Adults who present to the primary level of care due to back impairment are in a good clinical path however, an increase in comorbidity and burden is associated with higher levels of back-related disability according to research results published in the journal Pain.

The back Complaints within the older-Norway (BACE-N) research study ( ID NCT04261309) was a prospective observational study carried out between 2015 until 2020. Patients (N=452) who were 55 years old and over who sought primary treatment for back-related impairment through a general practitioner or physiotherapist chiropractor were assessed by the Roland-Morris Disability Test (RMDQ) every three months throughout the year.

The participants included those who had an average aged of 66 (IQR between 59 and 72) years. 52.0 percent were females, 25.6% had a BMI at or below 30.00 kg/m 2. and 67% were experiencing discomfort for less than six weeks, and the RMDQ scores were 9 (IQR 4-13). The most frequent comorbidities included hypertension (35.3 percent) and osteoarthritis (30.6%)) and heart disease (15.4 percent) and depression (7.6%), depression (7.6) as well as diabetes (6.9 percent) and osteoporosis (6.7 percent) and lung disease (5.8 percent).

The amount of patients who completed the RMDQ at the time of baseline was 407; it dropped to 336 by month 3, 326 in month 6 and 300 at month 12 at month 12, and 300 at month 12.

Our prognostic factor analysis confirmatory of our findings highlight the need for healthcare professionals to determine and manage the comorbidities of older adults suffering from back problems…

The most significant improvement of RMDQ scores was seen between month 3 and baseline. In general, scores stable from month 3 through month 12.

A rise in the number of comorbidities by one was linked to the development of a 0.75-point greater RMDQ score. In the same way, an increase of 1 point in the burden of comorbidity boosted RMDQ scores to 0.47 points. In the complete model the comorbidity number (R 2, 0.287) and burden of comorbidity (R 2, 0.301) were associated to back-related disability for 12 months.

Results from a sensitivity test were in line with findings from the principal analysis.

The study’s limitations include a large number of patients who were lost following follow-up, and the inability to gather data on all eligible patients and using self-reported measures to assess the presence of comorbidity.

“The treatment of back-related disabilities for older adults generally is positive, which is crucial for doctors when providing prognostic data in their encounters with patients,” the study authors stated. “Our confirmation-based prognostic factor analysis underscore the necessity for doctors to evaluate and manage the comorbidities of older adults suffering from back pain, as well as for all stakeholders to create integrated care paths for better outcomes.”


Vigdal On, Storheim K, Killingmo RM, Smastuen MC, Grotle M. The course of 1 year clinical of back-related disabilities and the prognostic significance of comorbidity among elderly patients suffering from back discomfort in the primary treatment. Pain. Published online September 8, 2022. doi:10.1097/j.pain.0000000000002779