Back Pain Tops Portugal's Chronic-Illness League as INE Finds One in Three Adults Affected and a Majority Overweight

Almost one in three adults in Portugal lives with chronic back pain, and more than half the adult population is now overweight or obese, according to the latest National Health Survey (Inquérito Nacional de Saúde) published by the national statistics office, INE (Statistics Portugal). The portrait that emerges is of a population that lives long but increasingly manages a stack of long-term conditions — and one in which women carry a markedly heavier load of chronic illness than men.

The survey, which questioned residents aged 15 and over about their health in the previous twelve months, is the most comprehensive snapshot of how Portugal actually feels — as opposed to how often it visits a hospital. For the country's large foreign-resident community, it is also a useful map of where the health system's pressure points lie.

Back pain leads, and it is not just an older person's complaint

Low back pain (lombalgia) was the single most common chronic condition, affecting roughly 3.2 million residents — close to a third of the population studied. Crucially, it is not confined to the elderly: back pain was also among the conditions most reported by younger adults aged 25 to 34, a sign of the toll taken by sedentary work, long commutes and screen-bound days.

After back pain, the most prevalent chronic conditions were high blood pressure (hipertensão arterial) at 25.6 percent, high cholesterol at 23.8 percent, chronic neck pain (cervicalgia) at 21.6 percent, allergies at 20.2 percent and arthritis at 19 percent. Taken together, they describe a familiar Western profile: musculoskeletal wear-and-tear layered on top of the cardiovascular risk factors that drive heart disease and stroke.

A clear — and persistent — gender gap

Each of the six leading chronic conditions was reported more often by women than by men, in several cases by a wide margin. Arthritis affected 25.9 percent of women against 11.8 percent of men; chronic neck pain 27.8 percent of women against 15.1 percent of men; and back pain 37.1 percent of women against 26.1 percent of men. The pattern echoes findings across Europe and reflects a mix of biological factors, longer female life expectancy and differences in how symptoms are reported and recorded.

The weight of the nation

More than half of Portuguese adults — 57.1 percent — were overweight or obese, with a body-mass index of 25 or above. The figure confirms that excess weight, long treated as a Southern European latecomer to the obesity story, is now a majority condition. Regional readings are starker still: in the Azores, close to two-thirds of the population were found to be overweight or obese, among the highest rates in the country.

Excess weight matters well beyond appearance. It is a primary driver of the hypertension, high cholesterol and joint disease that top the same survey, and it feeds the rising burden of type-2 diabetes — making it the connective tissue running through almost every other number in the report.

What this means for expats

• Primary care is where these conditions are managed. Hypertension, cholesterol and back pain are bread-and-butter work for a family doctor, which makes getting into the public system early a priority. If you have not yet done so, securing a número de utente and a health-centre registration is the first step — see our guide to registering with the SNS.
• Chronic care, not emergencies, is the real test of the system. The conditions this survey highlights are managed over years, through prescriptions, monitoring and physiotherapy — not through the urgent-care channels that dominate the headlines.
• It helps explain the private-sector boom. An ageing, chronically ill population is exactly what is driving the surge in private hospital revenue and health-insurance take-up, as patients seek faster access to specialists, scans and physiotherapy.
• Prevention is cheap and portable. The leading conditions — back pain, hypertension, weight-linked disease — respond to the same low-cost levers everywhere: movement, diet and routine check-ups. Portugal's outdoor climate makes the first of those easier than in many places.

Portugal still enjoys one of the longer life expectancies in the European Union. But the National Health Survey is a reminder that those extra years increasingly come with chronic conditions attached — and that the quieter, slower-burning work of managing them, rather than the drama of the emergency room, is what will define the health system foreign residents come to rely on.