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Age and Ageing Advance Access originally published online on March 17, 2006
Age and Ageing 2006 35(3):229-234; doi:10.1093/ageing/afj055
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© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Systematic Review

Does back pain prevalence really decrease with increasing age? A systematic review

Clermont E. Dionne1,2,3, Kate M. Dunn3 and Peter R. Croft3

1 Population Health Research Unit, Research Centre of the Laval University Affiliated Hospital, Quebec, Canada
2 Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada
3 Primary Care Sciences Research Centre, Keele University, Staffordshire, UK

Address correspondence to: Clermont E. Dionne. Tel: (+1) 418 682 7511x4675; Fax: (+1) 418 682 7949. Email: clermont.dionne{at}uresp.ulaval.ca

Background: it is believed that the prevalence of back pain decreases around the middle of the sixth decade. However, back pain is still among the most commonly reported symptoms in the elderly and osteoarthritis, disc degeneration, osteoporosis and spinal stenosis all increase with age. In light of this, it is difficult to understand why the prevalence of back pain would decrease with increasing age.

Objective: this study aimed at summarising the scientific evidence on the trends of back pain prevalence with age.

Methods: population-based studies reporting the prevalence of back pain, including people aged 65 years and over, were systematically retrieved from several bibliographic databases. These were read and assessed by two reviewers, and papers retained (‘good quality studies’) were aggregated according to specific criteria.

Results: good quality studies showed a large heterogeneity as to their methods and prevalence figures. No specific patterns were detected by country nor outcome measure. However, most studies that considered severe forms of back pain found an increase of prevalence with increasing age. The curvilinear association between age and back pain prevalence that is widely mentioned in the literature was found only for benign and mixed problems.

Conclusions: the evidence concerning the association of back pain prevalence with age is more sparse than currently believed and this association seems to be modified by the severity of the problem. This knowledge could have important public health implications, as the proportion of older people will increase considerably in the coming years in most industrialised societies.

Keywords: back pain, age, epidemiology, systematic reviews

Received September 1, 2005; accepted in revised form January 18, 2006.


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