Evaluation and Management of Back Pain in the Elderly

Abstract

Back pain is common in the elderly. Most back pain is uncomplicated but identifying back pain due to serious systemic disease is essential. History and physical exam are critical to this distinction and guide further diagnostic evaluation. There are numerous treatments available for acute and chronic back pain, yet there are special considerations when treating the elderly. Treatment is comprehensive with pharmacotherapy, physical therapy, and alternative methods. Pharmacologic therapy for back pain is targeted at reducing inflammation and providing analgesia. Physical therapy is a necessary part of any treatment plan. Non-pharmacologic treatments are broad in scope and consist of activity-based modalities and alternative therapies. Acute back pain generally has a good prognosis, while chronic back pain can be associated with significant morbidity. This update will review the epidemiology, pathophysiology, evaluation, and treatment of back pain with a particular emphasis on issues unique to the geriatric population.

Differences in performance on the functional movement screen between chronic low back pain patients and healthy control subjects

“…The FMS is designed to challenge the interaction of kinetic chain mobility and stability, which is necessary to perform fundamental and functional movement patterns 9 , 10 ) . Therefore, the FMS may be a useful tool for identifying movement deficits in CLBP patients, who tend to show decreased mobility, core stability, and coordination 11 ) . However, no study has examined FMS in CLBP patients.…”