Back Pain Is Killing Patients, Literally

FEBRUARY 27, 2017
Caitlyn Fitzpatrick
pain management, chronic pain, low back pain, mortality, neck pain, spinal pain

People with low back pain have a 13% higher risk of dying of any cause, according to an Australian study.

Chronic back pain is becoming an increasing problem in the United States. Evidence supports that opioids shouldn’t be used for acute cases, and literature is shaky when it comes to chronic cases. But how much does low back pain impact patients’ overall health? Researchers from The University of Sydney explored how spinal pain, including back and neck, impacted all-cause and disease-specific cardiovascular mortality.

“With a rapidly growing aging population, spinal health is critical in maintaining older age independence, highlighting the importance of spinal pain in primary health care as a presenting symptom,” lead author, Matthew Fernandez, BSpSc, MChiro, of the Faculty of Health Sciences, said in a news release.

The team gathered data from the Danish Cause of Death Registry, which recorded patient outcomes until the end of 2014. The cohort included 4,390 twins, which took out the genetic factor influence on the analysis. Spinal pain was reported at baseline by both twin pair on an individual level. Two crude and adjusted Cox proportional hazards regression analyses were used to uncover risk rate.

People with spinal pain had increased risk of all-cause mortality (hazard ratio (HR): 1.13; 95% confidence interval (CI): 1.06 to 1.21). However, the researchers did not find a link between spinal pain and cardiovascular disease mortality (sub-distribution hazard ratio (SHR) 1.08; 95% CI: 0.96 to 1.21). The association became insignificant after adjusting for physical functional ability and depressive symptoms. It was noted that the statistical insignificance had a greater magnitude for identical twins.

“Spinal pain may be part of a pattern of poor health and poor functional ability, which increases mortality risk in the older population,” said senior author, Paulo Ferreira, PhD, associate professor and physiotherapy researcher at the University’s Faculty of Health Sciences. “Policy makers should be aware that back pain is a serious issue – it is an indicator of people’s poor health and should be screened for, particularly in the elderly.”

Older people with spinal pain had a 13% higher risk of mortality per years lived, the team found. This link, however, was not causal.

“This is a significant finding as many people think that back pain is not life-threatening,” Ferreira continued. “These findings warrant further investigation because while there is a clear link between back pain and mortality we don’t know yet why this is so.”

Although many questions still linger in the world of low back pain, it’s likely to impact patients’ longevity and quality of life, Ferreira said. Since medications and surgery usually don’t provide the best outcomes, the best thing physicians can advise their patients to do is adapt a healthy, active lifestyle.

The study, “Is this back pain killing me? All-cause and cardiovascular-specific mortality in older Danish twins with spinal pain,” was published in the European Journal of Pain. The news release was provided by The University of Sydney.

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