Clinics (Sao Paulo) 2019 (Oct 28); 74: e789 ~ FULL TEXT
Ingred Merllin Batista de Souza, Tina Fujii Sakaguchi, Susan Lee King Yuan, Luciana Akemi Matsutani, Adriana de Sousa do Espírito-Santo, Carlos Alberto de Bragança Pereira, Amélia Pasqual Marques
Departamento de Fisioterapia,
Fonoaudiologia e Terapia Ocupacional,
Faculdade de Medicina,
Universidade de Sao Paulo, Sao Paulo, SP, BR.
The aim of this study was to estimate the prevalence of low-back pain (LBP) and to identify the level of functional disability in elderly individuals in different populations. From January 1985 to October 2018, a search was performed using the following databases: Embase, LILACS, SciELO, Scopus, Medline, and the Web of Science. The descriptors were low-back pain, back pain, lower-back pain, prevalence, and elderly in Portuguese and English. Two independent reviewers conducted a search for studies and evaluated their methodological quality. The search strategy returned 2,186 titles, and 35 were included in this review. The studies evaluated 135,059 elderly individuals aged between 60 and 102 years, and the prevalence of LBP ranged from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This review indicated a high prevalence of LBP in elderly individuals and functional disability that affects factors important for independence. However, the studies used different methodologies, suggesting that more studies be conducted with scientific accuracy, methodological quality, and low risk of bias to contribute to the proposal of preventive actions for elderly populations.
Keywords: Prevalence, Low Back Pain, Spine, Elderly, Systematic Review
From the FULL TEXT Article:
Low-back pain (LBP) is one of the most common health problems in primary care.  LBP can be defined as any pain between the last ribs and the lower gluteal folds, with or without pain in the lower limbs.  In addition, the duration of pain is one criterion for LBP classification. Acute LBP has a sudden onset and lasts less than six weeks, subacute LBP lasts from six to 12 weeks, and chronic LBP presents for a period greater or equal to 12 weeks. 
It is estimated that 70% to 85% of the population will experience an episode of LBP at some point. Ninety percent of these individuals will have more than one episode. [4–6] The United States spent more than $100 billion on LBP-related healthcare in 2005 , and these costs are expected to increase as the prevalence of back pain also increases. 
Historically, research on LBP has primarily focused on young people and adults, while little attention has been given to the elderly population.  There is evidence that LBP may be responsible for a large percentage of functional limitations , result in difficulty performing daily life activities , and be a risk factor for incapacity and invalidity. LBP is one of the symptoms most frequently reported by older people.  Notwithstanding the fact that it has been identified as a major health problem, its prevalence is not well known in the elderly population. [13, 14]
This systematic review aims to identify, analyze and synthesize, in a systematic way, the prevalence of LBP in the elderly population.
The protocol of this review is registered at PROSPERO (CRD42019118004), and the methods followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. 
Search Strategy and Literature Sources
Searches were performed in the following databases: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences (LILACS), US National Library of Medicine (Medline), Scopus Info Site (Scopus), the Web of Science, and Embase (Excerpta Medica).
The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) used for the English search were low-back pain, back pain, lower back pain, prevalence, and elderly; for the search in Portuguese, they were low-back pain, prevalence, and elderly. For MeSH and DeCS, the operators “OR” and “AND” were used to form research topics that could be combined. The search strategy is shown in the supplementary material.
The inclusion criteria were as follows: studies that primarily or secondarily investigated LBP prevalence among elderly individuals aged 60 years or over according to the World Health Organization ; studies that included both sexes and individuals living in the community or institutionalized (in clinics, hospitals or public or private care institutions), regardless of duration of LBP symptoms (i.e., acute, subacute, or chronic LBP); and articles that are available in English or Portuguese.
Studies published in Portuguese and English with a cross-sectional design from 1985 to October 2018 were searched. Two independent reviewers (IMBS and TFS) selected studies based on the title and summary. The ones that met the eligibility criteria were analyzed and evaluated. After fully reading the selected studies, no conflicts were found between the two independent reviewers.
