Ageing well with chronic musculoskeletal pain: protocol for a systematic review of non-pharmacological interventions aimed at reducing pain in an ageing population

Abstract

Background: Chronic musculoskeletal pain in the elderly is highly prevalent, with osteoarthritis, low back pain, neck pain and other musculoskeletal disorders as the leading contributors to pain chronicity and disability. Previous reviews identifying effective components of non-pharmacological interventions for treating chronic pain have either few studies or the included studies examine outcome over a limited time span. This systematic review will investigate the effectiveness and components of interventions associated with management of chronic musculoskeletal pain in older adults (≥65 years).

Methods/Design: This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Randomised controlled trials of non-pharmacological interventions aimed at reducing pain in older adults with chronic musculoskeletal pain will be included. Articles will be identified through a comprehensive search of the following databases: Ovid MEDLINE, Embase, CINAHL, AMED, Scopus, Web of Science and PEDro. Two review authors will independently screen articles retrieved from the search for eligibility, and extract relevant data on methodological issues. A narrative synthesis will be completed if there are insufficient data for a meta-analysis. The narrative synthesis will summarise the current state of knowledge, interventions, study designs and robustness of evidence.

Discussion: Findings of the study will inform support programs and interventions to assist people aging with pain, carers and other supporters and practitioners.

Systematic review registration: PROSPERO 2017:CRD42017074173.

Keywords:

• Chronic pain
• ageing
• elderly
• pain management
• pain measurement
• randomised controlled trials

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study is supported by a Lottery Health Research Grant.

Notes on contributors

Poonam Mehta

Dr. Poonam Mehta's doctoral research was in the area of Neuropathic pain and was completed in 2015; her thesis was entitled “Neuropathic pain: Outcome measures and their psychometric properties”. This study focused on identifying the reliable and valid outcome measures for diabetic neuropathic pain. Her current research interests are in the health and wellbeing of ageing people and through her current roles she is further developing her skills and passion for research in the area of ageing health and wellbeing.

Mandeep Kaur

Dr. Mandeep Kaur graduated with a PhD from the University of Otago (School of Physiotherapy, New Zealand) in 2018. Her research was focused on the outcomes of anterior cruciate ligament reconstruction (ACLR) from 2 to-20 years post-surgery. She explored the medium (2-10 years) and long-term (10-20 years) outcomes of current management of ACLR in terms of muscle strength, physical performance, knee laxity and biomechanical outcomes. She also explored the participants' experiences of the outcomes of their surgery more than 2 years in relation to physical activity, sports, occupation and quality of life. Her research focus is on the ACL injury prevention, management and rehabilitation.

Catherine M. Smith

Dr. Catherine M. Smith was a lecturer at the School of Physiotherapy, University of Otago. She has been a qualitative researcher most of her research life. Her current research interests are focused on improvements in physical fitness via dog-walking, which also helps mental wellbeing and social connectedness. Her interest in dog-walking as a form of physical activity has been inspired by the stories of patients and research participants.

Ramakrishnan Mani

Dr. Ramakrishnan Mani is a senior lecturer at the School of Physiotherapy, University of Otago. His research interests are Chronic pain mechanisms (central sensitisation, neuroplasticity, and psychosocial factors); life-course approach to predict MSK pain development and chronicity; pain education / curriculum; sedentary behaviour.

G. David Baxter

Prof. David Baxter TD is currently Director for the New Zealand National Science Challenge for Ageing Well. David's research expertise is in the fields of rehabilitation, low back pain, complementary and alternative medicine, as well as in laser medicine. His current projects include physical activity interventions (principally walking interventions) for health, photobiomodulation of delayed wound healing, and clinical effectiveness of acupuncture (including laser devices) as an alternative to needles in treatment of pain.