Age-Related Transitions in Low Back Pain Pathology: A Life-Course Narrative Review.

IF 4.4 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2026-09-17 DOI:10.1007/s40122-026-00891-2

Tatsunori Ikemoto, Atsuhiko Hirasawa, Norimitsu Wakao

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引用次数: 0

Abstract

Introduction: Low back pain (LBP) represents the primary global cause of years lived with disability, significantly compromising health-related quality of life and imposing a substantial economic burden on healthcare systems. This narrative review conceptualizes LBP as a dynamic life-course process rather than a static diagnostic entity.

Method: A comprehensive search of PubMed, Scopus, and Web of Science was conducted using MeSH and free-text terms (e.g., "Low Back Pain," "Aging," spine diseases) for clinical trials, cohorts, and reviews published from inception through to January 2026.

Results: In adolescence, the focus is primarily on mechanical stress-induced spondylolysis among young athletes. As individuals transition into young adulthood, the pathological emphasis shifts toward intervertebral disc health, marked by symptomatic herniation and the emergence of Modic changes, alongside the increasing relevance of psychosocial "Yellow Flags" in predicting chronicity. By middle and older adulthood (60+), cumulative degenerative changes involve both the intervertebral discs and facet joints, frequently manifesting as lumbar spinal stenosis and sagittal malalignment. During this phase, global spinal balance replaces localized pathology as the primary determinant of disability. For late-old adults (80+), the clinical landscape is dominated by the synergistic impacts of sarcopenia and osteoporosis, shifting the assessment focus from flexibility to functional standing and walking capacity. The high prevalence of fragility fractures and the potential for serious "red flag" conditions necessitate a high index of clinical suspicion in this demographic.

Conclusions: LBP is not a static diagnostic entity but a dynamic, evolving process that shifts across the human lifespan.

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腰痛病理的年龄相关转变：一个生命历程的叙述回顾。

简介：腰痛（LBP）是全球致残多年的主要原因，严重影响与健康相关的生活质量，并给医疗保健系统带来巨大的经济负担。这种叙事回顾概念化LBP作为一个动态的生命历程过程，而不是一个静态的诊断实体。方法：对PubMed、Scopus和Web of Science进行全面检索，使用MeSH和自由文本术语（例如“Low Back Pain”、“Aging”、脊柱疾病），检索从开始到2026年1月发表的临床试验、队列和综述。结果：在青春期，焦点主要集中在年轻运动员中机械应力诱导的峡部裂。随着个体进入青年期，病理重点转向椎间盘健康，以症状性突出和modc变化的出现为标志，同时社会心理“黄旗”在预测慢性方面的相关性也在增加。到中老年（60岁以上），累积性退行性改变涉及椎间盘和小关节突，通常表现为腰椎管狭窄和矢状面排列失调。在这一阶段，整体脊柱平衡取代局部病理成为残疾的主要决定因素。对于老年老年人（80岁以上），临床景观以肌肉减少症和骨质疏松症的协同影响为主，将评估重点从灵活性转移到功能性站立和行走能力。脆性骨折的高患病率和潜在的严重“危险信号”需要在这一人群中进行高指数的临床怀疑。结论：腰痛不是一个静态的诊断实体，而是一个动态的、不断发展的过程，在人类的一生中发生变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.