The descriptive data extracted and analyzed from the studies were as follows: first author/year of publication, participant's characteristics (sex, age, population), country, instrument of collection, sample size, definition of LBP, absolute frequency of LBP, prevalence, investigated duration of LBP and functional disability level.
Risk of bias assessment
To assess the risk of bias and the methodological quality, the instrument developed by Hoy et al. was used.  Considering that selected studies could present potential sources of bias that could influence the results (Table 2), the tool was used to assess the risk of bias of the eligible studies. This instrument allows for the verification of the risk of bias related to external and internal validity, allowing for the classification of the risk of bias as low, moderate, or high. This instrument was chosen mainly because it is easy to use, shows high interexaminer agreement, and was developed specifically to measure the risk of bias in prevalence studies of patients with LBP.
This instrument  uses the following criteria:
(1) representativeness of the study sample in relation to the national population to assess the generalizability of the results;
(2) a sampling system that represents the target population;
(3) a method for selecting the sample;
(4) probability of nonresponse bias;
(5) method of obtaining a response of interest;
(6) definition of LBP used to select the sample;
(7) reliability and validity of the tools used;
(8) standardization of the collection process;
(9) period of prevalence of appropriate interest; and
(10) presence of error in calculation and/or reporting values of the numerator and denominator of the parameter of interest.
The first four topics are related to the external validity of the study. Consequently, the other items report the risk of bias in categories relating to internal validity. At the end of the analysis, studies with at least nine criteria were classified as having a low risk of bias; studies that had between seven and eight of the criteria had a medium risk of bias; and those with less than seven of the criteria had a high risk of bias.
Summary of included studies
We identified 2,186 titles; of these, 38 were duplicates. During the search by title and abstract, 2,148 studies were selected, and 1,936 were excluded after reading the summaries. One hundred six studies were selected for full-text reading, and only 35 met the eligibility criteria and were included in the systematic review (Figure 1). Because of great heterogeneity, a meta-analysis was not possible.
Characteristics of the studies
The prevalence of LBP among the elderly individuals ranged from 21 to 75%. These studies included a total of 135,059 elderly individuals, with sample sizes ranging from 54 to 55,690 elderly individuals, and LBP was present in 34,516 of the participants (Tables 1, Table 2, Table 3).
An approach regarding complaints of LBP at different moments was found in this systematic review. Eight studies [18–25] addressed acute LBP prevalence, and 21 studies [26–46] addressed chronic LBP prevalence; however, six studies [47–52] did not specify the prevalence period investigated.
Of the 35 original studies, 26 included both sexes. The age range was from 60 to ≥86 years, and the places where the studies took place included North America (USA and Canada), South America (Brazil), Europe (Spain, Sweden, Italy, Denmark and Switzerland), Asia (Japan, South Korea, Bangladesh, Taiwan, and China), and Africa (Nigeria).
Regarding data collection instruments, a customized questionnaire was employed in 20 studies [18–22, 24, 26–28, 32, 35, 43–45], and a Roland-Morris questionnaire was employed in four studies. [31, 36–38] The Oswestry questionnaire [47, 50], the Visual Analog Scale [31, 38], the Face Pain Scale [23, 41], the Numeric Scale [40, 41], the Physical Activity Scale of the Elderly [33, 36], and the Nordic questionnaire [39, 45] were employed in two studies each. The following instruments were used in only one study each: the Lawton questionnaire , the McGill questionnaire , the Quebec Pain Disability Scale , the Graded Chronic Pain Scale , the North American Spine Society Questionnaires for Back and Neck Pain , the Katz index  and medical records from a physiotherapy clinic school at the State University of Southwestern Bahia, Brazil. 
