Disgnosis and Management of Chronic Low Back Pain in Elders

Park, Jung Yul

Abstract

As degenerative changes of lumbar spine and surrounding structures progress with aging, the strength of not only the bony tissues but also the supporting structures become weak and dysfunctional with pain. This phenomenon is increasingly evident as elderly population increases rather progressively in contemporary era. Therefore, the chronic back pain in this subpopulation group is relatively common and comprise of various pain syndromes originating from vertebral bodies, joints, muscles, and other soft tissues. The causes of chronic low back pain in elders also differ patient to patient. but common presentations seen in clinical setting are disorders related to intervertebral disc, spinal stenosis, spondylolisthesis, compression fracture related to osteoporosis, and pain originating from zygapophysial joints and other surrounding structures. Less common but other important causes include metastatic lesions, infection, and myofacical pain syndromes. Here, evidence-based literature review on common disorders affecting elderly patients causing chronic low hack pain is presented with special attention focused on diagnostic and therapeutic approaches based on etiologic processes and clinical presentations Every effort should be made to contemplate all possible factors that might have played roles in generating the chronic pain in these patients. Also, whatever management chosen it should have been decided based upon the clinical presentation that closely correlated with definitive findings from studies best available whenever possible.