Skip to main content

Advertisement

SpringerLink
Log in

Risk factors for non-specific low back pain in older people: a systematic review with meta-analysis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To conduct a systematic review about risk factors associated with non-specific low back pain (LBP) in older people.

Methods

The study protocol was prospectively registered with Prospero (CRD42020191619). This systematic review with meta-analysis included cohort studies that investigated risk factors for LBP in older people. The following databases were searched up to 12 December 2020: MEDLINE (Ovid), Embase, CINAHL, SCOPUS and Web of Science. Two independent reviewers appraised methodological quality using the Critical Appraisal Checklist for Cohort Studies instrument.

Results

We identified 3939 potentially relevant publications. After removing duplicates, screening title, and abstracts, we assessed 86 publications in full text. We included the remaining 11 publications for analysis. There is strong evidence that depressive symptoms are a risk of reporting future back pain onset (I2 = 52,7%, Odds ratio 1.4, CI 1.28–1.53).

Conclusion

Depressive symptoms are a risk factor for LBP in older people. Due to the limitations of the literature, the role of some risk factors remains unclear. An additional high-quality prospective cohort is needed to better elucidate these relationships.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Maher C, Underwood M, Buchbinder R (2017) Non-specific low back pain. Lancet 389(10070):736–747. https://doi.org/10.1016/S0140-6736(16)30970-9

    Article  PubMed  Google Scholar 

  2. Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D (2020) Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med 8(6):299. https://doi.org/10.21037/atm.2020.02.175

    Article  PubMed  PubMed Central  Google Scholar 

  3. Rundell SD, Sherman KJ, Heagerty PJ, Mock CN, Jarvik JG (2015) The clinical course of pain and function in older adults with a new primary care visit for back pain. J Am Geriatr Soc 63(3):524–530. https://doi.org/10.1111/jgs.13241

    Article  PubMed  Google Scholar 

  4. Stewart Williams J, Ng N, Peltzer K, Yawson A, Biritwum R, Maximova T, Wu F, Arokiasamy P, Kowal P, Chatterji S (2015) Risk factors and disability associated with low back pain in older adults in low- and middle-income countries. Results from the WHO Study on Global AGEing and Adult Health (SAGE). PLoS ONE 10(6):127880. https://doi.org/10.1371/journal.pone.0127880

    Article  CAS  Google Scholar 

  5. do Carvalho NPR, Ferreira ML, Poitras S, Bilodeau M (2019) Exclusion of older adults from ongoing clinical trials on low back pain: a review of the WHO Trial Registry Database. J Am Geriatr Soc 67(3):603–608. https://doi.org/10.1111/jgs.15684

    Article  Google Scholar 

  6. Paeck T, Ferreira ML, Sun C, Lin CW, Tiedemann A, Maher CG (2014) Are older adults missing from low back pain clinical trials? A systematic review and meta-analysis. Arthritis Care Res 66(8):1220–1226. https://doi.org/10.1002/acr.22261

    Article  Google Scholar 

  7. Felício DC, Diz JBM, Pereira DS, Queiroz BZ, Silva JP, Moreira BS et al (2017) Handgrip strength is associated with, but poorly predicts, disability in older women with acute low back pain: a 12-month follow-up study. Maturitas 104:19–23. https://doi.org/10.1016/j.maturitas.2017.07.006

    Article  PubMed  Google Scholar 

  8. Kherad M, Rosengren BE, Hasserius R, Nilsson JÅ, Redlund-Johnell I, Ohlsson C, Mellström D, Lorentzon M, Ljunggren Ö, Karlsson MK (2017) Risk factors for low back pain and sciatica in elderly men-the MrOS Sweden study. Age Ageing 46(1):64–71. https://doi.org/10.1093/ageing/afw152

    Article  PubMed  Google Scholar 

  9. Yip YB, Ho SC, Chan SG (2001) Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women. J Adv Nurs 36(3):409–416. https://doi.org/10.1046/j.1365-2648.2001.01988.x

