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  • Writer's picturePaul Monaro

Lumbar - Chronic Low Back Pain & Mortality

A recent article in the European Journal of Pain explored the association between chronic low back pain and increased mortality. It was found that older people with spinal pain had a 13% increased risk of mortality per year. However, the cause was understood to be indirect, and not to be familial. It was found that spinal pain is part of a pattern of poor health, that increases mortality risk.

Previous research has shown that persistent pain may be associated with adverse health factors such as increased smoking, reduced social participation, reduced physical activity, and symptoms of anxiety or depression. There is also a possible association with increased bodyweight or obesity, and its associated conditions such as diabetes.

It was found that subjects who were still alive at the end of the study were more likely to engage in heavy physical activity, including gardening, long duration walks, bike riding, or be involved in sports participation.

The authors concluded that with a rapidly growing ageing population, spinal health is critical in maintaining older age independence and wellbeing.

Research over the past 10 years has revealed that people who suffer from chronic low back pain are more likely to display fear-avoidance behavior. In other words, their response to pain is to avoid activities that they perceive as being pain generating. They also exhibit an above average fear of pain and disability. Paradoxically, the fear-avoidance behavior adds to their disability.

Physical interventions for patients with chronic LBP now look to target fear avoidance. This involves behavior modification, and re-education of healthy movement patterns. Patients often avoid specific spinal movements, such as flexion, as well as physical activity in general. Interventions begin with attempting to restore a relatively normal lumbar pattern of movement. Patients are reassured that such movements are safe and beneficial. Once they learn that movement is not harmful, they begin to feel more in control. The aim is to enhance a positive cycle where spinal movement and physical activity improves overall symptomology and wellbeing.

The advice to remain active after back injury is an important facet of recovery from acute back pain. And it becomes critical for persistent back pain. As this study has shown, your back pain won’t kill you, but the consequences of that pain may potentially shorten your life.

Reference: Fernandez, M et al (2017). Is this back pain killing me? All-cause and cardiovascular-specific mortality in older Danish twins with spinal pain. European Journal of Pain, 21, 938-948.

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