Back Pain Registry (BOLD)

Nearly one in three U.S. seniors (adults aged 65 or older) has severe and disabling back pain. However, little is known about the long-term course of back pain or risk factors for developing chronic back pain among elderly patients.

To begin addressing these knowledge gaps, we established the Back pain Outcomes using Longitudinal Data (BOLD) registry. BOLD is a group of people over the age of 65 who have agreed to provide information about their back pain. We started BOLD in 2011 to address the problem that little is known about the long-term course of back pain among older adults, despite nearly one in three experiencing severe and disabling back pain. 

The BOLD Registry consists of 5,239 people who received health care from one of three healthcare systems (Kaiser Permanente, Northern California; Henry Ford Health System; and Harvard Vanguard Medical Associates). BOLD Registry participants shared information with us at 3 months, 6 months, one year, and 2 years after their first primary care doctor visit for their back pain. 

What Have We Learned from the BOLD Registry?

As a result of the information you and the other participants have shared with us about your back pain, we have been able to explore different aspects of how back pain is treated and how this information can have an impact on future health care practices! 

Back Pain and Function Differs For Older Adults

We examined 3 age sub-groups of BOLD registry participants (65-74, 75-84, and 85+ years of age) for changes in pain and function over time. We found that the older age groups had more functional limitations as a consequence of their back pain to begin with and don’t improve in function over time as much as the younger age groups. This was different from pain, where pain levels remained similar over time across all age groups. In general, younger older adults were more likely to see an improvement in function than older seniors, but most people, regardless of age, did not see a dramatic improvement in pain over time. Furthermore, across age groups, complete resolution of functional limitations and pain happened only about a quarter (23%) of the time, and an even lower number (16%) had complete resolution of both functional limitations and pain.

Conclusion: Adults aged 85 and older were less likely to have substantial improvement in their back-related disability compared with adults between the ages of 65-84. Regardless of age, only one-quarter of adults 65 and older with a new episode of back pain had resolution of their back-related disability and pain after 24 months. Previously published guidance has implied that most people will have a rapid recovery from an episode of back pain – and many researchers and physicians believe in and use this message as guidance in treating people with low back pain. We will need to disseminate the results of our research to physicians and patients to make sure to set realistic expectations for back pain treatment and to encourage more research into providing more relief for older adults with back pain.

Do you have personal experience with back pain, or experience caring for someone with back pain? We need your expertise! Contact us to learn how you can get involved.