For people over 55 years old, if you only use medicine for your lower back pain, you can expect to get most of your relief in the first 3-6 months. Most of you will not become pain free within 3 months, and this does not improve over 5 years. ~ Dr. Broussard
Wendelien H. van der Gaag, Wendy T. M. Enthoven, Pim A. J. Luijsterburg, Jantine van Rijckevorsel-Scheele, Sita M.A. Bierma-Zeinstra, Arthur M. Bohnen, Maurits W. van Tulder and Bart W. Koes
The Journal of the American Board of Family Medicine
November 2019, 32 (6) 781-789; DOI: https://doi.org/10.3122/jabfm.2019.06.190041
Abstract
Introduction: Back pain is a prevalent health problem. Research often focuses on adults. Evidence on the long-term course of back pain in older patients is limited. A prospective cohort study (BACE) was conducted in a primary care setting in the Netherlands. We aim to investigate the 5-year course and medical consumption of older adults (>55 years) presenting with back pain in general practice.
Methods: Patients aged >55 years, consulting their general practitioner with a new back pain episode, were included between 2009 to 2011. Follow-up questionnaires included, for example, pain severity, disability, quality of life, recovery, and medical consumption.
Results: A total of 675 patients (mean age ± SD, 66.4 ± 7.6 years) participated, showing a mean (± SD) back pain reduction from 5.2 (± 2.7) to 3.6 (± 2.8) (numeric rating scale, 0 to 10) at 3 months follow-up; disability decreased from 9.8 (± 5.8) to 7.8 (± 6.2) (Roland-Morris Disability Questionnaire, 0 to 24). After 6 months, this remained practically constant over time. Medical consumption was highest in the first months; medication was used by 72% at baseline and approximately one-third (25% to 39%) during follow-up. At 5-year follow-up (response rate 58%; n = 392), 43% had recovered; a majority reported persistent or recurrent back pain.
Conclusion: Clinically relevant improvements in back pain intensity and disability were seen in the first 3 to 6 months of follow-up. A majority of patients does not become pain free within 3 months; this does not improve over 5 years. However, most patients stop consulting health care professionals during follow-up. Current medical strategies may not be sufficient in older back pain patients, where back pain becomes a recurrent or chronic condition in the majority of patients.