Deconstructing chronic low back pain in the older adult–step by step evidence and expert-based recommendations for evaluation and treatment: Part IX: Anxiety

Jordan F. Karp, Elizabeth A. Dinapoli, Julie Wetherell, Chloe Bolon, Eric Rodriguez, Joseph Shega, Debra K. Weiner

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective. As a part of a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults, this article focuses on anxiety—a significant contributor of reduced health-related quality of life, increased use of medical services, and heightened disability in older adults with CLBP. Methods. A modified Delphi technique was used to develop an algorithm for the screening and clinical care of older adults with CLBP and anxiety. A 4member content expert panel and a nine-member primary care panel were involved in this iterative development process. Evidence underlying the recommendations is not strictly based on VA populations; therefore, the algorithm can be applied in both VHA and civilian settings. The illustrative clinical case was taken from one of the contributor’s clinical practice. Results. We present a treatment algorithm and supporting tables to be used by providers treating older adults who have anxiety and CLBP. A case of an older adult with anxiety and CLBP is provided to illustrate the approach to management. Conclusions. To promote early engagement in evidence-based treatments, providers should routinely evaluate anxiety in older adults with CLBP using a screening and treatment algorithm.

Original languageEnglish (US)
Pages (from-to)1423-1435
Number of pages13
JournalPain Medicine (United States)
Volume17
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

Keywords

  • Anxiety
  • Avoidance behavior
  • Chronic pain
  • Cognitive behavior therapy
  • Fear
  • Low back pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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