Functional disability due to LBP was investigated in 60% of the studies, and LBP was shown to hinder functionality [18, 20, 21, 23, 27, 28, 30, 37, 39] and result in major dependence for daily living activities [24, 29, 48, 38, 52] and physical capacity. [30, 33, 36, 24, 46]
The methodological quality assessment (Table 4) ranged from four to ten points. Four studies [19, 25, 28, 42] presented methodological quality without risk of bias, and eleven studies [20, 23, 27, 29, 34, 38–40, 43] were classified as a low risk of bias. Seventeen [18, 21, 22, 24, 26, 30, 31, 33, 35–37, 41, 45–47, 51, 52] were classified as having a medium risk of bias, and three studies [32, 48, 49] presented a high risk of bias, with scores lower than seven.
Among all chronic pain problems and spinal pain conditions, LBP is the most common public health, economic, and social problem. Moreover, LBP affects the population indiscriminately worldwide.  Nevertheless, the prevalence of LBP varies according to the definitions used and the population studied. 
This systematic review summarizes the international literature data on the prevalence of LBP in the elderly population. The results indicate a high prevalence of LBP among elderly individuals, ranging from 21.7 to 75%.
Furthermore, the prevalence of LBP is high in developed countries such as:
Canada  (75%),
the United States  (67%),
Sweden  (49%),
China  (39.2%) and
Japan  (32%).
LBP occurs in 43% of both men and women, differing from the mean global prevalence, which was 31%.  This finding was also true in developing countries such as Brazil, where the prevalence was 33.6% to 68.3%. In other Brazilian studies [37, 39], the small samples studied may have contributed to a high prevalence, and the samples may not have been representative of the study population.
Only one systematic review performed in 1999, including only developed countries in the Northern Hemisphere, evaluated the prevalence of LBP among elderly individuals. This study also showed a prevalence ranging from 12.8% to 51% (age above 65 years), based on the prevalence of punctual pain, pain in the last six months and pain in the last year.  Another systematic review of the prevalence of spinal pain among elderly individuals, including studies conducted in developed countries, presented a 20% prevalence (≥60 years).  However, the study did not separately analyze elderly individuals with LBP.
It was found that 46.6% of the studies included in the review defined a six-month period of LBP in the last year as chronic LBP; this definition was in accordance with one of the diagnostic criteria for research on chronic noncancer pain recommended by the taxonomy of the “International Association for Study of Pain”. 
The most recent assessment of the global prevalence of punctual LBP comprising all age groups estimated that pain is an emerging problem in the elderly population that requires monitoring , especially in developing countries. Furthermore, another study reported that LBP is more frequent and is characterized by longer episodes in elderly individuals than in young adults. 
The proportion of elderly individuals (60 years or more) in almost all developed and developing countries worldwide is increasing faster than any other age group.  In a world report on aging and health by the World Health Organization (WHO), it was stated that the world population aged over 60 years will increase from the current 841 million to two billion by 2050, turning chronic diseases and the welfare of older people into new challenges for global public health. [58, 59]
Fejer et al.  reported that the prevalence of LBP increases until 80 years of age and then decreases slightly, except among women, who report a greater frequency of LBP than men. There are several possible explanations for the decline in pain with advancing age (from 80 years on). Not only is there an increase in life expectancy, there is also an increase in the incidence of chronic noncommunicable diseases, which leads to increased morbidity and disability.  Pain is experience by elderly individuals due to their fragility, threatening their safety, autonomy, and independence. Pain often prevents them from performing daily life activities, as well as limits their social interactions, which are situations that considerably diminish their quality of life. 
Consequently, pain among elderly individuals should be considered as a continuation of pain from previous years , while accepting that pain among the elderly population occurs as a part of aging.  In other words, pain becomes a natural part of life; therefore, it becomes less disturbing or it is simply ignored. Finally, a decline in the prevalence of pain in the elderly population may be explained by a phenomenon of “survival of the fittest”. 
Another aspect that can be highlighted in this review is the greater prevalence among females observed in various studies [22, 23, 33, 39, 42, 47, 48]; the prevalence ranged from 35% to 82%. These findings confirm that women outlive men, despite suffering longer exposure to risk factors; women live with more comorbidities and experience the chronicity of clinical conditions – a phenomenon called “feminization” of old age.  A recent systematic review showed that the prevalence of LBP seemed higher among middle-aged adults and women.  A biopsychosocial model of chronic pain attributes sexual differences in pain to interactions between biological, psychological, and sociocultural factors. [67, 68] A greater sensitivity to pain among women may also partially explain higher reports of pain by women than by men. 
