Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Tips for Interdisciplinary Pain Management in Older Patients

Susan Bernstein  |  Issue: April 2019  |  April 15, 2019

Collaborative Care

Collaborative care models embrace the interdisciplinary team approach to care. In one trial of 401 patients with musculoskeletal pain who were randomized to receive either collaborative pain care or usual care at five VA primary care clinics, a care manager worked in conjunction with a pain specialist to manage patients in the collaborative care arm, assess their needs and then refer them to physical, occupational or recreational therapy, following up with the pain specialist on the decisions made.21

Stratified care models are newer and have less evidence behind them. In one non-randomized, implementation trial published in 2014, 922 patients with low back pain who received care at a family practice clinic were compared with a subsequent group of patients who received a new, stratified back pain intervention called the STarT Back Tool.22 This tool uses questionnaires to help providers identify levels of pain risk and disability so they can target patients for particular interventions. The study showed small, but significant, benefits for patients who used the STarT Back Tool over those receiving typical care, she said.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Susan Bernstein is a freelance journalist based in Atlanta.

References

  1. National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services, U.S. Department of State. Why Population Aging Matters: A Global Perspective (Publication No. 07-6134). 2007 Mar.
  2. AGS Panel on Persistent Pain in Older Persons. The management of persistent pain in older persons. J Am Geriatr Soc. 2002 Jun;50(6 Suppl):S205–S224.
  3. Leveille SG, Jones RN, Kiely DK, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009 Nov;302(20):2214–2221.
  4. Reid MC, Williams CS, Gill TM. The relationship between psychological factors and disabling musculoskeletal pain in community-dwelling older persons. J Am Geriatr Soc. 2003 Aug;51(8):1092–1098.
  5. Leveille SG, Ling S, Hochberg MC, et al. Widespread musculoskeletal pain and progression of disability in older disabled women. Ann Intern Med. 2001 Dec;135(12):1038–1046.
  6. Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: Estimates from U.S. national surveys, 2002. Spine (Phila Pa 1976). 2006 Nov 1;31(23):2724–2727.
  7. Centers for Disease Control and Prevention (CDC. Prevalence and most common causes of disability in adults—United States, 2005. MMWR Morb Mortal Wkly Rep. 2009 May 1;58(16):421–426.
  8. Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am. 2006 Apr:88(Suppl 2):S21–S24.
  9. Makris UE, Higashi RT, Marks EG, et al. Physical, emotional and social impacts of restricting pain in older adults: A qualitative study. Pain Med. 2017 Jul 1;18(7):1225–1235.
  10. Weiner DK, Marcum Z, Rodriguez E. Deconstructing chronic lower back pain in older adults: Summary recommendations. Pain Med. 2016 Dec;17(12):2238–2246.
  11. Engel GL. The need for a new medical model: A challenge for biomedicine. Science. 1977 Apr 8;196(4286):129–136.
  12. Krebs EE, Gravely A, Nugent S, et al. Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain: The SPACE Randomized Clinical Trial. JAMA. 2018 Mar 6;319(9):872–882.
  13. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514–530.
  14. Makris UE, Higashi RT, Marks EG, et al. Ageism, negative attitudes and competing comorbidities: Why older adults may not seek care for restricting back pain: A qualitative study. BMC Geriatr. 2015 Apr 8;15:39.
  15. Reid MC, Ong AD, Henderson CR Jr. Why we need nonpharmacologic approaches to manage chronic low back pain in older adults. JAMA Intern Med. 2016 Mar;176(3):338–339.
  16. Raveendran R, Nelson AE. Lower extremity osteoarthritis: Management and challenges. N C Med J. 2017 Sep–Oct.78(5):332–336.
  17. Meneses SR, Goode AP, Nelson AE, et al. Clinical algorithms to aid osteoarthritis guideline dissemination. Osteoarthritis Cartilage. 2016 Sep;24(9):1487–1499.
  18. Lee J, Song J, Hootman JM, et al. Obesity and other modifiable factors for physical inactivity measured by accelerometer in adults with knee osteoarthritis. Arthritis Care Res (Hoboken). 2013 Jan;65(1):53–61.
  19. Allen KD, Choong PF, Davis AM, et al. Osteoarthritis: Models for appropriate care across the disease continuum. Best Prac Res Clin Rheumatol. 2016 Jun;30(3):503–535.
  20. Moore BA, Anderson D, Dorflinger L, et al. Stepped care model of pain management and quality of pain care in long-term opioid therapy. J Rehabil Res Dev. 2016;53(1):137–146.
  21. Dobscha SK, Corson K, Perrin NA, et al. Collaborative care for chronic pain in primary care: A cluster randomized trial. JAMA. 2009 Mar 25;301(12):1242–1252.
  22. Bamford A, Nation A, Durrell S, et al. Implementing the Keele stratified care model for patients with low back pain: An observational impact study. BMC Musculoskelet Disord. 2017 Feb 3;18(1):66.

Page: 1 2 3 4 5 | Single Page
Share: 

Filed under:AnalgesicsConditions Tagged with:2018 ACR/ARHP Annual MeetingbiopsychosocialcollaborationExerciseinterdisciplinaryPain Managementstepped care

Related Articles

    Tackling Multicomplexity in Aging Patients with RA

    November 22, 2021

    Two sessions at ACR Convergence 2021 addressed a holistic approach to taking care of older patients with RA & other rheumatic diseases.

    As Population Ages, Rheumatologists Prepare to Treat Elderly Patients with More Comorbidities

    November 1, 2012

    Cardiovascular disease, diabetes are among the conditions that add another layer of complexity in treating older rheumatology patients

    The 2018 ACR/ARHP Annual Meeting Program Preview

    September 20, 2018

    Save the date for the 2018 ACR/ARHP Annual Meeting, Oct. 19–24 in Chicago. Connect with your colleagues for an unmatched educational experience featuring exceptional sessions by leading rheumatology experts. The ACR/ARHP Annual Meeting is your gateway to global rheumatology education. With more than 450 sessions—including The Great Debate—the meeting provides boundless opportunities for professional development,…

    Physical Activity, Exercise Can Benefit Patients with RA

    November 9, 2017

    While medical advances in rheumatoid arthritis (RA) have led to improvements in disease control and quality of life for patients worldwide, the rate for stable remission remains low.1 Management of RA symptoms is traditionally accomplished through a combination of medications and nonpharmacological interventions.2 This approach can prevent the development of secondary adverse health outcomes. Two…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences