The purpose of this study was to analyze the factor structure of items pertaining to health on the Minnesota Multiphasic Personality Inventory (MMPI2) for chronic back pain patients in comparison to a control group. The results may be used as groundwork for developing an MMPI2 subscale to describe this population. The groups differed in the sequence of the resulting factors and the percentage of variance accounted for by each factor. The factors extracted when evaluating the control group were titled in order: Poor Physical Health, Digestive Difficulties, Equilibrium, Depression/Malaise, and Multiple Somatic Complaints. Resulting factors for the pain group were: Depression/Malaise, Digestive Difficulties, Multiple Somatic Complaints, Headaches/Dizziness, and Neurological Reaction/Poor Physical Health.

Abstract Modic changes are vertebral bone marrow signal intensity changes adjacent to the endplates of the degenerated intervertebral discs in magnetic resonance imaging (MRI). This study evaluated the prevalence and the determinants of Modic changes and their association with low back pain symptoms in an occupational cohort of middle-aged Finnish men. The prevalence and the natural course of Modic changes were assessed over a 3-year follow-up period among sciatica patients. Finally, in a patient population, the characteristics of bone marrow changes in MRI were compared to the imaging findings in CT. The prevalence of Modic changes was 56% in an occupational cohort of middle-aged males. Besides age, the determinants of Modic changes and disc degeneration were different. Weight-related factors, which add to the load of the lumbar spine, were associated with Modic changes, whereas whole-body vibration was associated with severe disc degeneration. The prevalence of Modic changes among sciatica patients was 65%, type II change being the most frequent. During the 3-year follow-up, 14% of changes converted to another type, while the incidence of new Modic changes was 6%. Among middle-aged working males, Modic changes located at L5–S1 and type I Modic changes were more likely to be associated with pain symptoms than other types of Modic changes or changes located at other lumbar levels. Thirty-eight percent of the endplates with Modic changes had sclerosis in CT. Of specific Modic types, mixed I/II and II/III associated significantly with endplate sclerosis. Endplate sclerosis was not detected in MRI. In conclusion, Modic changes are a common MRI finding both among patients and middle-aged working males. In addition to age, weight-related factors seem to be important in the pathogenesis of Modic changes. Modic changes can convert from one type to another and type II changes may be less stable than previously assumed. A considerable proportion of Modic changes are sclerotic as observed in CT. Modic changes were always found in combination with a degenerative intervertebral disc and thus they are assumed to be a specific phenotype of degenerative disc disease. Finally, Modic changes may be painful – especially when located at L5–S1 and type I changes.