Although most LBP is self-limiting, begins to improve after a few days and resolves within a month , some patients are susceptible to chronic LBP that leads to significant disability. Age is a well-known risk factor for chronic LBP , and other factors may perpetuate LBP in older adults. The understanding of these factors can help identify high-risk patients and improve their LBP management. Since older adults usually face both age-related physical and psychosocial issues, comprehensive assessments and treatments are needed to effectively manage LBP in the elderly population.
Methodological limitations, when related to external validity relevant to criterion  (representatives of the study sample in relation to the national population to allow for the generalizability of results), were not found in 22 studies. [18, 22, 24, 27, 29, 31–34, 36, 37, 40, 41, 43–48] The researchers involved in these studies conducted data collection in regions or municipalities without nationally representing the target population, which would not occur if there were core studies or multicentric groups to produce representative samples. Random selection was used in 18 studies. [19–22, 24, 27, 29, 34, 35, 37, 41, 51, 53] In the remaining studies, convenience sampling was the technique of choice to obtain quick, low-cost information.  Regarding internal validity, which was involved in this criterion , 53.3% of the studies [18–22, 26–30, 33, 35, 37, 40, 42, 48, 49, 51, 52] used their own questionnaires. These studies only questioned whether the individuals had LBP or not. Nonetheless, the lack of standardization of instruments used in data collection may have influenced the results. 
We attempted to minimize these limitations by evaluating the methodological criteria of the eligible studies, but unlike other reviews [72, 73], we did not establish a cut-off point based on this methodological evaluation to include the studies in this review.
Based on previous findings and the most recent global prevalence of occasional LBP, including all age groups (i.e., 9.4%, 95% CI 9 to 9.8) , this review estimates that LBP is a health problem in the elderly population. The adequate epidemiological description of LBP in the elderly can improve the distribution of resources for the clinical management of this condition, especially in developing countries. [58, 69, 74] Data show that both the number and proportion of individuals aged older than 65 years have been increasing in most western populations.  It is believed that LBP will lead to even greater health care costs in the future. 
This study helped to reveal the main shortcomings of the current studies on the prevalence of LBP in the elderly population worldwide. These findings can guide actions to produce robust evidence on this topic in future studies and in clinical practice. We strongly recommend the performance of further robust studies with low risk of bias and consistent LBP definitions.
The limitation of the study was the different definitions of LBP used in the studies, which may lead to a misunderstanding about the actual location of LBP. In addition, a uniform definition of LBP for the purpose of LBP epidemiological studies would significantly enhance our ability to compare and pool results across studies.
This systematic review indicates a high prevalence of LBP in the elderly population and that functional disability affects factors that are important for independence. However, the investigated studies present diverse methodologies, and different definitions of LBP were used, suggesting that more research should be carried out with scientific accuracy, methodological quality and low risk of bias to contribute towards developing preventive actions for the elderly population affected by LBP. Finally, such studies will provide information to devise public policy plans by health managers and professionals.
Souza IMB designed the study, edited the manuscript and critically reviewed its final version. Sakaguchi TF acquired some of the data. Yuan SLK, Espirito-Santo AS and Matsutani LA critically reviewed the final version of the manuscript. Pereira CAB conducted the statistical analysis. Marques AP performed the data collection and analysis, and critically reviewed the final version of the manuscript. All authors read and approved the final version of the manuscript.
The authors would like to thank all collaborators in the Laboratory of Professor PhD Marques for their collaboration and support since 2016.
J Rapoport, P Jacobs, NR Bell, S Klarenbach
Refining the measurement of the economic burden of chronic diseases in Canada
Chronic Dis Can, 25 (1) (2004), pp. 13-21
Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al.
