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Severe Neck and Low Back Pain Predicts Severe Pain 5 Years Later in Older Men: A Cohort Study
Henrik Damm1, Björn E Rosengren1, Lars Jehpsson1
1Orthopedics, Faculty of Medicine, Departments of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
Purpose:
To describe the prevalence of neck pain (NP) and low back pain (LBP) of varying severity in older community-dwelling men, identify associated factors, and evaluate whether prevalent NP/LBP are risk factors for experiencing pain 5 years later.
Patients And Methods:
MrOS Sweden is a prospective observational study that included 3014 community-dwelling men aged 69-81 years, of whom 1962 attended a 5-year follow-up. NP/LBP were assessed based on 1-year prevalence (yes/no), pain severity (none, mild, moderate, severe), and the presence of radicular pain with or without motor deficits (yes/no), at both baseline and follow-up.
Results:
At baseline, the 1-year prevalence for having either NP, LBP, or both was 55%. The 1-year prevalence for NP was 29% and for LBP 45%. Among men with NP, 18% reported severe pain, while 17% of men with LBP reported severe pain. Men with NP at baseline had a relative risk (RR) of 4.0 (95% CI: 3.4-4.6) for reporting NP 5 years later, compared to men without NP at baseline. Men with severe NP had an RR of 10.7 (95% CI: 7.5-15.1) for reporting severe NP 5 years later, compared to men without severe NP at baseline. The corresponding RRs for LBP were 2.8 (95% CI: 2.5-3.1) and 6.5 (95% CI: 4.9-8.6). Poor self-rated health and dizziness were associated with NP/LBP at both time points, while smoking was associated with lower risk of NP.
Conclusion:
More than half of community-dwelling men aged 69-81 experience pain in the spinal region during a year (nearly one-third NP and just below half LBP). The majority experience only mild to moderate pain. Baseline pain, especially severe pain, strongly predicts pain 5 years later, and associated factors may help identify high-risk groups suitable for targeted interventions.
Insights
Over half of older men experience neck pain (NP) or low back pain (LBP), with severe pain at baseline significantly predicting future pain. Identifying associated factors like poor self-rated health can help target interventions for older adults.
Area of Science:
- Gerontology
- Epidemiology
- Musculoskeletal Health
Background:
- Neck pain (NP) and low back pain (LBP) are common issues in aging populations.
- Understanding the prevalence and risk factors for spinal pain in older men is crucial for public health.
- Previous studies may not fully capture the long-term impact of prevalent NP/LBP in this demographic.
Purpose of the Study:
- To determine the prevalence of neck pain (NP) and low back pain (LBP) of varying severity in community-dwelling older men.
- To identify factors associated with the presence of NP and LBP.
- To assess if prevalent NP/LBP predict future pain experiences over a 5-year period.
Main Methods:
- Prospective observational study (MrOS Sweden) including 3014 men aged 69-81 years.
- Assessment of 1-year prevalence, pain severity (none to severe), and radicular symptoms at baseline and 5-year follow-up.
- Statistical analysis including relative risk (RR) calculations to evaluate predictive value of baseline pain.
Main Results:
- At baseline, 55% reported NP, LBP, or both; 29% had NP, 45% had LBP.
- Severe NP and LBP at baseline were strongly associated with reporting similar pain 5 years later (RR 10.7 for severe NP, RR 6.5 for severe LBP).
- Poor self-rated health and dizziness were associated with NP/LBP; smoking showed a lower risk for NP.
Conclusions:
- More than half of older men experience spinal pain annually, with mild to moderate severity being most common.
- Baseline pain, particularly severe NP or LBP, is a strong predictor of persistent pain over 5 years.
- Associated factors like self-rated health can aid in identifying high-risk individuals for targeted interventions.
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