Does the Number of Comorbidities Predict Pain and Disability in Older Adults With Chronic Low Back Pain? A Longitudinal Study With 6- and 12-Month Follow-ups

Abstract

Background and Purpose: People who live longer often live with multimorbidity. Nevertheless, whether the presence of multimorbidity affects pain and disability in older adults with chronic low back pain (LBP) remains unclear. The aim of this study was to investigate whether multimorbidity predicts pain intensity and disability at 6- and 12-month follow-ups in older adults with chronic LBP. Methods: This was a prospective, longitudinal study with 6- and 12-month follow-ups. Participants with chronic LBP (age ≥ 60 years) were recruited and interviewed at baseline, 6 months, and 12 months. Self-reported measures included the number of comorbidities, assessed through the Self-Administered Comorbidity Questionnaire, pain intensity, assessed with the 11-point Numerical Rating Scale, and disability, assessed with the Roland-Morris Disability Questionnaire. Data were analyzed using univariate and multivariate regression models. Results and Discussion: A total of 220 participants were included. The number of comorbidities predicted pain intensity at 6-month (β= 0.31 [95% CI: 0.12 to 0.50]) and 12-month (β= 0.29 [95% CI: 0.08 to 0.50]) follow-ups. The number of comorbidities predicted disability at 6-month (β= 0.55 [95% CI: 0.20 to 0.90]) and 12-month (β= 0.40 [95% CI: 0.03 to 0.77]) follow-ups. Conclusion: The number of comorbidities at baseline predicted pain and disability at 6-month and 12-month follow-ups in older adults with chronic LBP. These results highlight the role of comorbidities as a predictive factor of pain and disability in patients with chronic LBP, emphasizing the need for timely and continuous interventions in older adults with multimorbidity to mitigate LBP-related pain and disability.

Are the attitudes and beliefs of Australian exercise‐based practitioners associated with their use of, and confidence in, treatment modalities for people with chronic low back pain?

“…We previously acknowledged the pragmatism of practitioners beginning with a smaller dose of exercise that is tolerated by their patient and then gradually increasing this up to physical activity guidelines levels (Gibbs et al, 2023) and this was supported by qualitative data in this study where multiple practitioners reported adopting this approach. Given the clear burden of co-morbidities in people with CLBP (Goodson et al, 2013;Rönnegård et al, 2022;Williams et al, 2018) and the increasing calls for a paradigm shift towards a more multimodal lifestyle approach to management (Lemes et al, 2023), we encourage more practitioners to consider the physical activity guidelines in their exercise prescription to increase the chances of secondary health benefits for their patients with CLBP.…”