Chapter 4. European Guidelines for the Management of Chronic Nonspecific Low Back Pain
European Spine Journal 2006 (Mar); 15 Suppl 2: S192–S300
R Martins, MH Foss, R Santos Junior, M Zancheta, IC Pires, AMR Cunha, et al.
A eficácia da conduta do grupo de postura em pacientes com lombalgia crônica
Rev Dor, 11 (2) (2010), pp. 116-121
MC Silva, AG Fassa, NC Valle
[Chronic low back pain in a Southern Brazilian adult population: prevalence and associated factors]
Cad Saude Publica, 20 (2) (2004), pp. 377-385
Programa Nacional de Promoção da Atividade Física “Agita Brasil”: Atividade física e sua contribuição para a qualidade de vida
Rev Saude Publica, 36 (2) (2002), pp. 254-256
Epidemiological features of chronic low-back pain
Lancet, 354 (9178) (1999), pp. 581-585
Lumbar disc disorders and low-back pain: socioeconomic factors and consequences
J Bone Joint Surg Am, 88 (Suppl 2) (2006), pp. 21-24
JK Freburger, GM Holmes, RP Agans, AM Jackman, JD Darter, AS Wallace, et al.
The rising prevalence of chronic low back pain
Arch Intern Med, 169 (3) (2009), pp. 251-258
Woolf AD, Pfleger B.
Burden of Major Musculoskeletal Conditions
Bull World Health Organ 2003 (Nov 14); 81: 646–656
SL Edmond, DT Felson
Function and back symptoms in older adults
J Am Geriatr Soc, 51 (12) (2003), pp. 1702-1709
JK Cooper, T Kohlmann
Factors associated with health status of older Americans
Age Ageing, 30 (6) (2001), pp. 495-501
MJ Teixeira, WGJ Teixeira, FPS Santos, DCA Andrade, SL Bezerra, JB Figueiró, et al.
Epidemiologia clínica da dor músculo-esquelética
Rev Med, 80 (ed. esp. pt.1) (2001), pp. 1-21
HB Bressler, WJ Keyes, PA Rochon, E Badley
The prevalence of low back pain in the elderly. A systematic review of the literature
Spine, 24 (17) (1999), pp. 1813-1819
Low back pain, health status, and quality of life in older adults: challenge and opportunity
Pain Med, 4 (4) (2003), pp. 305-307
D Moher, A Liberati, J Tetzlaff, DG Altman
Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
Ann Intern Med, 151 (4) (2009), pp. 264-269
World Health Organization
Active Ageing: A Policy Framework. A Contribution of the World Health Organization to the Second United Nations World Assembly on Ageing
Accessed Oct 2019
D Hoy, P Brooks, A Woolf, F Blyth, L March, C Bain, et al.
Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement
J Clin Epidemiol, 65 (9) (2012), pp. 934-939
J Hartvigsen, K Christensen, H Frederiksen
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) (2003), pp. 528-534
SL Blay, SB Andreoli, FL Gastal
Chronic painful physical conditions, disturbed sleep and psychiatric morbidity: results from an elderly survey
Ann Clin Psychiatry, 19 (3) (2007), pp. 169-174
T Meyer, J Cooper, H Raspe
Disabling low back pain and depressive symptoms in the community-dwelling elderly: a prospective study
Spine, 32 (21) (2007), pp. 2380-2386
MG Lima, MB Barros, CL César, M Goldbaum, L Carandina, RM Ciconelli
Impact of chronic disease on quality of life among the elderly in the state of São Paulo, Brazil: a population-based study
Rev Panam Salud Publ, 25 (4) (2009), pp. 314-321
AM Rana, A Wahlin, PK Streatfield, ZN Kabir
Association of bone and joint diseases with health-related quality of life among older people: a population-based cross-sectional study in rural Bangladesh
Ageing Soc, 29 (05) (2009), pp. 727-743
C Gálvez-Barrón, L Narvaiza, MD Dapena, O Macho, A Rodríguez-Molinero
Prevalence and treatment of pain in non-institutionalized very old population: transversal study at national level
Aging Clin Exp Res, 28 (2) (2016), pp. 347-353
Y Tomita, K Arima, M Kanagae, T Okabe, S Mizukami, T Nishimura, et al.
Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older
Medicine, 94 (35) (2015), Article e1449
C Cedraschi, C Luthy, AF Allaz, FR Herrmann, C Ludwig
Low back pain and health-related quality of life in community-dwelling older adults
Eur Spine J, 25 (9) (2016), pp. 2822-2832
M Lavsky-Shulan, RB Wallace, FJ Kohout, JH Lemke, MC Morris, IM Smith
Prevalence and functional correlates of low back pain in the elderly: the Iowa 65+ Rural Health Study
J Am Geriatr Soc, 33 (1) (1985), pp. 23-28
DK Weiner, CL Haggerty, SB Kritchevsky, T Harris, EM Simonsick, M Nevitt, et al.
How does low back pain impact physical function in independent, well-functioning older adults? Evidence from the Health ABC Cohort and implications for the future
Pain Med, 4 (4) (2003), pp. 311-320
F Cecchi, P Debolini, RM Lova, C Macchi, S Bandinelli, B Bartali, et al.
Epidemiology of back pain in a representative cohort of Italian persons 65 years of age and older: the InCHIANTI study
Spine, 31 (10) (2006), pp. 1149-1155
MS Dellaroza, CA Pimenta, YA Duarte, ML Lebrão
[Chronic pain among elderly residents in São Paulo, Brazil: prevalence, characteristics, and association with functional capacity and mobility (SABE Study)]
Cad Saude Publica, 29 (2) (2013), pp. 325-334
GE Hicks, JM Gaines, M Shardell, EM Simonsick
Associations of back and leg pain with health status and functional capacity of older adults: findings from the retirement community back pain study
Arthritis Rheum, 59 (9) (2008), pp. 1306-1313
F Kovacs, J Noguera, V Abraira, A Royuela, A Cano, MT Gil del Real, et al.
The influence of psychological factors on low back pain-related disability in community dwelling older persons
Pain Med, 9 (7) (2008), pp. 871-880
LA dos Reis, CH Mascarenhas, LE Marinho Filho, PS Borges
Lombalgia na terceira idade: distribuição e prevalência na Clínica Escola de Fisioterapia da Universidade Estadual do Sudoeste da Bahia
Rev Bras Geriatr Gerontol, 11 (1) (2008), pp. 93-103
J Woo, J Leung, E Lau
Prevalence and correlates of musculoskeletal pain in Chinese elderly and the impact on 4-year physical function and quality of life
Public Health, 123 (8) (2009), pp. 549-556
Holton KF, Denard PJ, Yoo JU, Kado DM, Barrett-Connor E, Marshall LM, et al., editors.
Diffuse idiopathic skeletal hyperostosis and its relation to back pain among older men: the MrOS Study
Semin Arthritis Rheum, 41 (2) (2011), pp. 131-138
KA Abegunde, ET Owoaje
Health problems and associated risk factors in selected urban and rural elderly population groups of South-West Nigeria
Ann Afr Med, 12 (2) (2013), pp. 90-97
S Exarchou, I Redlund-Johnell, M Karlsson, D Mellström, C Ohlsson, C Turesson, et al.
The prevalence of moderate to severe radiographic sacroiliitis and the correlation with health status in elderly Swedish men–the MrOS study
BMC Musculoskelet Disord, 14 (2013), p. 352
VF Figueiredo, LS Pereira, PH Ferreira, AM Pereira, JS Amorim
Incapacidade funcional, sintomas depressivos e dor lombar em idosos
Fisioter Mov, 26 (3) (2013), pp. 549-557
I Ghanei, BE Rosengren, R Hasserius, JÅ Nilsson, D Mellström, C Ohlsson, et al.
