Osteoporos Sarcopenia.  2017 Dec;3(4):195-200. 10.1016/j.afos.2017.09.001.

Sarcopenia in elderly patients with chronic low back pain

• Sakai Y
• Matsui H
• Ito S
• Hida T
• Ito K
• Koshimizu
• Harada A

• KMID: 2404904
• DOI: http://doi.org/10.1016/j.afos.2017.09.001

Abstract

OBJECTIVES
The prevalence of chronic low back pain (CLBP) increases with age and several mechanisms are involved in the development of CLBP, including osteoporosis; however, no associations with sarcopenia have yet been identified.
METHODS
In total, 100 patients with CLBP and 560 patients without CLBP (nCLBP) aged over 65 years were studied. Skeletal muscle mass index (SMI) and percentage of body fat were evaluated using wholebody dual-energy X-ray absorptiometry. Sarcopenia was diagnosed when the relative SMI was more than 2 standard deviations below the mean in young adults. Thus, the cutoff value for sarcopenia was defined according to Sanada's Japanese population data. Paraspinal muscle cross-sectional areas of the lumbar multifidus and the erector spinae muscles were calculated using magnetic resonance imaging.
RESULTS
Forty patients (40.0%) from the CLBP group and 149 (26.6%) from the nCLBP group met the criteria of sarcopenia. SMI was significantly lower and the body fat ratio was significantly higher in the CLBP group compared with the nCLBP group. Sarcopenic obesity was significantly observed in the CLBP group. Lumbar multifidus and the erector spinae muscle cross sectional area were significantly lower in the CLBP group.
CONCLUSIONS
Elderly patients with CLBP have significantly lower skeletal muscle mass, and age-related mechanisms in sarcopenia are considered to be associated with chronic pain. Therapeutic procedures that are used to treat elderly aging muscle, including muscle strengthening and performance training, can possibly be a treatment for or used to prevent elderly CLBP.

Keyword

Sarcopenia; Chronic low back pain

MeSH Terms

Absorptiometry, Photon
Adipose Tissue
Aged*
Aging
Asian Continental Ancestry Group
Chronic Pain
Humans
Low Back Pain*
Magnetic Resonance Imaging
Muscle, Skeletal
Muscles
Obesity
Osteoporosis
Paraspinal Muscles
Prevalence
Sarcopenia*
Young Adult