Background/Purpose: Although back pain is the most common type of pain disorder reported by older adults, its impact on the daily life of older adults remains poorly understood, particularly among racial/ethnic minorities. In this qualitative study, we explored older adults’ beliefs and attitudes regarding restricting back pain (defined as back pain severe enough to restrict activity).

Methods: We conducted in-depth, one-on-one interviews and focus groups with older adults (ages ≥65 years) who reported restricting back pain within the past 3 months. We recruited participants from 3 different sources (interviews and focus groups in Connecticut and focus groups in New York City) to ensure a racially diverse sample; recruitment efforts ended once thematic saturation was achieved. A semi-structured discussion guide was used to prompt participants to discuss their beliefs, attitudes, and experiences regarding restricting back pain. Audio recordings were transcribed and analyzed (using NVivo) in an iterative process to develop and analyze thematic categories. All transcripts were independently coded (blinded to population) by four reviewers using iterative thematic analysis. Discrepancies in coding were resolved through group discussion until consensus was reached.

Results: We conducted 23 one-on-one interviews and 16 focus groups (n=70 participants), for a total of 93 participants. The majority of participants were female (68%). The median age was 83; over one-half lived alone, and 46% belonged to a minority group. We identified 3 themes related to worry and fear about restricting back pain (Table 1): (1) worry and preoccupation with deteriorating function [and need for mobility aids], (2) concerns about loss of independence and reliance on others, (3) fear of medication. Themes did not vary by race/ethnicity or by gender.

Conclusion: This study suggests that older adults with restricting back pain worry about future physical deterioration, reliance on mobility aids, and dependence on others (related to the back pain). Older adults described a common distrust of medications. A better understanding of the attitudes and beliefs, including worries and fears, of older adults with restricting back pain, will inform the development of non-pharmacological, multimodal interventions. Additionally, these data will enable clinicians and researchers to gain insight about potential barriers and facilitators to engaging in or adhering to restricting back pain management.

Table 1: Illustrative Quotes of Themes

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/what-older-adults-with-restricting-back-pain-worry-about-deteriorating-function-reliance-on-others-distrust-of-medications/