Course of back complaints in older adults: a systematic literature review

BACKGROUND: Back pain is a common musculoskeletal complaint seen in older people. It is important to get an insight in the course of back complaints and to identify factors associated with a chronic course. AIM: To describe the course of acute and subacute back complaints in older people (≥ 45 years) and to identify prognostic factors for developing chronic back complaints. DESIGN: Systematic review of the literature. METHODS: A database search was conducted in MEDLINE, EMBASE, Cochrane library, CINAHL, PsycINFO and PEDro. Cohort studies or randomized controlled trials reporting on the course of acute or subacute back complaints in older people were included. The percentage of patients that developed chronic back complaints was calculated, if possible. RESULTS: The search yielded 9293 potentially relevant articles. Of these, 5 studies met all inclusion criteria. At 3 months follow-up 37-40% of the patients still had back complaints. At 12 months follow-up, the percentage ranged from 26-45%. Older age was frequently reported as a prognostic factor for developing chronic back complaints of the whole study population. No prognostic factors could be retrieved for patients aged 45 years and older. CONCLUSIONS: At 3 and 12 month follow-up, about 40% of the older people still reported back complaints. However, the heterogeneity of the studies made comparisons difficult. In order to get a clear insight in the course of back complaints in the older adult patients and to indentify prognostic factors for developing chronic back complaints in older people, high quality prospective cohort studies are needed. CLINICAL REHABILITATION IMPACT: More than one-third of the older patients with back pain still experience complaints after 3 and 12 months.

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