Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 18808
  Title Back pain in an Ontario long term care facility: a pilot study [poster presentation; the Association of Chiropractic Colleges' Thirteenth Annual Conference, 2006]
Journal J Chiropr Educ. 2006 Spring;20(1):58-59
Peer Review Yes
Publication Type Meeting Abstract
Abstract/Notes BACKGROUND: Back pain is one of the leading causes of chronic health problems in the population over 65 years of age. Although the prevalence of back pain in the elderly is not accurately known, some studies suggest that older adults have an even higher prevalence of nonspecific musculoskeletal pain (65% to 80%) with 36% to 40% reportedly suffering from a back pain condition. The problem of back pain in residents of long-term care facilities is essentially unknown. Recently, the Ontario Ministry of Health and Long Term Care de-listed chiropractic services from the Ontario Health Insurance Plan at a critical time in the development of chiropractic care for the chronic geriatric residential care population in Ontario. The impact of this policy decision has yet to be determined.

OBJECTIVES: To determine the prevalence, characteristics and predictors of back pain among geriatric residents in a long-term care facility.

STUDY DESIGN: Retrospective, randomized chart review of residents from a long-term care facility.

METHODS: A retrospective, randomized chart review was conducted on a representative sample of residents’ clinical charts from a long-term care facility in Toronto, Canada. Data concerning age, gender, report of pain, pain location, analgesic use, depression, cognitive status, ambulatory status and co-morbidities were abstracted on a standardized form. Variables were chosen based on the literature and their suggested correlation with back pain.

RESULTS: 140 charts were randomly selected and reviewed. Sixty-nine percent of the selected residents were female, and the average age was 83.7 years (51-101). Residents in this long-term care facility had a pain prevalence of 64% (89/140), with a 40% (55/140) prevalence of musculoskeletal pain. Of those with a charted report of pain, 6% (5/89) had head pain, 2% (2/89) neck pain, 21% (19/89) back pain, 33% (29/89) extremity pain and 38% (34/89) had a nondescript pain complaint. A logistic regression analysis revealed that osteoporosis was the only predictor for back pain from the variables chosen (p=0.001). Descriptive statistics were used to summarize the patients’ characteristics or variables between study groups.

DISCUSSION: Residents with back pain represent 8% (19/140) of the resident population studied, making back pain as prevalent as other common conditions in the long-term care population such as diabetes and congestive heart failure. Among all the variables tested, osteoporosis appears to be the only statistically significant predictor for those with reported back pain. The back pain resident in this facility can be typically described as female, osteoporotic, with mild to moderate dementia, independent or assisted walkers and with a low rate of depression. Although there are problems in retrieving accurate information from chart reviews, under-reporting of pain in general and back pain specifically is likely in this population. Further research including multiple sites is needed to determine the overall prevalence of this condition and its impact on quality of life issues. The results of this study should inform future research in this area.

This abstract is reproduced with the permission of the publisher.

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