2023 Volume 14 Issue 6 Pages 884-890
Introduction: There is a lack of medical evidence regarding the prognosis and course of chronic low back pain in elderly individuals. In this study, longitudinal data on chronic low back pain from a project aimed at elucidating the pathology of chronic pain in elderly people and developing treatment methods were used, and factors that contribute to intractability in patients with nonspecific chronic pain were analyzed.
Methods: A one-year longitudinal evaluation was performed involving 341 patients aged 65 years or older with chronic low back pain that persisted for 3 months or longer (mean age 78.5 years; 133 males, 208 females). After 1 year follow-up including the therapeutic exercise and/or pharmacotherapy, those who improved to 3 cm or less on the visual analogue scale (VAS) were classified as the improvement group, and multivariate analysis was performed to evaluate the factors related to improvement of low back pain.
Results: There were 141 patients (41.3%) in the improvement group with VAS < 3 cm within 1 year. The non-improvement group had a significantly longer disease duration, a higher pretreatment VAS, and a significantly lower limb skeletal muscle mass, and the erythrocyte volume distribution width (RDW) was significantly higher. Logistic regression analysis with age and sex added as explanatory variables to the factors with p<0.1 in the comparison between the two groups showed that VAS, RDW, and L4/5 high trunk muscle cross-sectional area were significant factors.
Conclusions: In chronic low back pain, maintaining trunk muscles can be expected to improve low back pain. On the other hand, the fact that the RDW, which is reported to reflect aging, was high in the non-improved group suggests an irreversible aspect of chronic low back pain in elderly people.
