OBJECTIVES : To explore the differences in health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), and healthcare resource utilization (HRU) among lower back pain (LBP) sufferers with and without a diagnosis (dxLBP vs. LBP) in Asia and USA.

METHODS : This study utilized data from the 2020 National Health and Wellness Surveys (NHWS) in Korea and Taiwan, and 2019 NHWS in Japan and USA. The percentages of diagnosed LBP respondents (dxLBP/LBP) were descriptively analysed for each country. HRQoL, WPAI and HRU were compared in dxLBP vs. LBP using bivariate analyses for each country.

RESULTS : The total respondents of the NHWS per country were: Korea=20,108; Taiwan=20,050; Japan=30,006; USA=74,994. Respectively 1.7%, 4.0%, 2.2% and 16.8% of the respondents had experienced LBP in the past month. The percentages of dxLBP in Korea, Taiwan and Japan were lower (29.3%, 29.1%, 17.1%) compared to USA (48.0%). In Asia, only few statistically significant differences in HRQoL, WPAI and HRU were observed in dxLBP vs. LBP: Lower physical component scores (PCS) in Korea (43.4 vs. 46.6, p=0.002) and Japan (46.9 vs. 48.6, p=0.036); Higher absenteeism in Japan (8.5% vs. 4.0%, p=0.025); Higher presenteeism in Taiwan (30.0% vs. 24.9%, p=0.012); Higher number of visits to physicians in the past 6 months in Taiwan (10.4 vs. 6.1, p<0.001) and Japan (12.5 vs. 8.0, p<0.001). In USA, significant differences were observed for all measures (p<0.001). Specifically, dxLBP had higher mental health component score (45.5 vs. 44.8, p=0.001), lower PCS (41.6 vs. 48.9, p<0.001) and all WPAI and HRU measures were significantly higher (p<0.001).

CONCLUSIONS : LBP is an underdiagnosed condition in Korea, Taiwan and Japan compared to USA. In Asia, LBP sufferers with and without a diagnosis experience similar worsened HRQoL and increased WPAI and HRU, whereas in USA significant difference was observed.