Hicks Gregory E, Gaines Jean M, Shardell Michelle, Simonsick Eleanor M
University of Delaware, Department of Physical Therapy, 303 McKinly Lab, Newark, DE 19716, USA.
Arthritis Rheum. 2008 Sep 15;59(9):1306-13. doi: 10.1002/art.24006.
Low back pain (LBP) is the most frequently reported musculoskeletal problem in older adults, but its impact on health status is not well understood. Our objective was to determine whether LBP and concurrent leg pain are associated with health-related quality of life (HRQOL) and function in a cohort of older adults, and to examine care-seeking behaviors related to LBP.
This was a population-based, cross-sectional survey study of 522 community-dwelling men and women (67.4%) ages >or=62 living in 4 retirement communities in Maryland and northern Virginia. LBP status in the past year was categorized as no pain in the low back or leg, LBP only, and LBP with leg pain. HRQOL and function were measured with the Medical Outcomes Study Short Form 36 (SF-36).
A total of 26.8% of the sample reported LBP only and 21.3% reported LBP plus leg pain. Participants with LBP and LBP plus leg pain had lower scores in all SF-36 domains, reflecting worse HRQOL (P < 0.0001). LBP and LBP plus leg pain were associated with 2-fold greater odds of falling and increased difficulty lifting grocery bags, walking several blocks, and bathing. LBP plus leg pain was associated with difficulty in social interactions (odds ratio 10.63, 95% confidence interval 3.57-31.60). Less than half sought care for LBP and those who did had poorer health status and greater pain burden.
LBP is common among older adults and strongly associated with reduced HRQOL and function. These findings argue strongly for both identifying cases of LBP by health care practitioners and pursuing effective treatments for LBP given the potential consequences.
腰痛（LBP）是老年人中最常报告的肌肉骨骼问题，但其对健康状况的影响尚未得到充分了解。我们的目的是确定在一组老年人中，腰痛和并发腿痛是否与健康相关生活质量（HRQOL）及功能相关，并研究与腰痛相关的就医行为。
这是一项基于人群的横断面调查研究，研究对象为居住在马里兰州和弗吉尼亚州北部4个退休社区的522名社区居住男性和女性（67.4%），年龄≥62岁。过去一年的腰痛状况分为腰部或腿部无疼痛、仅腰痛以及腰痛伴腿痛。采用医学结局研究简明健康调查量表（SF-36）测量HRQOL和功能。
共有26.8%的样本报告仅腰痛，21.3%报告腰痛伴腿痛。患有腰痛和腰痛伴腿痛的参与者在所有SF-36领域的得分较低，反映出HRQOL较差（P<0.0001）。腰痛和腰痛伴腿痛与跌倒几率增加两倍以及提购物袋、步行几个街区和洗澡困难增加有关。腰痛伴腿痛与社交互动困难有关（优势比10.63，95%置信区间3.57-31.60）。不到一半的人因腰痛寻求治疗，而那些寻求治疗的人健康状况较差且疼痛负担更大。
腰痛在老年人中很常见，并且与HRQOL降低和功能下降密切相关。鉴于可能的后果，这些发现强烈支持医疗保健从业者识别腰痛病例并寻求有效的腰痛治疗方法。
