Affiliations: [a] Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands | [b] Department of Family Medicine, Chung-ang University Medical Center, Seoul, Korea | [c] Department of Orthopedics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
Correspondence:
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Corresponding author: Pim A.J. Luijsterburg, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands. Tel.: +31 10 7037513; Fax: +31 10 7044766; E-mail: [email protected].
Abstract: BACKGROUND: It is unclear whether bone quality associates with severity and prognosis of back pain. OBJECTIVES: To investigate the association between bone quality and back pain severity at baseline, and whether low bone quality is a prognostic factor for persistent back pain in patients aged over 55 years at 1-year follow-up. METHODS: In this prospective cohort study persistent back pain was defined as a decrease in the back pain severity score of less than 30% at 1-year follow-up compared with baseline score or as a back pain severity score greater than 1 (0–10: 0 = no pain) Low bone quality was categorized as a T-score, calculated using a stiffness index by quantitative ultrasound of the heel, of 2.5 or below. Data were analyzed in multiple regression analyses. RESULTS: Of all 513 patients, 68 (13%) showed low bone quality at baseline. Back pain severity showed no differences between patients with normal and with low bone quality. At 1-year follow-up, low bone quality was not associated with persistent back pain (defined as < 30%: OR 1.0; 95% CI: 0.40–2.30, p-value = 0.93; and defined as score > 1: OR 0.4; 95% CI: 0.17–1.15), p-value = 0.09), adjusted for all covariates. CONCLUSIONS: In older adults with back pain presenting in general practice, low bone quality was not associated with severity of back pain at baseline nor with persistent back pain at 1-year follow-up.
Keywords: Older adults, bone quality, back pain, general practice
