The following is a summary of “Movement-Evoked Pain Versus Widespread Pain: A Longitudinal Comparison in Older Adults With Chronic Low Back Pain From the Delaware Spine Studies,” published in the June 2023 issue of Pain by Knox et al.

It is unknown at this time which pain-related factors contribute to long-term disability and inferior perceived health in older adults with chronic low back pain (LBP). This study aimed to assess the unique influence of movement-evoked pain (MeP) and widespread pain (WP) on longitudinal health outcomes (i.e., gait speed, perceived disability, and self-efficacy) in 250 older adults with chronic low back pain (LBP). MeP was elicited using three standardized functional assessments, while WP was determined using the McGill Pain Map. 

Researchers used robust regression with HC3 standard errors to investigate the associations between these baseline pain variables and 12-month health outcomes. Age, gender, body mass index, resting and recall LBP intensity, LBP duration, depression, pain catastrophizing, and baseline outcome (e.g., baseline locomotor speed) were included as covariates in these models. Greater MeP was independently related to worse 12-month LBP-related disability (b =.384, t = 2.013, P =.046) and lower self-efficacy (b = -.562, t = -2.074, P =.039); but not gait speed (P >.05). After adjustment, there was no association between WP and quiescent and recall LBP intensity and any prospective health outcome (all P > .05). 

MeP is most strongly associated with longitudinal health outcomes among older adults with chronic LBP compared to WP and stationary and recall LBP intensity. This article establishes novel independent associations between MeP and worse perceived disability and self-efficacy in older individuals with chronic LBP at 12 months. MeP likely has biopsychosocial causes and effects and may significantly predict health outcomes in LBP and other geriatric populations with chronic pain.

Source: sciencedirect.com/science/article/pii/S1526590023000214