The Best and Worst States for Back Pain

By Jesse Cannone

United States map

Where does your state rank for back pain?

Two years ago I wrote a book, The 7-Day Back Pain Cure.

When the book was almost ready for publication, I decided to offer a little contest to give away 10 copies.

Literally hundreds of people from all over the country and around the world wrote to tell me why they needed help with their back pain.

Not able to pick from all the entrants who “deserved” to get rid of their back pain… they all did… I decided instead to give away the entire first print run of 1,000 books to the first 1,000 people who asked for a copy.

I figured they would all go. But not nearly as fast as they did. The entire first print run was snapped up in less than 12 hours!

So I decided to go ahead and order several thousand more copies from the publisher and give those away too. Gone in days.

What started as a small idea to give away a few books to generate some interest in my first book became a significant portion of the Healthy Back Institute’s mission “to completely transform the way back pain is treated so people can reduce or eliminate their pain and enjoy more of their lives.”

How? We plan to give away 1,000,000 copies of The 7-Day Back Pain Cure by 2013.

Which State Has the Most Back Pain?

Now that we’ve already given away over 150,000 print copies of my book, we thought it would be interesting to examine where all the requests for them are coming from to see which states have the most back pain and which states have the least.

First, we took all the requests for books we received and broke them down by the state we shipped them to. Predictably, states like California, Texas, New York and Florida with the largest populations also had the most book requests.

But that didn’t answer what we were really curious about. What we wanted to know was which states have the most back pain and least back pain based on a percent of the population? Are the most populous states really the worst states for back pain? Or was there some other pattern?

So we crunched a few more numbers and compared the number of book requests with last year’s Census figures to order the states from most back pain to least back pain as a percent of their population.

Here’s our revised list, ordered from the worst state for back pain at the top to the best state for back pain at the bottom:

1          Wyoming

2          Utah

3          Alaska

4          Montana

5          Hawaii

6          Colorado

7          Idaho

8          Oregon

9          Washington

10         Arizona

11         New Mexico

12         Nevada

13         New Hampshire

14         Florida

15         Kansas

16         South Dakota

17         California

18         Vermont

19         Virginia

20         Maryland

21         Iowa

22         Connecticut

23         Minnesota

24         Wisconsin

25         Nebraska

26         North Dakota

27         Maine

28         Massachusetts

29         Delaware

30         DC

31         Texas

32         Oklahoma

33         New Jersey

34         Missouri

35         Pennsylvania

36         Michigan

37         Ohio

38         Rhode Island

39         Illinois

40         Georgia

41         New York

42         Indiana

43         Arkansas

44         North Carolina

45         Tennessee

46         South Carolina

47         Louisiana

48         Alabama

49         West Virginia

50         Kentucky

51         Mississippi

The results turned out to be quite interesting.

The state with the least population of all states (563,626), Wyoming, turned up as the state with the most back pain.

Washington, DC, which actually boasts more population (601,723) than the entire state of Wyoming, shows up near the middle of the list.

And the state with the least back pain, Mississippi, which falls in at position #31 in overall population (2,967,297), shows up at the bottom of the list to indicate Mississippi has the least back pain per capita in the country!

What Do You Think?

Why do you think Wyoming appears on our list as the worst state for back pain? Why do you suppose Mississippi appears as the best state for back pain? Where does your own state rank?

Tell us what you think in the comments below. And if you have back pain, let us know what kind of pain you have and what state you’re from. And of course, if you haven’t already, be sure to ask for a free copy of my book for yourself.

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Filed Under: Back Pain
Written By:  Updated:
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Jesse Cannone, CFT, CPRS, MFT

Jesse is the co-founder and visionary CEO of The Healthy Back Institute®, the world-leading source of natural back pain solutions. His mission as a former back pain sufferer is to help others live pain free without surgery and pharmaceuticals.

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29 thoughts on “The Best and Worst States for Back Pain”

  1. john says:

    I think DC is the cause of most of the back side pain in the USA.

  2. Paula says:

    Your survey may be more an issue of how much the book was showing up on the sites where people from that area go than how much actual back pain the population there has. Also, in less populated states, the individual person is a larger percentage of the whole than in larger populations. Lots of variables to take into consideration.

