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The Prevalence of Low Back Pain in the Elderly: A Systematic Review of the Literature

Bressler, Hartley B., DC, MD, CCFP*†‡§; Keyes, Warren J., BSc(Hon), DC; Rochon, Paula A., MPH, MD, FRCPC*¶#; Badley, Elizabeth, PhD***

Literature Review

Study Design. The prevalence of low back pain in the older population (≥ 65 years) was reviewed in an analysis of the literature from 1966 to the present.

Objective. To determine the prevalence of low back pain in the geriatric population.

Summary of Background Data. Back pain is one of the most frequently reported conditions affecting the adult population. However, the prevalence of low back pain in the older age population is not accurately known.

Methods. A methodologic search of five computerized bibliographic databases was performed to identify citations on the prevalence of low back pain in the elderly. Data were summarized, and prevalence studies were critically appraised in detail for their quality.

Results. There is wide variability in the reported prevalence of back pain. Many factors have been proposed to explain these findings including sample source, study design, definitions of back pain, and use of patient-reported data. Comorbidity among older patients also contributes to the variability in the reporting of prevalence of back pain.

Conclusion. There is an under-representation of the older population in the back pain literature. The data in the current study suggest that the prevalence of low back pain in this population is not known with certainty and is not comparable with that in the younger population. The authors stress the need for future studies to improve the reporting of age information to make prevalence studies more informative and applicable.

From the *University of Toronto, Toronto, the †Department of Family and Community Medicine, Toronto, ‡Mount Sinai Hospital, Toronto, §Ajax Pickering General Hospital, Ajax, ∥Canadian Memorial Chiropractic College, Research Division, Toronto, the ¶Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Toronto, #Department of Public Health Sciences, Toronto, and the **Toronto Hospital Research Institute, Toronto, Ontario, Canada.

Acknowledgment date: June 18, 1998.

First revision date: September 17, 1998.

Acceptance date: November 3, 1998.

Address reprint requests to

Hartley B. Bressler, DC, MD, CCFP

720 Sheppard Avenue, Suite 6

Pickering, Ontario

Canada L1V 1G5


Device status category: 1.

© 1999 by Lippincott Williams & Wilkins