Low back pain in older adults

Low back pain (LBP) is one of the most common reasons for enduring long-term disability and difficulty with activities of daily living. The assessment of LBP in older adults should first carefully rule out the rare possibility that the pain represents a serious spinal or systemic pathology. Thereafter, a clinical reasoning framework can be used to identify the specific mix of biopsychosocial factors which are most relevant in the pain presentation of each individual patient. A cognitive functional approach for each patient should then address those specific factors for each person, with a view to enhancing pain control, maintaining participation in valued activities, and reducing dependence on the health service.

Download Full-text

Long-Term Medicare Costs Associated With Opioid Analgesic Therapy vs Spinal Manipulative Therapy for Chronic Low Back Pain in a Cohort of Older Adults

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/j.jmpt.2021.09.001 ◽

2021 ◽

Author(s):

James M. Whedon ◽

Anupama Kizhakkeveettil ◽

Andrew Toler ◽

Todd A. MacKenzie ◽

Jon D. Lurie ◽

...

Keyword(s):

Older Adults ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Opioid Analgesic ◽

Spinal Manipulative Therapy ◽

Low Back ◽

Manipulative Therapy ◽

Medicare Costs

Download Full-text

The effect of long-term use of lumbar brace on the electromyography frequency spectrum of trunk and lower limbs in low back pain older adults with pronated feet during walking

Medical Journal of Tabriz University of Medical Sciences and Health Services ◽

10.34172/mj.2020.060 ◽

2020 ◽

Vol 42 (4) ◽

pp. 394-401

Author(s):

AmirAli Jafarnezhadgero ◽

Farshad Ghorbanloo ◽

Ghader Ghane

Keyword(s):

Older Adults ◽

Low Back Pain ◽

Back Pain ◽

Frequency Spectrum ◽

Lower Limbs ◽

Low Back

Download Full-text

RESTORATIVE NEUROSTIMULATION FOR MECHANICAL CHRONIC LOW BACK PAIN: LONG TERM RESULTS FROM THE REACTIV8-A CLINICAL TRIAL V. Mehta on behalf of the ReActiv8-A investigators.

10.26226/morressier.5ab3c881a874c600265593ea ◽

2018 ◽

Author(s):

Vivek Mehta

Keyword(s):

Clinical Trial ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Long Term Results ◽

Low Back

Download Full-text

Safety of Acupuncture Treatments for Chronic Low Back Pain in Older Adults

Case Medical Research ◽

10.31525/ct1-nct03850717 ◽

2019 ◽

Author(s):

Keyword(s):

Older Adults ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Low Back

Download Full-text

Faculty Opinions recommendation of Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1136875.593969 ◽

2008 ◽

Author(s):

Karen Anderson

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Low Back Pain ◽

Back Pain ◽

Nerve Stimulation ◽

Controlled Trial ◽

Low Back ◽

Therapeutic Exercise ◽

Electrical Nerve Stimulation ◽

Randomized Controlled

Download Full-text

Low Back Pain and Substance Use: Diagnostic and Administrative Coding for Opioid Use and Dependence Increased in U.S. Older Adults with Low Back Pain

Pain Medicine ◽

10.1093/pm/pnaa428 ◽

2021 ◽

Author(s):

Beth B Hogans ◽

Bernadette C Siaton ◽

Michelle N Taylor ◽

Leslie I Katzel ◽

John D Sorkin

Keyword(s):

Older Adults ◽

Substance Use ◽

Low Back Pain ◽

Back Pain ◽

National Sample ◽

Cross Sectional Study ◽

Diagnostic Code ◽

Low Back ◽

Opioid Use ◽

Cross Sectional

Abstract Objective Low back pain (LBP) is a leading cause of pain and disability. Substance use complicates the management of LBP, and potential risks increase with aging. Despite implications for an aging, diverse U.S. population, substance use and LBP comorbidity remain poorly defined. The objective of this study was to characterize LBP and substance use diagnoses in older U.S. adults by age, gender, and race. Design Cross-sectional study of a random national sample. Subjects Older adults including 1,477,594 U.S. Medicare Part B beneficiaries. Methods Bayesian analysis of 37,634,210 claims, with 10,775,869 administrative and 92,903,649 diagnostic code assignments. Results LBP was diagnosed in 14.8±0.06% of those more than 65 years of age, more in females than in males (15.8±0.08% vs. 13.4±0.09%), and slightly less in those more than 85 years of age (13.3±0.2%). Substance use diagnosis varied by substance: nicotine, 9.6±0.02%; opioid, 2.8±0.01%; and alcohol, 1.3±0.01%. Substance use diagnosis declined with advancing age cohort. Opioid use diagnosis was markedly higher for those in whom LBP was diagnosed (10.5%) than for those not diagnosed with LBP (1.5%). Most older adults (54.9%) with an opioid diagnosis were diagnosed with LBP. Gender differences were modest. Relative rates of substance use diagnoses in LBP were modest for nicotine and alcohol. Conclusions Older adults with LBP have high relative rates of opioid diagnoses, irrespective of gender or age. Most older adults with opioid-related diagnoses have LBP, compared with a minority of those not opioid diagnosed. In caring for older adults with LBP or opioid-related diagnoses, health systems must anticipate complexity and support clinicians, patients, and caregivers in managing pain comorbidities. Older adults may benefit from proactive incorporation of non-opioid pain treatments. Further study is needed.

Download Full-text

Long-term improvements following a residential combined physical and psychological programme for chronic low back pain

BMJ Open Quality ◽

10.1136/bmjoq-2020-001068 ◽

2021 ◽

Vol 10 (2) ◽

pp. e001068

Author(s):

Shaun Wellburn ◽

Cormac G Ryan ◽

Andrew Coxon ◽

Alastair J Dickson ◽

D John Dickson ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Chronic Low Back Pain ◽

Rating Scale ◽

Secondary Outcome ◽

Low Back ◽

Residential Setting ◽

Wide Range

ObjectivesEvaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.DesignA longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.SettingResidential, multimodal rehabilitation.Participants136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.InterventionA 3-week residential CPPP.Outcome measuresPrimary outcome measures were the STarT Back screening tool score; pain intensity—11-point Numerical Rating Scale; function—Oswestry Disability Index (ODI); health status/quality of life—EQ-5D-5L EuroQol five-Dimension-five level; anxiety—Generalised Anxiety Disorder-7; depression—Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.ResultsAt discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.ConclusionsParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.

Download Full-text