Back and neck pain do not only affect the person experiencing the pain; they also place a substantial burden on relatives. This is shown in a new Danish study from the Spine Centre of Southern Denmark and the University of Southern Denmark, which may have implications for how chiropractors and other clinicians should plan treatment pathways.
The need for a better understanding of the role of relatives is only increasing. The number of people with back pain is expected to rise significantly and could reach up to one billion globally by 2050, a rise which can be explained by an ageing population. At the same time, most cases are non-specific and often chronic or recurrent, increasing the burden on both patients and their families.
Emotions Have the Greatest Impact on Relatives
The study, which includes nearly 300 relatives of patients with long-term back pain, shows that the burden is primarily emotional. Worry is by far the most dominant factor: as many as 93% of relatives report being affected by worry, and more than half report being affected to a great extent. Emotions such as frustration and sadness are also widespread, while more practical aspects such as finances and diet play a much smaller role.
This points to an important conclusion: the patient’s pain is not only a physical problem; it is also, to a large extent, a psychosocial issue within the family.
Partners Are the Most Affected
The study shows that the burden is greatest among partners, especially if they are younger and assess their own health as poor. In addition, greater burden is associated with the patient’s level of disability, the duration of pain, and the overall symptom burden.
This means that chiropractors in practice can identify high-risk groups among relatives: long-term and complex cases with high levels of functional impairment increase the risk of burden for the relative who cares for the patient.
Perspective: From Patient-Centred to Family-Centred Care
The study supports a shift in pain management toward more holistic and family-centred approaches. For chiropractors, this means that:
- relatives should be seen as part of the treatment context
- emotional factors should be systematically addressed
- education and guidance should target both patient and partner
Back pain is not only an individual condition—it is a family burden. For chiropractors, this opens the door to a broader clinical approach, where success is measured not only by the patient’s pain reduction but also by the overall well-being of the family.
Measurement Tool Falls Short
The study also evaluates the FROM-16 questionnaire for measuring the burden on relatives. Although it performs acceptably, the researchers identify several important limitations:
- some questions are irrelevant for certain groups (e.g., retirees or non-partners)
- up to 20% of responses are missing for some items
- key aspects of the caregiver role are not captured
As a result, the true burden may be underestimated. The researchers therefore call for the development of a measurement tool specifically tailored to back pain.
Casper Nim, Pernille Platz Skrubbeltrang, Peter Måhr, Henrik Hein Lauridsen. The impact of spinal pain on family members’ burden: a cross-sectional study. Scandinavian Journal of Pain 2026.
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