Chronic Pain in the Lower Extremities and Low Back is Associated With Recurrent Falls in Community-Dwelling Japanese People Aged 40-74 Years

Objective: To determine the longitudinal association between chronic pain in the lower extremities and low back and the odds of recurrent falls in middle-aged and older people. Design: A cohort study. Setting: Communities in Japan. Participants: Participants were 7540 community -dwelling volunteers aged 40-74 years (N=7540). The baseline survey was a self-administered questionnaire conducted between 2011-2013. Predictors were presence of chronic pain in the knee, foot or ankle, and low back, with the degree of pain categorized as none, very mild/mild, moderate, or severe/very severe. Covariates in the multivariate model of chronic pain in a site were demographics, body mass index, physical activity level, disease history, and chronic pain in the other 2 sites. Logistic regression analysis was used to calculate odds ratios (ORs). Interventions: None. Main Outcome Measure(s): Recurrent falls in the year before the 5 -year follow-up survey. Results: Mean participant age was 60.2 years. Higher degrees of chronic pain were associated with higher odds of recurrent falls for the knee ( P =.0002) with a higher OR of 1.48 (95% CI: 1.11-1.97), for the foot or ankle ( P =.0001) with a higher OR of 1.97 (95% CI: 1.362.86), and for the low back ( P =.0470) with a higher OR of 1.45 (95% CI: 1.09-1.91) in those with any degree of pain relative to those without pain. Higher degrees of chronic knee pain were associated with higher odds of recurrent falls in women ( P =.0005), but not in men ( P =.0813). Meanwhile, higher degrees of chronic low back pain were associated with the odds of recurrent falls in men ( P =.0065), but not in women ( P =.8735). Conclusions: Chronic pain in the knee, foot or ankle, and lower back was independently and dose -dependently associated with a higher risk of recurrent falls. A marked sex -dependent difference was also noted in the association. Archives of Physical Medicine and Rehabilitation 2024;(c) 2023 by the American Congress of Rehabilitation Medicine.