Lower back pain doubles risk for recurrent falls in knee osteoarthritis
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Patients with knee osteoarthritis who experience any lower back pain have a 2.7-times greater risk for recurrent falls, according to data published in Arthritis Care & Research.
“Clear identification of the risk factors for falls in patients with knee OA can facilitate the development of multifactorial and multiple-component interventions for the prevention of falls,” Hirotaka Iijima, PT, PhD, of Keio University, in Yokohama, Japan, and colleagues wrote. “A potential risk factor for falls in patients with knee OA that was not adequately addressed in earlier studies is low back pain (LBP).”
“However, no study has directly investigated the relationship among LBP, knee pain, and falls in patients with knee OA,” they added. “A clear understanding of the correlation between LBP and the risk of falls in patients with knee OA may help researchers in future clinical studies to establish effective programs for the prevention of falls in patients with knee OA.”
To examine the link between lower back pain and recurrent falls among individuals with knee OA over the course of a year, Iijima and colleagues assessed community-dwelling elderly patients using a questionnaire. A total of 189 participants, recruited through a mailed survey, reported to the Health and Welfare Center in Ayabe-shi, Kyoto, Japan, answered questions regarding lower back pain and falls that occurred in the preceding 12 months. Lower back pain was defined as pain in the lower back or buttocks, illustrated using a pain diagram, and ranked in terms of severity on a scale of 0 to 10.
The researchers used binary and ordinal logistic regression analyses to determine the relationship between any or moderate-to-severe lower back pain, with the latter defined as a 4 or higher on the severity scale. Adjustments were made for age, sex, Kellgren and Lawrence (K&L) grade, knee pain severity and quadriceps strength. In addition, the researchers performed sensitivity analyses, excluding those with sciatica, non-chronic lower back pain, a K&L grade 1 and those receiving pain medications.
According to the researchers, 21.6% of participants self-reported falls in the preceding year. The 101 participants who reported any lower back pain demonstrated 2.7-times greater odds for recurrent fall, while the 45 with moderate-to-severe lower back pain had 3.7-times greater odds, compared with those without lower back pain. In addition, the researchers’ sensitivity analyses suggested a strong correlation between moderate-to-severe lower back pain and recurrent falls.
“People with moderate-to-severe LBP have an increased likelihood of having recurrent falls in the preceding 12 months,” Iijima and colleague wrote. “A thorough investigation of LBP may provide a novel insight into the pathomechanics of recurrent falls. It is necessary to determine the causality and ascertain the effectiveness of therapeutic interventions for LBP for the prevention of falls in people with knee OA.” – by Jason Laday
Disclosure: The researchers no relevant financial disclosures.
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