• Wendelien H van der Gaag, Enthoven Wendy T M WTM From Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands (WHvdG, WTME, PAJL, SMAB-Z, AMB, BWK); Resea, Luijsterburg Pim A J PAJ From Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands (WHvdG, WTME, PAJL, SMAB-Z, AMB, BWK); Res, Jantine van Rijckevorsel-Scheele, Bierma-Zeinstra Sita M A SMA From Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands (WHvdG, WTME, PAJL, SMAB-Z, AMB, BWK);, Arthur M Bohnen, Maurits W van Tulder, and Bart W Koes.
• From Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands (WHvdG, WTME, PAJL, SMAB-Z, AMB, BWK); Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands (JvR-S); Department of Orthopedics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands (SMAB-Z); Department of Health Sciences & Amsterdam Movement Sciences Institute, Faculty of Science, Vrije Universiteit Amsterdam, The Netherlands (MWvT); Department of Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark (MWvT); Center for Muscle and Health, University of Southern Denmark, Odense, Denmark (BWK) w.vandergaag@erasmusmc.nl.
• J Am Board Fam Med. 2019 Nov 1; 32 (6): 781-789.

IntroductionBack pain is a prevalent health problem. Research often focuses on adults. Evidence on the long-term course of back pain in older patients is limited. A prospective cohort study (BACE) was conducted in a primary care setting in the Netherlands. We aim to investigate the 5-year course and medical consumption of older adults (>55 years) presenting with back pain in general practice.MethodsPatients aged >55 years, consulting their general practitioner with a new back pain episode, were included between 2009 to 2011. Follow-up questionnaires included, for example, pain severity, disability, quality of life, recovery, and medical consumption.ResultsA total of 675 patients (mean age ± SD, 66.4 ± 7.6 years) participated, showing a mean (± SD) back pain reduction from 5.2 (± 2.7) to 3.6 (± 2.8) (numeric rating scale, 0 to 10) at 3 months follow-up; disability decreased from 9.8 (± 5.8) to 7.8 (± 6.2) (Roland-Morris Disability Questionnaire, 0 to 24). After 6 months, this remained practically constant over time. Medical consumption was highest in the first months; medication was used by 72% at baseline and approximately one-third (25% to 39%) during follow-up. At 5-year follow-up (response rate 58%; n = 392), 43% had recovered; a majority reported persistent or recurrent back pain.ConclusionClinically relevant improvements in back pain intensity and disability were seen in the first 3 to 6 months of follow-up. A majority of patients does not become pain free within 3 months; this does not improve over 5 years. However, most patients stop consulting health care professionals during follow-up. Current medical strategies may not be sufficient in older back pain patients, where back pain becomes a recurrent or chronic condition in the majority of patients.© Copyright 2019 by the American Board of Family Medicine.

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