    Article  CAS  PubMed  Google Scholar 

  10. Yip YB, Ho SC, Chan SG (2004) Identifying risk factors for low back pain (LBP) in Chinese middle-aged women: a case-control study. Health Care Women Int 25(4):358–369. https://doi.org/10.1080/07399330490278367

    Article  CAS  PubMed  Google Scholar 

  11. Wong AY, Karppinen J, Samartzis D (2017) Low back pain in older adults: risk factors, management options and future directions. Scoliosis Spinal Disord 18(12):14. https://doi.org/10.1186/s13013-017-0121-3

    Article  Google Scholar 

  12. Van Tulder M, Furlan A, Bombardier C et al (2003) Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine 28:1290–1299. https://doi.org/10.1097/01.brs.0000065484.95996.af

    Article  PubMed  Google Scholar 

  13. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Lisy K, Qureshi R, Mattis P, Mu P. (2020) Systematic reviews of etiology and risk. In: Aromataris E, Munn Z (eds) JBI manual for evidence synthesis. https://doi.org/10.46658/JBIMES-20-08

  14. Docking RE, Fleming J, Brayne C, Zhao J, Macfarlane GJ, Jones GT (2011) Epidemiology of back pain in older adults: prevalence and risk factors for back pain onset. Rheumatol 50(9):1645–1653. https://doi.org/10.1093/rheumatology/ker175

    Article  Google Scholar 

  15. Hartvigsen J, Christensen K, Frederiksen H (2003) Back pain remains a common symptom in old age. A population-based study of 4486 Danish twins aged 70–102. Eur Spine J 12(5):528–5534. https://doi.org/10.1007/s00586-003-0542-y

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hartvigsen J, Christensen K, Frederiksen H, Pedersen HC (2004) Genetic and environmental contributions to back pain in old age—a study of 2,108 Danish twins aged 70 and older. Spine 29(8):897–901. https://doi.org/10.1097/00007632-200404150-00015

    Article  PubMed  Google Scholar 

  17. Hartvigsen J, Frederiksen H, Christensen K (2006) Physical and mental function and incident low back pain in seniors—a population-based two-year prospective study of 1387 Danish twins aged 70 to 100 years. Spine 31(14):1628–1632. https://doi.org/10.1097/01.brs.0000222021.00531.ea

    Article  PubMed  Google Scholar 

  18. Hartvigsen J, Christensen K (2007) Active lifestyle protects against incident low back pain in seniors: a population-based 2-year prospective study of 1387 Danish twins aged 70–100 years. Spine 32(1):76–81. https://doi.org/10.1097/01.brs.0000250292.18121.ce

    Article  PubMed  Google Scholar 

  19. Hubscher M, Hartvigsen J, Fernandez M, Christensen K, Ferreira P (2016) Does physical activity moderate the relationship between depression symptomatology and low back pain? Cohort and co-twin control analyses nested in the longitudinal study of aging Danish twins (LSADT). Eur Spine J 25(4):1226–1233. https://doi.org/10.1007/s00586-015-4138-0

    Article  PubMed  Google Scholar 

  20. Jacobs JM, Hammerman-Rozenberg R, Cohen A, Stessman J (2006) Chronic back pain among the elderly: prevalence, associations, and predictors. Spine 31(7):E203–E207. https://doi.org/10.1097/01.brs.0000206367.57918.3c

    Article  PubMed  Google Scholar 

  21. Makris UE, Fraenkel L, Han L, Leo-Summers L, Gill TM (2014) Risk factors for restricting back pain in older persons. J Am Med Dir Assoc 15(1):62–67. https://doi.org/10.1016/j.jamda.2013.09.013

    Article  PubMed  Google Scholar 

  22. Meyer T, Cooper J, Raspe H (2007) Disabling low back pain and depressive symptoms in the community-dwelling elderly—a prospective study. Spine 32(21):2380–2386. https://doi.org/10.1097/brs.0b013e3181557955

