Spine: Aging Population


Lead Author(s): 

Beatrice J. Edwards, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Older adults will often experience musculoskeletal diseases affecting the spine, with spondyloarthritis and osteoporosis with vertebral fractures often the cause of pain and functional decline. Seniors with such problems may find themselves unable to push or pull large objects, or at times even to reach above their heads. They may have problems lifting grocery bags from the floor or completing household tasks. Bending at the waist may increase the risk for vertebral fractures in people with osteoporosis, reducing breathing capacity and predisposing older adults to chronic lung disease and pneumonias.

Self-Reported Back Pain

Self-reported back and neck pain rates peaked in the age range of 45 to 64 in 2015 and was reported at slightly lower rates for persons age 65 years and older. More than one in three people age 45 years and older reported back or neck pain. (Reference Table 7B.2 PDF CSV

Healthcare Visits

People aged 65 and older had the highest rate of healthcare visits for back and neck pain (43.7 per 100 persons) but accounted for only 26% of the 83 million total healthcare visits for back or neck pain in 2013. The rate of healthcare visits for people age 45 to 64 years was nearly as  high (41.0 per 100 persons) and accounted for nearly one-half (48%) of total visits. While only 19.1 in 100 people ages 18 to 44 years had a healthcare visit in 2013 for back and neck pain, this age group comprised 30% of all visits. Total healthcare visits included hospital discharges, emergency department (ED) and outpatient clinic visits, and physician office visits. (Reference Table 7B.2 PDF CSV)

Those aged 45 to 64 years had the highest number of spinal fusion procedures performed for back or neck pain, with one in four, or 25.3%, of hospital discharges in this age group with a back or neck pain diagnosis having had a spinal fusion procedure performed. However, the highest rate of hospital discharges with a fusion procedure was among those under 18 years of age (74%), primarily due to the very small number of discharges for back pain in this age group. (Reference Table 7B.2 PDF CSV)

Bed and Lost Workdays

Most bed days reported due to back pain (90%) are accounted for by people under the age of 65. A higher number of younger people, those aged 18 to 45 years, report taking bed days than those aged 45 to 64, for spine pain. However, because they report a lower mean number of bed days than the older cohort (6.2 days versus 9.0 days) they account for a slightly smaller share of the total bed days for back pain. People aged 65 years and older account for only a small share of the people who report taking a bed day due to spinal pain (5%), but a larger mean number of days (14.9 days). (Reference Table 9B.2 PDF CSV)

Lost workdays due to spine pain or problems in 2015 were taken primarily by people aged 18 to 64 years (96%), the prime workforce ages, and split nearly equally between those under and over the age of 45 years. In 2015, 264 million workdays were reported lost due to back pain. (Reference Table 9B.2 PDF CSV)


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