scholarly journals The Association of Persistent Low Back Pain With Older Adult Falls and Collisions: A Longitudinal Analysis

2020 ◽  
pp. 073346482096651
Author(s):  
Tyler Bell ◽  
Caitlin Pope ◽  
Pariya Fazeli ◽  
Michael Crowe ◽  
Karlene Ball

Mobility-related injuries associate with reduced quality of life, greater functional dependence, and quicker mortality in older adults—warranting prevention efforts. One factor elevating injury risk may be persistent low back pain, which can negatively affect cognitive and physical functions essential for safe mobility. Among older adults obtaining license renewal ( n = 1,127), this study examined the association between persistent low back pain and incidence of falls and motor vehicle collisions (MVCs) for up to 15 years. Overall, older adults with persistent low back pain were more likely to have a fall (odds ratio [OR] = 1.54, 95% confidence interval [CI] = [1.34, 1.77]) or MVC (OR = 1.38, 95% CI = [1.07, 1.77]) than those without back pain. Furthermore, the number of falls and MVCs was lower for people with better lower limb and visuospatial function, respectively. Ameliorating pain and functioning in persistent lower back pain might contribute to improved mobility and a reduction of injury-related risk in later life.

2018 ◽  
Vol 28 (9) ◽  
pp. 1434-1448 ◽  
Author(s):  
Meredith Stensland ◽  
Sara Sanders

Chronic low back pain (CLBP) is older adults’ most common pain complaint and is associated with many physical and psychosocial consequences, which have been quantitatively examined. However, little research has qualitatively examined the experience itself of CLBP in later life. Study objective was to understand older adults’ lived CLBP experience. Guided by van Manen’s phenomenological method, 21 pain clinic patients aged 66 to 83 completed semistructured interviews. Under the main theme “living a life full of pain,” results are reflected in four existential subthemes: (a) Corporeality: The pain is relentless and constantly monitored, (b) Temporality: To live with pain is to live by pacing day and night, (c) Relationality: Pain creates limits that can be tested or obeyed, and (d) Spatiality: Manipulating the space around me to accommodate the pain. Findings improve understanding of the patient experience of late life CLBP and highlights the importance of empathy and patient-centeredness when treating older adults.


Pain Medicine ◽  
2021 ◽  
Author(s):  
Beth B Hogans ◽  
Bernadette C Siaton ◽  
Michelle N Taylor ◽  
Leslie I Katzel ◽  
John D Sorkin

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.


Pain Medicine ◽  
2015 ◽  
Vol 17 (8) ◽  
pp. 1436-1446 ◽  
Author(s):  
Jaclyn Megan Sions ◽  
Andrew Craig Smith ◽  
Gregory Evan Hicks ◽  
James Matthew Elliott

2017 ◽  
Vol 30 (suppl 1) ◽  
pp. 63-73 ◽  
Author(s):  
Flora Pereira Guerra ◽  
Rosângela Corrêa Dias ◽  
Leani Souza Máximo Pereira ◽  
Luciana de Oliveira Assis ◽  
Marcella Guimarães Assis

Abstract Introduction: Low back pain is a common condition among older adults and an important cause of disability. Objective: To evaluate the relationship between functional performance of older adults with low back pain and the following variables: sociodemographic and clinical factors, self-perceived health and back pain beliefs. Methods: A cross-sectional study that used data from the Back Complaints in the Elders international consortium. Information about sociodemographic factors (sex, age, marital status, formal education), clinical factors (intensity and frequency of pain, comorbidities), self-perceived health, back pain beliefs and functional performance (measured by the disability component of the Late Life Function and Disability Instrument - LLFDI) were collected through self-report. 191 older adults above 60 years with a new episode of back complaints who did not have any cognitive disorder, visual or hearing impairment, or motor disabilities participated in the study. A bivariate analysis was conducted between each independent variable and each outcome. Associations with p < 0.20 were selected for the multiple linear regression analysis, which was carried out for each LLFDI domain. Results: The multiple regression coefficients of determination were significant despite the modest magnitude. The variables related to functional performance were back beliefs, self-perceived health, formal education, pain frequency and marital status. Conclusion: These results may contribute to the expansion of health professionals’ work in the therapeutic approach of low back pain, broadening its focus beyond clinical aspects in order to value beliefs of older adults and their self-perceived health.


Pain Medicine ◽  
2017 ◽  
Vol 19 (11) ◽  
pp. 2138-2145 ◽  
Author(s):  
José G Luiggi-Hernandez ◽  
Jean Woo ◽  
Megan Hamm ◽  
Carol M Greco ◽  
Debra K Weiner ◽  
...  

Abstract Objective Mindfulness is a nonpharmacologic mind-body therapy that has been shown to be effective in older adults with chronic low back pain (cLBP). There are few first-person accounts in the literature that describe the older adult experience and perspective while learning mindfulness and meditation to treat pain. The objective of this study was to investigate dominant themes present in the experiences of older adults applying mindfulness and meditation to cope with cLBP. Design Qualitative analysis of four focus groups. Subject Twenty-five adults age 65 years or older who had completed an eight-week mindfulness program. Methods The focus groups met for a comprehensive discussion session about their experience with mindfulness and meditation. The audio for each session was recorded, and the discussions were transcribed. Codebook development, qualitative coding, and thematic analysis were performed. The coders each coded all four transcripts, following which they met to adjudicate all coding differences until they were in complete agreement on coding. Results Several key themes were brought up by older adults utilizing mindfulness as a means of coping with pain, which included overcoming fear of pain (“Before [learning mindfulness], I used to dread pain”), pain awareness (“You’re focusing more on being aware than the pain; now that’s what helps me”), and pain significance (“It becomes insignificant”). Conclusions The themes identify several ways mindfulness impacts older adults with cLBP, including decreased negative emotions related to chronic pain such as fear of pain, a different perspective or change in awareness about pain, and reducing the significance of pain.


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