    Article  PubMed  Google Scholar 

  23. Parreira PCS, Maher CG, Ferreira ML, Machado GC, Blyth FM, Naganathan V et al (2017) A longitudinal study of the influence of comorbidities and lifestyle factors on low back pain in older men. Pain 158(8):1571–1576. https://doi.org/10.1097/j.pain.0000000000000952

    Article  PubMed  Google Scholar 

  24. Reid MC, Williams CS, Concato J, Tinetti ME, Gill TM (2003) Depressive symptoms as a risk factor for disabling back pain in community-dwelling older persons. J Am Geriatr Soc 51(12):1710–1717. https://doi.org/10.1046/j.1532-5415.2003.51554.x

    Article  PubMed  Google Scholar 

  25. Alexopoulos GS (2005) Depression in the elderly. Lancet 365:1961–1970. https://doi.org/10.1016/S0140-6736(05)66665-2

    Article  PubMed  Google Scholar 

  26. Carroll LJ, Cassidy JD, Cote P (2004) Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain 107:134–139. https://doi.org/10.1016/j.pain.2003.10.009

    Article  PubMed  Google Scholar 

  27. Sohrab A, Sepideh B, Esfandiar A (2020) Back pain and depressive symptoms: a systematic review and meta-analysis. Int J Psychiatry Med 27:91217420913001. https://doi.org/10.1177/0091217420913001

    Article  Google Scholar 

  28. Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA (2009) Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician 12(4):E35-70 (PMID: 19668291)

    Article  Google Scholar 

  29. Demyttenaere K, Bruffaerts R, Lee S, Posada-Villa J, Kovess V, Angermeyer MC et al (2007) Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain 129(3):332–342. https://doi.org/10.1016/j.pain.2007.01.022

    Article  PubMed  Google Scholar 

  30. Øiestad BE, Hilde G, Tveter AT, Peat GG, Thomas MJ, Dunn KM, Grotle M (2020) Risk factors for episodes of back pain in emerging adults. A systematic review. Eur J Pain 24(1):19–38. https://doi.org/10.1002/ejp.1474

    Article  PubMed  Google Scholar 

  31. Taylor JB, Goode AP, George SZ, Cook CE (2014) Incidence and risk factors for first-time incident low back pain: a systematic review and meta-analysis. Spine J 14:2299–2319. https://doi.org/10.1016/j.spinee.2014.01.026

    Article  PubMed  Google Scholar 

  32. Messing RB, Lytle LD (1977) Serotonin-containing neurons: their possible role in pain and analgesia. Pain 4(1):1–21. https://doi.org/10.1016/0304-3959(77)90083-5

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was financed the CNPq, Conselho Nacional de Desenvolvimento Científico e Tecnológico do Brasil (process 150262/2019-1) and CAPES, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (finance code 001).

Author information

Authors and Affiliations

  1. Programa Pós-Graduação Em Ciências da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil

    Diogo Carvalho Felício, Daniele S. Pereira, Vitor T. M. Rocha, Juliana M. M. Barbosa, Marcella Guimarães Assis & Leani S. M. Pereira

  2. Faculdade de Fisioterapia da Universidade Federal de Juiz de Fora (UFJF), Programa Pós-Graduação Em Ciências da Reabilitação E Desempenho Físico-Funcional, Juiz de Fora, MG, Brazil

    Diogo Carvalho Felício, José E. Filho, Túlio M. D. de Oliveira & Carla Malaguti

Authors
  1. Diogo Carvalho Felício
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. José E. Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Túlio M. D. de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniele S. Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Vitor T. M. Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Juliana M. M. Barbosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marcella Guimarães Assis
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Carla Malaguti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Leani S. M. Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Diogo Carvalho Felício.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 14 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Felício, D.C., Filho, J.E., de Oliveira, T.M.D. et al. Risk factors for non-specific low back pain in older people: a systematic review with meta-analysis. Arch Orthop Trauma Surg 142, 3633–3642 (2022). https://doi.org/10.1007/s00402-021-03959-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-021-03959-0

Keywords

Search

Navigation