No association between low bone quality and back pain in older adults: A cohort study

Abstract

BACKGROUND:

It is unclear whether bone quality associates with severity and prognosis of back pain.

OBJECTIVES:

To investigate the association between bone quality and back pain severity at baseline, and whether low bone quality is a prognostic factor for persistent back pain in patients aged over 55 years at 1-year follow-up.

METHODS:

In this prospective cohort study persistent back pain was defined as a decrease in the back pain severity score of less than 30% at 1-year follow-up compared with baseline score or as a back pain severity score greater than 1 (0–10: 0 $=$ no pain) Low bone quality was categorized as a T-score, calculated using a stiffness index by quantitative ultrasound of the heel, of 2.5 or below. Data were analyzed in multiple regression analyses.

RESULTS:

Of all 513 patients, 68 (13%) showed low bone quality at baseline. Back pain severity showed no differences between patients with normal and with low bone quality. At 1-year follow-up, low bone quality was not associated with persistent back pain (defined as $<$ 30%: OR 1.0; 95% CI: 0.40–2.30, $p$ -value $=$ 0.93; and defined as score $>$ 1: OR 0.4; 95% CI: 0.17–1.15), $p$ -value $=$ 0.09), adjusted for all covariates.

CONCLUSIONS:

In older adults with back pain presenting in general practice, low bone quality was not associated with severity of back pain at baseline nor with persistent back pain at 1-year follow-up.