back pain

Geriatric-Focused Approach Could Improve Low Back Pain in Older Adults

Aging Back Clinics (ABC) could help to reduce pain and prevent potential morbidity in older veterans with chronic low back pain (CLBP), according to the results of a recent study.

“Treating CLBP with spine-focused interventions is common, potentially dangerous, and often ineffective,” the authors wrote. “This preliminary trial tests the feasibility and efficacy of caring for CLBP in older adults as a geriatric syndrome in ABC.

For their study, the researchers randomly assigned 55 veterans aged 60 to 89 years with CLBP and no signs of underlying illness, prior back surgery, dementia, impaired communication, or uncontrolled psychiatric illness to either ABC care or to usual care for 6 months.

ABC care consisted of:

  • History and physical examination to identify pain contributors.
  • Patient education.
  • Collaborative decision-making.
  • Care guided by condition-specific algorithms.

The primary outcomes of the study were back pain severity and pain-related disability.

Overall, participants assigned to ABC care showed significantly greater reductions in 7-day average and worst pain, as well as SF-12 interference with social activities at 6 months than did those assigned to usual care. Those assigned to ABC were also less likely to be using muscle relaxants, require pain-related emergency room visits, and use nonsteroidal anti-inflammatory drugs than those assigned to usual care.

“This preliminary trial demonstrates that treating older adults with CLBP using a comprehensive geriatric syndrome approach is feasible, received positively by patients and providers, and may be efficacious. If supported by a larger randomized controlled trial, the proposed approach could improve quality of life and reduce morbidity and misdirected health care utilization for millions of older adults,” the researchers concluded.

—Michael Potts

Reference:
Weiner DK, Gentili A, Rossi M, et al. Aging back clinics—a geriatric syndrome approach to treating chronic low back pain in older adults: results of a preliminary randomized controlled trial. Pain Medicine. 2020;21(2):274–290. https://doi.org/10.1093/pm/pnz179.