↑5||Schneider, Sven, Dorothee Randoll, and Matthias Buchner. “Why do women have back pain more than men?: A representative prevalence study in the Federal Republic of Germany.” The Clinical journal of pain 22, no. 8 (2006): 738-747.|
|↑3||Alabas, O. A., O. A. Tashani, and M. I. Johnson. “Effects of ethnicity and gender role expectations of pain on experimental pain: A cross‐cultural study.” European Journal of Pain 17, no. 5 (2013): 776-786.|
|↑4||Olsen, Maria Belland, Line Melå Jacobsen, Elina Iordanova Schistad, Linda Margareth Pedersen, Lars Jørgen Rygh, Cecilie Røe, and Johannes Gjerstad. “Pain intensity the first year after lumbar disc herniation is associated with the A118G polymorphism in the opioid receptor mu 1 gene: evidence of a sex and genotype interaction.” The Journal of Neuroscience 32, no. 29 (2012): 9831-9834.|
|↑6||Percentage of adults in the U.S. with low back pain from 1997 to 2014, by gender. Statista|
|↑7||Han, T. S., J. S. A. G. Schouten, M. E. J. Lean, and J. C. Seidell. “The prevalence of low back pain and associations with body fatness, fat distribution and height.” International journal of obesity 21, no. 7 (1997): 600-607.|
|↑8||Hershkovich, Oded, Alon Friedlander, Barak Gordon, Harel Arzi, Estela Derazne, Dorit Tzur, Ari Shamis, and Arnon Afek. “Associations of body mass index and body height with low back pain in 829,791 adolescents.”American journal of epidemiology (2013): kwt019.|
|↑9||Lee, Ho Jun, Woo Hyun Lim, Jin-Woo Park, Bum Sun Kwon, Ki Hyung Ryu, Jung Hwan Lee, and Young Geun Park. “The relationship between cross sectional area and strength of back muscles in patients with chronic low back pain.” Annals of rehabilitation medicine 36, no. 2 (2012): 173-181.|
|↑10||Understanding back problems. Patient Education Center|
|↑11||Bengtsson, H., Ö. Norrgård, K. A. Ängquist, O. Ekberg, L. Öberg, and D. Bergqvist. “Ultrasonographic screening of the abdominal aorta among siblings of patients with abdominal aortic aneurysms.” British Journal of Surgery 76, no. 6 (1989): 589-591.|
|↑12||Curhan, Gary C., Walter C. Willett, Eric B. Rimm, and Meir J. Stampfer. “Family history and risk of kidney stones.” Journal of the American Society of Nephrology 8, no. 10 (1997): 1568-1573.|
|↑13||Nag, P.K. and Hsiang, S., 2000. Ergonomics in manual materials handling tasks. ICMR Bulletin, 30, pp.67-76.|
|↑14||Heneweer, Hans, Luc Vanhees, and H. Susan J. Picavet. “Physical activity and low back pain: a U-shaped relation?.” Pain 143, no. 1 (2009): 21-25.|
|↑15||Socioeconomic Factors and Consequences of Low-Back Pain. NIH.|
|↑16||Alnojeidi, Albatool H. “Gender Differences in Low Back Pain and Self-Reported Muscle Strengthening Activity Among US Adults.” (2015)|
|↑17||Alkherayf, Fahad, and Charles Agbi. “Cigarette smoking and chronic low back pain in the adult population.” Clinical & Investigative Medicine 32, no. 5 (2009): 360-367|
|↑18||Gender empowerment and female-to-male smoking prevalence ratios. World Health Organization|
|↑19||Fact Sheets – Excessive Alcohol Use and Risks to Men’s Health. Center for Disease Control and Prevention|
|↑20||White, Aaron, I‐Jen P. Castle, Chiung M. Chen, Mariela Shirley, Deidra Roach, and Ralph Hingson. “Converging patterns of alcohol use and related outcomes among females and males in the United States, 2002 to 2012.” Alcoholism: Clinical and Experimental Research 39, no. 9 (2015): 1712-1726.|