FACET JOINT OSTEOARTHRITIS INCIDENCE IS ASSOCIATED WITH BACK PAIN IN OLDER ADULTS: FRAMINGHAM STUDY

摘要

Back pain in older adults is a major public health problem, and facet joint osteoarthritis (FJOA) is commonly treated as the source of this pain. Despite the clinical importance, little is known about the relation between longitudinal changes in FJOA and pain symptoms. The purpose of this study was to determine the association between incidence of FJOA over 6yr, evaluated by CT, and self-reported back pain in a community-based cohort. Participants included 885 cohort members of the Framingham Study: 491 women, 394 men, 40–85 yr (mean=63 yr, SD=+8 yr). FJOA was graded by a musculoskeletal radiologist (MJ) bilaterally from T4/T5 to L4/L5 on baseline and follow-up CT images as: grade 0=normal, 1=mild, 2=moderate, or 3=severe. Incidence of moderate/severe FJOA was defined as an increase at any spinal level from grade 0 or 1 at baseline to grades 2 or 3 at follow-up. During the follow-up period, participants reported frequency of back pain (no, some, most, or all days/month in the past year). 6-year incidence was 33% for moderate/severe FJOA. 23% of participants reported having back pain on some days/month, 7% on most days/month, and 13% on all days/month. Incidence of moderate/severe FJOA increased with frequency of back pain: OR=1.00 (no back pain), OR=1.06, 0.74–1.51 (some days/month), OR=1.24, CI=0.72–2.14 (most days/month), OR=1.64, CI=1.07–2.50 (all days/month); trend, p=0.03. Our results suggest that CT based findings of incident moderate/severe FJOA may have clinical importance for prevention and treatment of back pain in older adults.