Public health

Back pain not a killer but still a suspect

The presence of spinal pain increases the risk of mortality in elderly people however the association is weak and unlikely to be causal.

Data from the Danish Twin Registry found the presence of low back pain and/or neck pain increased all-cause mortality by 13% per year. However the association waned when the researchers adjusted for physical functional ability and depressive symptoms.

The study, which followed participants for up to 14 years, found no association between spinal pain and cardiovascular mortality.

Only 36% of the 4,391 participants reported any spinal pain at baseline despite their mean age of 78 years.

Associate Professor Paulo Ferreira, a physiotherapy researcher and member of the Spinal Pain Research Group at the University of Sydney, said the findings in twins suggest back pain is not overly influenced by genetic factors or early shared environmental factors.

“We can’t infer from this study that there is an independent causal relationship between back pain and mortality,” he told the limbic.

“However spinal pain in the elderly is an indicator of poor health and poor functional ability, which increases mortality risk,” he said.

Participants with pain were less likely to have been physically active, the study found.

“Back pain is linked to a change in lifestyle and disease that might increase their chance of dying. For example, we know people with chronic back pain often develop symptoms of depression and comorbidities such as diabetes and cardiovascular disease.”

He said clinicians should be alert to the potential consequences for patients with even mild symptoms of spinal pain and encourage more physical activity.

“The more active the treatment the better, but back pain often doesn’t need to be medicalised. If it’s not too serious, then a good personal trainer with an understanding of exercise programs can help manage back pain in the community.”

“Overall, the general pattern is that moderate to vigorous physical activity that is recreational in nature is protective. Work-related physical activity especially bending, twisting and lifting heavy weights typically increases the risk of back pain.”

He said the definition of pain in the study was broad and a stronger association with mortality may be evident if the pain was more severe.

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