Clinical characteristics of geriatric patients with non-specific chronic low back pain

Abstract

A comprehensive analysis of clinical information in patients with chronic low back pain (CLBP) was performed to clarify the clinical characteristics of geriatric LBP from the perspective of body composition, spinal alignment, and blood findings related to senescence. We enrolled 203 patients with an average age of 79.0 years (77 men and 126 women), with non-specific CLBP as a single-center prospective cohort study, the patients were compared with age- and sex-matched controls without CLBP using a propensity score-matching. We performed laboratory analysis, radiographic evaluations for global spinal parameter and lumbar degeneration, and body composition analysis using whole-body dual-energy X-ray absorptiometry. We observed a higher red blood cell distribution width (RDW) (p < 0.001), which is an index of aging, as well as a lower vitamin D level (p = 0.002), skeletal muscle mass index (p = 0.045) and a higher fat mass (p = 0.007) in patients with CLBP. Moreover, patients with geriatric CLBP had significantly lower lumbar lordosis (p = 0.024), and higher sagittal vertical axis (p = 0.006) was correlated with lower extremity and trunk muscle mass (p < 0.001), independent of lumbar degeneration. Geriatric patients with CLBP have sarcopenic fat accumulation and spinal sagittal malalignment with senescent status, such as elevated RDW and hypovitaminosis D.

Virtual reality: a promising non-pharmacological modality for chronic low back pain management in elderly

“…Chronic low back pain (CLBP), as a major and potentially disabling musculoskeletal conditions, is highly prevalent among older adults [ 1 ]. Previous studies revealed that in different parts of the world approximately 30% of older adults experience CLBP that lasts for at least 3 months [ 2 , 3 ].…”

“…It has been previously shown that, despite its high prevalence and numerous negative consequences, CLBP in older adults remains untreated. Therefore, identifying a safe and cost-effective adjunctive treatment modality for CLBP management is crucial [ 1 , 6 , 7 ].…”

Relationships Between Skeletal Muscle Mass, Lumbar Lordosis, and Chronic Low Back Pain in the Elderly

“…Considering that muscle is vital for protecting the integrity of the musculoskeletal system, there must be meaningful associations between loss of skeletal muscle mass and painful musculoskeletal conditions. Previous studies examining the relationship between regional muscle mass and CLBP reported that the cross-sectional area of the trunk and back muscles, as assessed by computed tomography (CT) or magnetic resonance imaging (MRI), were reduced in patients with CLBP [ 6 - 8 , 13 ]. In addition, biomechanical factors underlying CLBP are influenced not only by trunk and back muscles but also by extremity muscles such as large hip muscles [ 14 , 15 ].…”

“…In addition, biomechanical factors underlying CLBP are influenced not only by trunk and back muscles but also by extremity muscles such as large hip muscles [ 14 , 15 ]. Furthermore, previous studies have shown an association between CLBP and low appendicular skeletal muscle mass (ASM), as assessed by bioelectrical impedance analysis (BIA) [ 7 , 8 ]. This supports the hypothesis that CLBP may share a close relationship with age-related loss of skeletal muscle mass, so called sarcopenia.…”

The Back Muscle Surface Electromyography-Based Fatigue Index: A Digital Biomarker of Human Neuromuscular Aging?

“…Low physical activity level is a key manifestation of the aging-related loss of muscle function [ 1 , 2 ], frequently present in persons with chronic low back pain (cLBP). Non-specific cLBP refers to pain in the lower back without a proven cause, and includes patients who present with imaging-based degenerative features of the spinal column [ 11 , 12 ]. As cLBP is the most prevalent health condition with epidemic-like dimensions in all age groups, it would be desirable to identify the digital biomarkers of aging-related decline in (neuro)muscular function, particularly from the back extensor muscles in this specific population.…”