Back Pain and It’s Effect on Elderly People
The population of elderly people in USA is increasing. Most of the working female and male are retiring at the age of 65 years. Most of the retirees had spent entire working life at work and hoped to travel or spend some time in out door sports following retirement. But majority of the older populations are now spending most of the time in taking care of back pain and other health related diseases. Majority of the back pain, about 98% or so, are nonspecific and self-limiting. Image studies have revealed that up to 85% of people with low back pain, despite a thorough medical examination, have not shown any specific cause of the pain. Symptoms may disappear within 2 to 4 weeks in 98% of the patients complaining of low back pain. Only 2% of patients continue having symptoms beyond 4 weeks and are supported by specific diagnosis. Back pain is the second most common symptom after upper respiratory tract infection to consult primary care physician in USA. It is also the second most common pain symptom after headache requiring frequent emergency room visits. Disc herniation has been observed in 33% of the adults older than 30 years, but only 2% suffer with long-term chronic pain. In USA, 90% of population have suffered with chronic low back pain and were unable to work for few days. After the initial episode of back pain, 50% of these individuals will have recurrent back pain at least once or more than once. Often radicular pain or sciatica pain is associated with low back pain. 80% of patients recover without surgery after suffering with just low back pain without radicular leg pain.
The study of 252 older patients suggests osteoarthritis of facet joint was the most common cause of back pain in older patients.5 Therapeutic management of back pain includes medications, physical therapy, interventional pain therapy and surgery. The guidelines and several options of treatment have resulted in increased cost of treatment. The cost of back pain management will increase as the aging population is also increasing. Low back pain is also common among obese patient6.
Back pain has restricted travelling and outdoor activities among retirees.
Back Pain And It's Effect On Young People:
Recent published epidemiology study compared 4 levels of severe back pain. Study was published1 in 2014. Study suggests low back pain (LBP) causes more global disability than any other conditions.1 Chronic primary or secondary smoking causes back pain in younger population. Back pain is more common among teenage female patient with history of smoking or living with parents who are smokers.2 Back pain among younger workers was more related to work habit and working conditions. Proper posture and equipment had reduced the frequency of back pain among manual workers over the last two decades. Most of the back pain now is related to weight distribution and adopting posture while at work to prevent pain in extremities. Manual work causes extra load of weight transmitted through the back and posture during the work is adjusted by the worker to prevent pain in lower extremity. Study has suggested addition of extra sole in shoes prevent back pain.3
Back Pain And It's Effect On Drivers:
Low back pain is also common among professional drivers who may spend several hours in one position while driving either long distance or short distance with several breaks. Comparison between female and male driver suggests back pain is more common among female drivers than male drivers. Back pain among drivers is also related to the condition of the vehicle, which is driven regularly by same driver. Recent study of 8.4 million ethnically diverse US army drivers suggest risk of low back pain was higher among the driver than general population.4 Back pain is caused by abnormality or disease of muscles, vertebral column, epidural space and nerve pinch. Back pain in older population is often caused by degenerative disk or facet joint disease. Severe disk degeneration causes narrowing of disk height. Thinner disk causes foraminal stenosis resulting in pinch of spinal nerve or facet joint subluxation resulting in facet joint arthropathy. Pain caused by pinch nerve is often back pain with radicular pain and facet joint pain is mostly back pain.
Tips On Preventing Or Minimizing The Frequency Of Back Pain:
Past scientific studies suggest back pain can be prevented or frequency of back pain is minimized by avoiding smoking, maintaining proper posture during long time sitting, maintaining proper weight and performing regular exercise.
1. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study.
Hoy D1, March L, Brooks P, Blyth F, Woolf A, Bain C, Williams G, Smith E, Vos T, Barendregt J, Murray C, Burstein R, Buchbinder R.
Ann Rheum Dis. 2014 Mar 24.
2. Spine Day 2012: spinal pain in Swiss school children- epidemiology and risk factors.
Wirth B1, Knecht C, Humphreys K.
BMC Pediatr. 2013 Oct 5;13:159.
3. The effect of cushioning insoles on back and lower extremity pain in an industrial setting.
Workplace Health Saf. 2013 Oct;61(10):451-7.
4. Occupational driving as a risk factor for low back pain in active-duty military service members.
Knox JB1, Orchowski JR2, Scher DL3, Owens BD4, Burks R5, Belmont PJ Jr3.
Spine J. 2014 Apr 1;14(4):592-7.
5. Presence and extent of severe facet joint osteoarthritis are associated with back pain in older adults.
Suri P1, Hunter DJ, Rainville J, Guermazi A, Katz JN.
Osteoarthritis Cartilage. 2013 Sep;21(9):1199-206.
6. An epidemiologic analysis of low back pain in primary care: a hot humid country and global comparison.
Bener A1, Dafeeah EE, Alnaqbi K, Falah O, Aljuhaisi T, Sadeeq A, Khan S, Schlogl J.
J Prim Care Community Health. 2013 Jul 1;4(3):220-7.