Chronic neck, back pain increasingly hits young adults

According to the World Health Organization (WHO), lower back pain is the leading cause of disability worldwide. In 2025, over 450 million working age adults were suffering from back pain, with cases projected to rise to 843 million by 2050. The Global Burden of Disease study also identifies lower back pain as one of the leading contributors to years lived with disability across age groups. Experts warn that ignoring persistent pain can allow relatively minor musculoskeletal problems to develop into chronic conditions.

Early onset

Today’s lifestyle is at the heart of the growing burden of neck and back pain among young adults, experts say. “There has been a noticeable rise in young adults seeking consultation for neck and back pain over the past few years,” says Dr Ashish Yadav, attending consultant, physical medicine and rehabilitation, Medanta, Noida. “Musculoskeletal pain, once considered primarily an older-age concern, is now frequently seen in people in their 20s and 30s. This shift appears to be driven by prolonged screen time, sedentary work routines, poor posture, reduced physical activity and rising stress levels.”

Echoing this, Dr Surender Pal Singh, head of physiotherapy at CK Birla Hospital, Delhi, says, “The occurrence of neck and back pain in individuals aged 18-35 years shows an increasing trend in recent years. The increase is mostly due to sedentary behaviour, incorrect posture and increased gadget usage.”

“Nutritional deficiencies (like vitamin D and vitamin B12) and, in some cases, autoimmune diseases, infections, or degenerative changes in the spine may provoke symptoms of musculoskeletal problems,” says Dr Pal, adding, “Symptoms usually start as a feeling of slight discomfort and worsen with time if the underlying causes remain ignored.”

According to Dr Vaibhav Bagaria, director, orthopaedics and joint replacement, Sir HN Reliance Hospitals, Mumbai, the problem extends beyond office work. “Long screen time, sitting for hours, work-from-home setups, less exercise, gym injuries, stress and poor sleep are all adding to it. Earlier this was seen more after 40; now even people in their 20s and sometimes schoolchildren are also coming with recurrent neck pain.”

Doctors also point to obesity, repetitive strain, improper lifting techniques, weak core muscles, nutritional deficiencies such as vitamin D and B12 deficiency, smoking, poor sleep and psychological stress as important contributors. While most cases are mechanical in nature, inflammatory disorders, congenital abnormalities and infections remain less common but important causes that require medical evaluation. Dr Bagaria adds, “Now even school kids are coming with recurrent neck pain.”

Signs & symptoms

The earliest warning signs of neck and back pain are often dismissed as temporary discomfort, say doctors. The most common presentation is mechanical or posture-related pain involving muscles, ligaments or joints rather than serious spinal disease. Dr Yadav notes that myofascial pain affecting the upper back and the area between the shoulder blades has become particularly common. “Trigger points and taut bands in muscles cause dull aching pain which gets aggravated in certain positions,” he says.

Equally important, he says, is recognising that chronic pain extends beyond physical symptoms. “Chronicity reflects in sleep and mood disturbance,” he explains, emphasising that pain should be addressed through biological, psychological and social aspects rather than as a purely physical complaint.

Dr Pramod Sudarshan, spine surgeon at Apollo Hospitals, Bengaluru, red-flags several symptoms that require urgent evaluation, including fever, unexplained weight loss, night pain, imbalance while walking, bowel or bladder dysfunction, groin numbness and severe limb weakness.

According to Dr Singh, chronic pain lasting more than two to three weeks “should not be disregarded”, particularly if accompanied by pain radiating into the arms or legs, numbness, tingling, muscle weakness or dizziness. Dr Bagaria advises that one should seek medical attention if  “pain keeps coming back, lasts more than two to three weeks, disturbs sleep or affects routine life”. Pain radiating into the limbs, weakness or numbness should never be ignored, he adds.

Courses of treatment

Treatment begins with identifying the underlying cause and combining symptom relief with long-term rehabilitation, says Dr Yadav. “For most cases of mechanical neck or back pain, a combination of activity modification, ergonomic correction, supervised physiotherapy, posture training and targeted strengthening exercises form the foundation of care,” he says, adding that patients are encouraged to stay active rather than remain on prolonged bed rest, since movement generally aids recovery.

Dr Sudarshan says patients with posture-related pain often recover with short-term medication, activity modification and physiotherapy. “Once the acute pain settles, physiotherapy and exercise become important. The focus then shifts to strengthening the core and back muscles, correcting posture and preventing recurrence.”

Long-term use of painkillers, analgesics or steroids is generally not recommended, he adds. “Painkillers are usually advised only for a short period, especially during acute severe pain. If pain does not settle with initial treatment and investigations do not show a major problem requiring surgery or other intervention, targeted pain-management procedures may be considered in selected cases. These may include local injections at the identified pain-generating area to provide relief.”

Medication is usually prescribed only during acute flare-ups to reduce pain and inflammation, allowing patients to participate in rehabilitation. Other treatments include heat therapy, and muscle relaxants for less severe pain.

“Most young patients do not need surgery,” says Dr Bagaria. “We advise them to remain active, correct posture, improve workstation ergonomics and start guided stretching and strengthening. Bed rest for many days generally makes things worse.” As he puts it, “Only taking painkillers is like putting tape on a leaking pipe.”

If left untreated

Neglected pain may eventually lead to “muscle wasting, worsening spinal degeneration, disability and chronic nerve symptoms because of compression,” warns Dr Singh. Dr Sudarshan adds that untreated muscle weakness and poor posture may contribute to disc degeneration, disc prolapse, nerve compression and spinal instability. In severe cases involving spinal cord compression, patients may develop walking imbalance and significant neurological deficits requiring urgent specialist intervention.

In these circumstances chronic pain can become debilitating in different ways. Dr Bagaria says patients often become fearful of movement, leading to reduced activity and progressively weaker muscles, creating a vicious cycle that worsens pain. Delayed treatment in nerve-related conditions may result in persistent numbness or weakness.

According to Dr Yadav, untreated chronic neck and back pain “can significantly affect physical function, emotional well-being and overall quality of life”. Reduced mobility, disturbed sleep, impaired work performance, weight gain, anxiety and depression may all develop over time.

Disclaimer: The information in this article is for educational and informational purposes only and is not intended as medical advice. While the author has incorporated expert medical guidance while producing the story and ensured full authentic information is provided to the reader, you should always seek the advice of a qualified healthcare provider regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.