  3. Judi says:

    I think Wyoming because of the strip mines and railroad work going on there…..lots of lifting and shoveling and running very large equipment.
    I am not from their but I visit there 2 times a year as my daughter and her family currently are living there. We are from Michigan and both of us have back issues…..

  4. Trina Williams says:

    Mississipi ranks with the “least” amount of back pain because 1) they are a poor state. People do not seek medical care and 2) They are at the bottom educationally. They do not know there are remedies for back pain. Statistics can be biased to show any thing you want!

  5. Christina says:

    Even after taking into consideration all the variables, I think it is quite interesting to see your statistics.

  6. bez says:

    Interesting survey , but I can’t comment I live in the UK and wouldn’t have a clue why some of your states are worse than others , maybe its climatic

  7. Edgar says:

    Maybe the number of people with email has something to do with your response. If you are too poor to afford health care, maybe you do not have internet either.

  8. Nick says:

    I would look at the “mean” tempature. the colder the states the more apt to have muscle cramps less so in a warm climate.

  9. Andrea says:

    I feel IL should be much higher on your list. There are so many pain management centers because doctors can not control the pain of their patience. More than 3/4 of Chicagoland have back pain. But they also have money and insurance. Most of them don’t have time to research or care for homeopathic remedies. Everyone wants the quick fix. PAIN PILLS. It gets them through their fast paced day. Lots get massages too, which doesn’t really work, it just gives them relief for a few hours. Chiropractors are starting to become more popular here as people realize what the pills are doing to them. In conclusion, I feel that the greater percentage of pain is more in the fast paced stressful, city life than in the slower, more relaxing country life. (Mainly from personal experience than statistics.) I don’t feel that book sales are a good judgement for statistics. There are many many factors to consider. To get truly accurate numbers, you would have to have the number of people seeking medical attention, chiropractic care, homeopathic doctors, homeopathic computer research, possibly psychological care, etc…all for back pain or maybe pain in general. Not everyone with back pain has had the blessing of your book or even know it exists. I wish we could get the word out more. Thank you for helping so very many outsole

  10. Andrea says:

    Sorry, it sent before I was finished. Leaving off with my last sentence. Outsole was a misprint. Thank you for helping so very many people. Not just helping, but changing their lives and the lives of their families. (Myself included.) This world would be heaven if more people were like you. Caring and helping as many people as you can. Again, thank you and may God bless you. -Andrea

  11. Andrea says:

    It appears that the states at the top of the list with the most back pain are also states where physical activity is an integral part of daily life…lots of outdoor activity in places like Florida, Hawaii, Montana, Wyoming, etc. Hiking, biking, surfing, etc. While physical activity is terrific, it also lends itself to greater opportunities for injury. At the other end of the list were a number of southern states which have long been noted for obesity, caused in part by limited physical activity among many persons who live in these regions. Limited physical activity translates to limited chances of injuring one’s back.

  12. Thanks everyone for commenting… some interesting points.

    As we mentioned in the post, this is by no means “accurate” or “scientific”… just an interesting analysis.

    Andrea: glad to hear you are doing better and even more happy to know that we were able to help you 🙂


  13. Linda says:

    I was surprised New Jersey was so far down on the list (my state). The concentration of people nestled between 2 large cities of NYC and Phila, I would have thought the stress alone of living here would be enough!

  14. jon bush says:

    we call it BAD BACK MONTUCKY(montana). have ya ever pulled a500 lb snowcat outta tree well or pulled winch line uphill with 6 chokers or run a freakin chain saw for years ?

  15. Dusty says:

    Look at the overall work ethic and people working hard labor verses lack of jobs and jobs that don’t put stress on your back along with population and some of the other comments on this sight and the state rankings make since. Older and rural people tend to work harder and longer than younger and city people.

  16. peter says:

    I think you got it wrong. Mississippi has the worst education in the U.S. and is the fattest state; therefore, I believe folks there–due to obesity–are likely to suffer more back problems. And coupled with the co-relation between lack of education and labor class jobs, I believe this would give further rise to back strain leading to long-term conditions. I doubt your findings were accurate,

  17. Janice says:

    I think it’s just an indicator of the states in which the most people are eager for a deal on a book!

