Sarcopenia in elderly patients with chronic low back pain

Sakai, Yoshihito; Matsui, Hiroki; Ito, Sadayuki; Hida, Takeyuki; Ito, Kenyu; Koshimizu, Hiroyuki; Harada, Atsushi

doi:10.1016/j.afos.2017.09.001

Cited by 65 publications

(88 citation statements)

References 42 publications

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“…Four articles used participants from the same study [ 18 – 20 , 40 ], and there were three other instances of articles using data, reporting different outcomes, from the same study [ 47 , 58 , 35 , 39 , 55 ] and [ 38 , 42 ], leaving 21 unique studies. The regions with multiple studies using the same parameter were widespread, low-back, knee and foot and thus these were included in the quantitative analysis ( n = 14) [ 16 , 35 – 37 , 39 – 43 , 47 – 49 , 51 , 52 ]. All of the studies included in the meta-analysis were cross-sectional.…”

Section: Resultsmentioning

confidence: 99%

The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

Walsh

Arnold

Evans

et al. 2018

BMC Musculoskelet Disord

123

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BackgroundObesity and musculoskeletal pain are strongly related, but there is emerging evidence that body fat, not body weight, may be a better indicator of risk. There is, therefore, a need to determine if body fat is associated with musculoskeletal pain as it may improve management strategies. The aim of this systematic review was to investigate the association between body fat and musculoskeletal pain.MethodsSeven electronic databases were searched from inception to 8th January 2018. Cross-sectional and longitudinal studies investigating the association between measures of body fat and musculoskeletal pain were included. All included articles were assessed for methodological rigour using the Epidemiology Appraisal Instrument. Standardised mean differences (SMDs) and effect estimates were pooled for meta-analysis.ResultsA total of 10,221 citations were identified through the database searching, which after abstract and full-text review, yielded 28 unique articles. Fourteen studies were included in the meta-analyses, which found significant cross-sectional associations between total body fat mass and widespread pain (SMD 0.49, 95% CI 0.37–0.61, p < 0.001). Individuals with low-back pain and knee pain had a higher body fat percentage than asymptomatic controls (SMD 0.34, 95% CI 0.17–0.52, p < 0.001 and SMD 0.18, 95% CI 0.05–0.32, p = 0.009, respectively). Fat mass index was significantly, albeit weakly, associated with foot pain (SMD 0.05, 95% CI 0.03–0.06, p < 0.001). Longitudinal studies (n = 8) were unsuitable for meta-analysis, but were largely indicative of elevated body fat increasing the risk of incident and worsening joint pain. There was conflicting evidence for an association between body fat percentage and incident low-back pain (3 studies, follow-up 4–20 years). Increasing knee pain (1 study) and incident foot pain (2 studies) were positively associated with body fat percentage and fat mass index. The percentage of items in the EAI graded as ‘yes’ for each study ranged from 23 to 85%, indicating variable methodological quality of the included studies.ConclusionsThis systematic review and meta-analysis identified positive cross-sectional associations between increased body fat and widespread and single-site joint pain in the low-back, knee and foot. Longitudinal studies suggest elevated body fat may infer increased risk of incident and worsening joint pain, although further high-quality studies are required.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2137-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

Walsh

Arnold

Evans

et al. 2018

BMC Musculoskelet Disord

123

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“…Elderly patients that have significantly lower skeletal muscle mass and strength are considered to be associated with chronic pain [12,13].…”

Section: Proteins Rich In Essential Amino Acidsmentioning

confidence: 99%

Evidence-Based Role of Nutrients and Antioxidants for Chronic Pain Management in Musculoskeletal Frailty and Sarcopenia in Aging

et al. 2020

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Musculoskeletal disorders in aging and pain are closely connected because of multiple mechanisms leading to loss of mobility and autonomy. Pain is predictive of diability and worsening frailty and the strength of this relationship increases with the severity of pain. This study presents a systematic review of randomized controlled trials, cross sectional studies, and observational studies based on treatment of pain in adults with musculoskeletal disorders using nutritional non-pharmacological (nutrients and antioxidants) interventions. The review found the efficiency of the following topics: (a) accession of the patient to a dietary counselling (e.g., daily recommended amount of protein—equivalent to at least of 1 g of protein per kilogram of body weight); (b) intake of glutamic acid-rich such as soy, egg, and cod and tryptophan-rich foods such as milk and peanuts—or taking quick-acting, free-form supplements; (c) supplementation of vitamin D and magnesium, if lacking; (d) weekly consumption of fish or supplements of omega-3 fatty acids; and (e) availability of botanicals, in particular curcumin and gingerol. These non-pharmacological interventions can help the pain therapist to create a personalized medicine (precision medicine), acting with the maximum efficacy and safety, and also reducing the dosage of analgesic drugs needed.

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“…Spinal muscle volume significantly influences spinal disorders in terms of pain, life quality, and spinal function [46]. Studies have determined that the loss of muscle mass owing to aging can lead to an imbalance between the extensor and flexor muscles of the spine [47][48][49]. This imbalance associated with spinal sarcopenia, along with all its other alterations, is noted in various parts of the spine.…”

Section: Progression and Characteristics Of Spinal Sarcopeniamentioning

confidence: 99%

“…This imbalance associated with spinal sarcopenia, along with all its other alterations, is noted in various parts of the spine. Moreover, this phenomenon could be caused by degenerative scoliosis followed by a forward bending of the trunk, owing to the specific myopathy of the paraspinal muscles [48]. Furthermore, the cross-sectional area (CSA) of the paraspinal muscles tends to decrease with age; the fat infiltration rate also increases with age [50].…”

Section: Progression and Characteristics Of Spinal Sarcopeniamentioning

confidence: 99%

Novel Insights into the Pathogenesis of Spinal Sarcopenia and Related Therapeutic Approaches: A Narrative Review

Kuo

Lin

Lee

et al. 2020

IJMS

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Spinal sarcopenia is a complex and multifactorial disorder associated with a loss of strength, increased frailty, and increased risks of fractures and falls. In addition, spinal sarcopenia has been associated with lumbar spine disorders and osteoporosis, which renders making decisions on treatment modalities difficult. Patients with spinal sarcopenia typically exhibit lower cumulative survival, a higher risk of in-hospital complications, prolonged hospital stays, higher postoperative costs, and higher rates of blood transfusion after thoracolumbar spine surgery. Several studies have focused on the relationships between spinal sarcopenia, appendicular muscle mass, and bone-related problems—such as osteoporotic fractures and low bone mineral density—and malnutrition and vitamin D deficiency. Although several techniques are available for measuring sarcopenia, each of them has its advantages and shortcomings. For treating spinal sarcopenia, nutrition, physical therapy, and medication have been proven to be effective; regenerative therapeutic options seem to be promising owing to their repair and regeneration potential. Therefore, in this narrative review, we summarize the characteristics, detection methodologies, and treatment options for spinal sarcopenia, as well as its role in spinal disorders.

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Sarcopenia in elderly patients with chronic low back pain

Cited by 65 publications

References 42 publications

The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

Evidence-Based Role of Nutrients and Antioxidants for Chronic Pain Management in Musculoskeletal Frailty and Sarcopenia in Aging

Novel Insights into the Pathogenesis of Spinal Sarcopenia and Related Therapeutic Approaches: A Narrative Review

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