Comparative view of the socioeconomic impact of migraine versus low back pain.

The burden of migraine in terms of cost and impact on socioeconomic indicators is still controversial. In a recent comparative study between migraineurs and controls from the French general population, we show that only general practitioner (GP) consultations and complementary examinations are more frequent in migraineurs. In this paper, we compare the socioeconomic impact of migraine versus another common neurological disease, low back pain, which has similar consequences in term of deficiencies, disabilities, and handicaps. Our study is a subproject of the Gazel cohort study, conducted on 20,000 volunteers working in the "Electricité et Gaz de France" company. The socioeconomic impact was evaluated prospectively by the number of workdays missed between 1989 and 1992 in 436 subjects with migraine but without low back pain (M group), 590 subjects with low back pain but without migraine (L group), 555 subjects with migraine and low back pain (ML group), and in 1005 subjects without headache or low back pain (C group). Moreover, in 1993 all subjects completed a mailed questionnaire on their 6-months' history of use of medical services. The number of workdays missed during this 4-year period was statistically greater in the ML group (58.1 days), followed by the L group (38.4 days), the C group (35.1 days), and the M group (31.8 days) (p = 0.0001). For the use of medical services, the results were different according to the different indicators: GP consultations were more frequent in the ML and M groups, specialist consultations and complementary examinations in the L and C groups. In conclusion, migraine and low back pain seem to have a similar socioeconomic impact. Absenteeism is particularly high when both neurological disorders are present.