The prevalence and severity of low back pain and associated symptoms in 3,009 old men
Eur Spine J, 23 (4) (2014), pp. 814-820
R Palma, MH de Conti, NM Quintino, MA Gatti, SF Simeão, A de Vitta
Functional capacity and its associated factors in the elderly with low back pain
Acta Ortop Bras, 22 (6) (2014), pp. 295-299
LV Pereira, PP de Vasconcelos, LA Souza, A Pereira Gde, AY Nakatani, MM Bachion
Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study
Rev Lat Am Enfermagem, 22 (4) (2014), pp. 662-669
FC Santos, NS Moraes, A Pastore, MS Cendoroglo
Chronic pain in long-lived elderly: prevalence, characteristics, measurements and correlation with serum vitamin D level
Revista Dor, 16 (3) (2015), pp. 171-175
M Scherer, H Hansen, J Gensichen, K Mergenthal, S Riedel-Heller, S Weyerer, et al.
Association between multimorbidity patterns and chronic pain in elderly primary care patients: a cross-sectional observational study
BMC Fam Pract, 17 (2016), p. 68
M Kherad, BE Rosengren, R Hasserius, JA Nilsson, I Redlund-Johnell, C Ohlsson, et al.
Age Ageing, 46 (1) (2017), pp. 64-71
LM Marshall, S Litwack-Harrison, UE Makris, DM Kado, PM Cawthon, RA Deyo, et al.
A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Men
J Gerontol A Biol Sci Med Sci, 72 (9) (2017), pp. 1264-1269
NM Quintino, MHS De Conti, R Palma, MAN Gatti, SFAP Simeão, A Vitta
Prevalence and factors associated with low back pain in elderly registered in the Family Health Strategy
Fisioter Mov, 30 (2) (2017), pp. 367-377
LAC Machado, JU Viana, SLA da Silva, FGP Couto, LP Mendes, PH Ferreira, et al.
Correlates of a Recent History of Disabling Low Back Pain in Community-dwellin Older Persons: The Pain in the Elderly (PAINEL) study
Clin J Pain, 34 (6) (2018), pp. 515-524
T Liu-Ambrose, JJ Eng, KM Khan, A Mallinson, ND Carter, HA McKay
The influence of back pain on balance and functional mobility in 65- to 75-year-old women with osteoporosis
Osteoporos Int, 13 (11) (2002), pp. 868-873
Y Kobuke, Y Abe, Z Ye, S Honda, M Tomita, M Osaki, et al.
Association of Age, Obesity, Joint Pain, and Chewing Ability with Chair Stand Difficulty among Community-dwelling Elderly People in Nagasaki, Japan
Acta Med Nagasaki, 53 (2009), pp. 65-68
LN Peng, MH Lin, HY Lai, SJ Hwang, LK Chen, CF Lan
Pain and health-care utilization among older men in a veterans care home
Arch Gerontol Geriatr, 49 (Suppl 2) (2009), pp. S13-S16
SR Baek, JY Lim, JY Lim, JH Park, JJ Lee, SB Lee, et al.
Prevalence of musculoskeletal pain in an elderly Korean population: results from the Korean Longitudinal Study on Health and Aging (KLoSHA)
Arch Gerontol Geriatr, 51 (3) (2010), pp. e46-e51
MB Barros, PM Francisco, MG Lima, CL César
Social inequalities in health among the elderly
Cad Saude Publica, 27 (Suppl 2) (2011), pp. S198-S208
H Kim, H Yoshida, X Hu, K Saito, Y Yoshida, M Kim, et al.
Association between self-reported urinary incontinence and musculoskeletal conditions in community-dwelling elderly women: a cross-sectional study
Neurourol Urodyn, 34 (4) (2015), pp. 322-326
L Manchikanti, V Singh, S Datta, SP Cohen, JA Hirsch
American Society of Interventional Pain Physicians Comprehensive review of epidemiology, scope, and impact of spinal pain
Pain Physician, 12 (4) (2009), pp. E35-E70
G Macfarlane, G Jones, J McBeth
Epidemiology of pain
Wall and Melzack’s textbook of pain (2005)
[No authors listed]
Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms.
Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy
Pain Suppl, 3 (1986), pp. S1-226
CE Dionne, KM Dunn, PR Croft
Does back pain prevalence really decrease with increasing age? A systematic review
Age Ageing, 35 (3) (2006), pp. 229-234
N Schillewaert, F Langerak, T Duharnel
Non probability sampling for WWW surveys: a comparison of methods
J Market Res Soc, 40 (4) (1998), pp. 1-13
JD Cassidy, P Cote, LJ Carroll, V Kristman
Incidence and course of low back pain episodes in the general population
Spine, 30 (24) (2005), pp. 2817-2823
Hoy, D, March, L, Brooks, P et al.
The Global Burden of Low Back Pain:
Estimates from the Global Burden of Disease 2010 study
Annals of Rheumatic Diseases 2014 (Jun); 73 (6): 968–974
R Fejer, A Ruhe
What is the prevalence of musculoskeletal problems in the elderly population in developed countries? A systematic critical literature review
Chiropr Man Therap, 20 (1) (2012), p. 31
KL Celich, C Galon
Dor crônica em idosos e sua influência nas atividades da vida diária e convivência social
Rev Bras Geriatr Gerontol, 12 (3) (2009), pp. 345-359
AD Lopez, CD Mathers, M Ezzati, DT Jamison, CJ Murray
Global burden of disease and risk factors
Oxford University Press New York, New York (2006)
SG Leveille, Y Zhang, W McMullen, M Kelly-Hayes, DT Felson
Sex differences in musculoskeletal pain in older adults
Pain, 116 (3) (2005), pp. 332-338
P Sjogren, O Ekholm, V Peuckmann, M Gronbaek
Epidemiology of chronic pain in Denmark: an update
Eur J Pain, 13 (3) (2009), pp. 287-292
MF Lima e Costa
A saúde dos adultos na Região Metropolitana de Belo Horizonte: um estudo epidemiológico de base populacional. A saúde dos adultos na Região Metropolitana de Belo Horizonte: um estudo epidemiológico de base populacional
UFMG; FIOCRUZ (2004), p. 120
DC Turk, A Okifuji
Psychological factors in chronic pain: evolution and revolution
J Consult Clin Psychol, 70 (3) (2002), pp. 678-690
Sex, gender and pain: The biopsychosocial model in action XX vs. XY
The International Journal of Sex Differences in the Study of Health, Disease and Aging, 1 (2003), pp. 98-101
GB Rollman, S Lautenbacher
Sex differences in musculoskeletal pain
Clin J Pain, 17 (1) (2001), pp. 20-24
UE Makris, L Fraenkel, L Han, L Leo-Summers, TM Gill
Epidemiology of restricting back pain in community-living older persons
J Am Geriatr Soc, 59 (4) (2011), pp. 610-614
SS Lim, T Vos, AD Flaxman, G Danaei, K Shibuya, H Adair-Rohani, et al.
A Comparative Risk Assessment of Burden of Disease and Injury
Attributable to 67 Risk Factors and Eisk Factor Clusters in 21 Regions,
1990-2010: A Systematic Analysis for the Global Burden of Disease Study 2010
Lancet. 2012 (Dec 15); 380 (9859): 2224–20260
E Klineberg, D Mazanec, D Orr, R Demicco, G Bell, R McLain
Masquerade: medical causes of back pain
Cleve Clin J Med, 74 (12) (2007), pp. 905-913
W Kim, YS Jin, CS Lee, CJ Hwang, SY Lee, SG Chung, et al.
Relationship between the type and amount of physical activity and low back pain in Koreans aged 50 years and older
PM R, 6 (10) (2014), pp. 893-899
D Hoy, C Bain, G Williams, L March, P Brooks, F Blyth, et al.
A systematic review of the global prevalence of low back pain
Arthritis Rheum, 64 (6) (2012), pp. 2028-2037
ML Ferreira, G Machado, J Latimer, C Maher, PH Ferreira, RJ Smeets
Factors defining care-seeking in low back pain: a meta-analysis of population based surveys
Eur J Pain, 14 (7) (2010), pp. 747.e1-747.e7
Return to MEDICARE
Return LOW BACK PAIN