Why is back pain in older people important?
Low Back Pain (LBP) is the leading cause of global disability,1,2 with the increase in disability associated with LBP due primarily to population growth and aging. One in four older Australians have LBP,3 and LBP in older people is more incapacitating than in younger people.4,5 LBP is also associated with poorer physical health6,7 and non-recovery.8 With an ageing population, where 6.2 million Australians will be aged older than 65 by 2042,9 LBP will have an increasingly large burden on the Australian economy. This study will exclusively focus on the burdensome condition of LBP in older Australians.
The Back Complaints in Elders (BACE) consortium is an international cohort study examining back complaints in older people in primary care.10 A European research group has begun a BACE - chiropractic cohort, and this project will join the global collaboration to explicitly explore LBP in older chiropractic patients.
1. Describe the population of adults aged 55 years or over who seek chiropractic care for low back pain;
2. Determine the health outcomes and examine the costs, safety and satisfaction of chiropractic care for the treatment of low back pain in adults aged 55 years or over;
3. Determine the predictors of disabling back pain in older adults.
We will use established methodology from an international consortium to collect practice-based data from Australian chiropractors. A total of 1,000 older participants will be recruited into a 12-month, prospective longitudinal cohort study. Patient participant inclusion criteria are a ‘new’ episode of LBP, defined as the patient not visiting a chiropractor during the preceding six months for the same back complaint. Questions about sociodemographic factors, lifestyle characteristics, health, pain, functional status, satisfaction and quality of life will be asked at baseline and at follow up surveys. Data will be collected using online questionnaires at baseline, and at 2 and 6 weeks and at 3, 6, 9 and 12 months follow up.
- Hoy D, Brooks P, Blyth F and Buchbinder R. The Epidemiology of low back pain. Best practice & research Clinical rheumatology. 2010; 24: 769-81.
- Hoy D, March L, Brooks P, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases. 2014; 73: 968-74.
- Australian Institute of Health and Welfare (AIHW). Impacts of chronic back problems. 2016.
- Dionne CE, Dunn KM and Croft PR. Does back pain prevalence really decrease with increasing age? A systematic review. Age and ageing. 2006; 35: 229-34.
- Rundell SD, Sherman KJ, Heagerty PJ, Mock CN and Jarvik JG. The clinical course of pain and function in older adults with a new primary care visit for back pain. Journal of the American Geriatrics Society. 2015; 63: 524-30.
- Hartvigsen J, Christensen K and Frederiksen H. Back and neck pain exhibit many common features in old age: a population-based study of 4,486 Danish twins 70-102 years of age. Spine. 2004; 29: 576-80.
- Manty M, Thinggaard M, Christensen K and Avlund K. Musculoskeletal pain and physical functioning in the oldest old. European journal of pain. 2014; 18: 522-9.
- Scheele J, Enthoven WT, Bierma-Zeinstra SM, et al. Course and prognosis of older back pain patients in general practice: a prospective cohort study. Pain. 2013; 154: 951-7.
- Australian Institute for Health and Family Welfare (AIHFW). Older Australia at a glance, Canberra: Australian Government. 2017.
- Scheele J, Luijsterburg PA, Ferreira ML, et al. Back Complaints in the Elders (BACE); design of cohort studies in primary care: an international consortium. BMC musculoskeletal disorders. 2011; 12: 193.