  18. Tim says:

    Genereally, states that are in line with Georgia and south experience the least back pain and states north of this experience more back pain due to the lack of sun exposure and resultant vitamin D from the sun. (The sun is not bad and sunscreen except for extremely fair-skinned is not really good. For most people, Cocoa butter alone with protect your skin from free radical damage.) The southern states that are listed as higher back pain are due to the large numbers of retired people in these states and are more likely to have back injuries. Other issues (like body mass index trends for the states) will have an effect on back pain, but for the most part it has do with sun exposure and age.

  19. Ralph says:

    I think this has to do with the amount of heat. The southern states appear at the bottom, so the heat may be helping alleviate their backpain by keeping it loose.

  20. Joanne says:

    A rebuttal to Pete:
    Mississippi may have the most obese in the union as a direct result of the health department dispensing free antibiotics to people. They don’t even have to be present or have a prescription! Most people don’t realize the side effects of antibiotics, regardless of their education.

  21. Barbara says:

    Like all statistics, this one is skewed by the lack of effecting factors. I hate to say this, but perhaps the “lack of back pain” should be renamed “lack of computers,” “lack of interest in any sort of self-improvement,” or even “lack of money to pay the shipping costs.” All too often, people in these lower-ranked states keep on thinking what they’ve always thought, and no amount of information penetratess that mind-set; consequently, they resist any sort of change, and refuse to admit the need for, never mind the possibility of, improvement. An awfully sweeping statement, I know; but I’ve lived in many places, and having been born and reared in one of these states, I’ve now moved back “home”–and very little has changed!
    P.S. – My back pain has increased since moving back “south”; maybe that should be factored into your research!

  22. Gary says:

    I would tend to agree with Barbara…I have lived my entire life in SC, and I believe that with the significantly lower level of income/education (overall and
    comparatively), and the lifestyles of many in the southeastern states, the “results” are probably skewed. These states have the highest obesity levels and worst overall diet in the nation (all of these statements are, of course, demographic generalizations). The physical, outdoor lifestyles of people in the western states (NOT California!) could account for more back injuries, yet it would also account for people being in better physical condition to start with. Sorry, but I just don’t put much stock in these results.

  23. Jacoba says:

    Maybe in some states people are less likely to go for help and won’t show up on surveys.

  24. Grace says:

    One factor you failed to mention in your statistics is the size of your contact list in each state and the percentage of that population which is a positive result. Your figures may be skewed by a different sample size from each state.

  25. Paul says:

    Excuse the pun, but your state ranking order for back pain seems to be all over the map. There are several different correlations to be made here, and one correlation may well contradict another. The whole survey sounds like a great thesis topic for a geography major.
    I have heard that back pain is the favorite ailment for Americans to complain about. I’m not sure what that says about either back pain itself or our country.

  26. Bryan says:

    I think that a lot of what people have to to say id true in some form or another. Bei.g born and raised in Idaho, i think that its not just the small population of a given area or the lack of internet (because there is no lack of), but more the lifestyles that people tend to have in the northwest that makes it such a high per-capita problem area. Wyoming is the #1oil producing western state and they are constantly drilling. Also, its the everyday lifestyle that we call normal (wicj that meaning extreamly active) that the same person living in say D.C. or Il, would call outdoors man or back country living. Population centers in the west except for the coast and the majority of the Southwest are sparce and few and far between. For the most part, having a ‘bljenew collar job’ out west here doesnt involve pencils or a tie, fatber a strong back and the ability to take pain everyday. Thats what scewz the numbers.

  27. Bryan says:

    Sorry for the miss-spellings in my last post. My old droid tends to interpret words wierd. 🙂

    Thank You

  28. clark says:

    When i look at the list the top places for back pain seem to be the states with the availability of outdoor sports and jobs, a lot of hiking skiing camping, movement, lifting, etc… there is alot of mining and oil drilling also- all tough work.

  29. Denise Sanders says:

    I live in Boulder, Colorado which rates at #6 for the worst states for back pain. I think this is largely because we live in a very dry climate and high altitude! The weather conditions change so much here and there is not a level of humidity and moisture here. I believe that especially people in Boulder and in Colorado in general are very physical and athletic! They run, ski, bike, hike, play games like football, dance, and are very physical. Running alone causes many knee and spinal injuries! However, for me the pro’s out way the con’s! Sincerely, Denise Sanders

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