AS MANY as 57% of older adults said their back pain had not improved in the five years after initially presenting to their general practitioner, a new international study shows.  The survey, which took place in the Netherlands and was published in the Journal of American Board of Family Medicine, included 675 patients aged 55 and older.  At the five-year follow-up, 392 responded.  The survey showed that most patients stopped seeking the advice of their medical professional during that five-year span.  “While it is known that spine pain can be difficult to treat, it is surprising that more than half of patients had pain five years later,” said Ron Riesenburger, director of the USbased Spine Center at Tufts Medical Center. Obidiugwu Duru, professor of medicine at UCLA’s David Geffen School of Medicine, suggested that some patients may simply give up and accept their pain, rather than seek alternative treatment.

“Back pain is a lot like knee arthritis in that it is always lurking in the background,” he said.  “As our patients get older, they are more likely to have other degenerative conditions that take longer to heal and aggravate these conditions.  Our patients may even throw their hands up and say it is not worth trying any other treatments.”

According to Professor Duru, clinicians need to encourage more healthy living among their patients: “that way patients don’t have to live in constant pain”.

Quality of life

The findings showed that at the five-year follow-up, 43% reported themselves as (almost) completely recovered.  The average clinical outcomes over the five-year course show that main improvements in pain, disability, and physical quality of life occur in the first three months of follow-up. After these three months, the average levels of pain and disability remain practically constant over time.  In other words, most patients experience persistent or recurrent back pain.

Medical consumption, mainly pain medication, remains substantial, with approximately one-third of the cohort (range 25% to 39%) using at least one type of medicine for their back pain.

However, over time, patients report less contact with healthcare professionals.  This implies most patients do not consult their GP or other medical healthcare professionals after the first year, despite having persistent (or recurrent) back pain.  They are “out of sight”, but their problem may not be solved.  Either they have accepted their disability and pain level and learned strategies on how to cope with their back pain, or patients refrain from a visit because they assume it will not help them further in alleviating the pain.  It remains unknown whether patients seek help from other healthcare workers or find alternative ways to relieve their pain.

Article from TalkBack, Spring | 2020 (BackCare)

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