Clinical and radiographic features of spinal osteoarthritis predict long-term persistence and severity of back pain in older adults - 09/02/22
, Alessandro Chiarotto a, Wendy T. Enthoven a, Evelien de Schepper a, Edwin H.G. Oei b, Bart W. Koes a, Sita M.A. Bierma-Zeinstra a, c
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | Back pain prognosis is unclear in older patients with spinal osteoarthritis. |
• | This longitudinal cohort study analysed data for 543 older adults with back pain. |
• | Spinal morning stiffness that is longer than 30 min predicts persistent back pain. |
• | Painful spine rotation also predicts long-term back pain persistence and severity. |
• | The presence of multilevel osteophytes is also prognostic for long-term back pain. |
Abstract |
Background |
Patients with back pain can show one or more features of spinal osteoarthritis (OA), such as morning stiffness, limited or painful range of motion (ROM), and lumbar disc degeneration (LDD). However, it has not been investigated whether these features are prognostic of long-term back pain.
Objectives |
This study assessed whether spinal morning stiffness, ROM and LDD are prognostic factors for back pain after 1 year in older adults with back pain.
Methods |
This prospective observational study (BACE cohort) included patients aged>55 years visiting a general practitioner for a back-pain episode. Baseline patient-reported morning stiffness, physical examined ROM and radiographic LDD features (i.e., multilevel osteophytes and disc space narrowing) were analysed as potential prognostic factors in unadjusted and adjusted regression models with the outcomes of persistent back pain (yes/no) and back pain severity after 1-year follow-up.
Results |
This study included 543 patients with mean (SD) age 67 (8) years, 59% female, and 62% reporting back pain at 1-year follow-up. When studied in separate adjusted models, persistent back pain was associated with morning stiffness>30min (OR 3.0, 95%CI 1.3; 5.5), restricted lateroflexion (OR 1.8, 95%CI 1.0; 3.2), pain during rotation (OR=1.7, 95%CI 1.0; 2.9), multilevel osteophytes (OR 2.4, 95%CI 1.4; 4.1), and multilevel disc space narrowing (OR 1.5, 95%CI 0.9; 2.4). When investigated in the same adjusted model, persistent back pain remained associated with only morning stiffness>30min (OR 2.4, 95%CI 1.0; 3.9), pain during rotation (OR 1.6, 95%CI 0.9; 2.8), and multilevel osteophytes (OR 2.1, 95%CI 1.2; 3.7). The same spinal OA-related features were associated with back pain severity.
Conclusions |
Spinal morning stiffness, painful rotation, and multilevel osteophytes are prognostic factors for persistent back pain and back pain severity after 1 year. Evaluating these clinical and radiographic features of spinal OA could help clinicians identify older patients who will experience long-term back pain.
Le texte complet de cet article est disponible en PDF.Keywords : Back pain, Range of motion, Articular, Intervertebral disc degeneration, Osteoarthritis, Spine, Prognosis
Plan
Vol 65 - N° 1
Article 101427- janvier 2022 Retour au numéro
Article précédent
- Patient acceptable symptom state for patient-reported outcomes in people with non-specific chronic low back pain
- Camille Daste, Hendy Abdoul, Frantz Foissac, Marie-Martine Lefèvre-Colau, Serge Poiraudeau, François Rannou, Christelle Nguyen
- Non-rigid lumbar supports for the management of non-specific low back pain: A literature review and meta-analysis
- Paul Gignoux, Charlotte Lanhers, Frédéric Dutheil, Laura Boutevillain, Bruno Pereira, Emmanuel Coudeyre
Bienvenue sur EM-consulte, la référence des professionnels de santé.