Abstract Low back pain (LBP) is a significant health problem in all developed countries. The high prevalence of LBP in youth is a cause of concern because a link has been reported between LBP in adolescence and chronic LBP (CLBP) in adulthood. In order to prevent CLBP in adulthood potential protective factors in youth should be identified. The association between trunk muscle strength and LBP has been widely studied but the results are conflicting. The current knowledge on the role of postural balance in relation to LPB is even more controversial. The aims of the thesis were to evaluate 1) the reproducibility of the inclinometric postural balance and maximal isometric trunk muscle strength measurements, 2) the association of low back symptoms with postural balance, trunk muscle strength, and cross-sectional area and fat content of extensor muscles, and 3) muscular fitness in relation to physical activity and television viewing. The study population belongs to the 1986 Northern Finland Birth Cohort (NFBC 1986), originally consisting of 9,479 children with an expected date of birth between July 1, 1985 and June 30, 1986. A total of 874 subjects completed the physical examination at a mean age of 19 years. Of those who participated in the physical examination 554 subjects took part in magnetic resonance imaging (MRI) of the lumbar spine, including extensor muscles, at a mean age of 21 years. Reproducibility of isometric trunk muscle testing was found to be comparable to other methods that are used to measure trunk muscle function. Low back symptoms were not associated with postural balance or trunk muscle strength. Neither was there an association between LBP and the cross-sectional area or fat content of the lumbar muscles. Trunk muscles were significantly stronger in those who participated in regular physical activity and weaker in those who watched TV more than two hours daily. In conclusion, physical activity has an association with muscular fitness whereas association with TV viewing is negative independently of the level of physical activity. Single measurement of trunk muscle strength, and cross-sectional area or fat content of lumbar extensor muscles has little significance in the evaluation of the severity of low back symptoms in young adults. / Tiivistelmä Alaselkäkipu on huomattava kansanterveydellinen ongelma kaikissa kehittyneissä maissa. Erityisen huolestuttavaa on alaselkäkivun yleisyys nuorilla, sillä tällä on todettu olevan yhteyttä krooniseen selkäkipuun aikuisuudessa. Jotta kroonista kipua aikuisiällä voitaisiin ehkäistä, kivulta suojaavat tekijät pitäisi pystyä tunnistamaan jo nuoruudessa. Vartalon lihasvoiman ja alaselkäkivun yhteyttä on tutkittu runsaasti viimeisten vuosikymmenten aikana mutta tulokset ovat ristiriitaisia. Tulokset seisomatasapainon yhteydestä alaselkäkipuun ovat niin ikään ristiriitaisia. Tämän tutkimuksen tavoitteena oli 1) arvioida inklinometrisen tasapainomittauksen ja isometristen lihasvoimamittausten luotettavuutta, 2) arvioida alaselkäoirein yhteyttä vartalon lihasvoimaan, seisomatasapainoon sekä ojentajalihasten rasvoittumiseen ja poikkipinta-alaan ja 3) arvioida lihasvoiman yhteyttä liikunta-aktiivisuuteen ja television katseluun. Tutkimusaineiston perustan muodostavat Pohjois-Suomen 1986 syntymäkohorttiin kuuluvat nuoret Oulun ja Lapin lääneistä, alkuperäiseen kohorttiin kuului 9,479 lasta, joiden laskettu syntymäaika oli heinäkuun 1:n 1986 ja kesäkuun 30:n 1986 välillä. Heistä Oulun Diakonissalaitoksen Liikuntaklinikalla suoritettuihin tutkimuksiin osallistui yhteensä 874 nuorta. Tutkimukseen liittyen Oulun yliopistollisen keskussairaalan radiologian klinikalla suoritettuihin selän magneetti- kuvauksiin osallistui 554 nuorta. Isometrinen lihasvoimatestaus osoittautui luotettavaksi tavaksi mitata vartalon lihasvoimaa. Alaselkäoireilla tai niiden vakavuudella ei todettu olevan yhteyttä vartalon lihasvoimaan tai seisomatasapainoon. Myöskään oireiden ja vartalon ojentajalihasten rasvoittumisen tai poikkipinta-alan välillä ei todettu olevan yhteyttä. Aktiivisemmin liikkuvien lihasvoima oli merkittävästi parempi kuin vähemmän liikkuvilla, toisaalta televisiota runsaasti katsovien lihasvoima oli televisiota vähän katsovia huonompi riippumatta siitä kuinka paljon he harrastivat liikuntaa. Aktiivisella liikunnalla on positiivinen yhteys lihasvoimaan. Toisaalta runsaalla television katsomisella on negatiivinen yhteys lihasvoimaan harrastetun liikunnan määrästä riippumatta. Yksittäisillä mittauksilla, kuten lihaksen poikkipinta-alalla tai vartalon lihasvoimalla ei todettu yhteyttä alaselkäoireiden vakavuuteen nuorilla aikuisilla.

Abstract Aim The aim of the study was to investigate the prevalence of lower back pain in the Greater Stockholm Fire Brigade.   MethodA web-based survey was designed and sent to all operational personnel within the Greater Stockholm Fire Brigade, a total of 530 people. The survey was not validity or reliability tested. The questions in the questionnaire had certain response options and had been modified according to the age group, number of years in the profession, and modified on a validated and reliable questionnaire, the Örebro Musculoskeletal Pain Screening Questionnaire. To strengthen the study's internal validity, a pilot study was conducted. For the statistical analysis, the statistical program SPSS was used and the result was analyzed with Spearman's non-parametric tests and Chisquare-test.   Results A total of 66% of the operating staff responded to the web-based survey, of which 79% reported having lower back pain in the past 12 months. There was not a correlation between lower back pain and age or number of years in the profession. Correlation were found in lower back pain and experienced adverse effects at work (p <0.05). A total of 11 % had reported absence from work due to lower back pain in the past year, and a total of 32% had applied for health care. The most sought after caregivers were naprapaths or chiropractors (p <0.05).   Conclusions: The study shows that the majority of operational personnel in The Greater Stockholm Fire Brigade reported lower back pain over the last 12 months. The result of the study showed no correlation between lower back pain and age or number of years within the profession. There was a correlation between lower back pain and negative impact on the work. There was also a correlation between lower back pain and absence from work. Naprapaths or chiropractors were the most sought caregivers at lower back pain cases. Future studies should include additional factors and causes that affect the presence of lower back pain. / Abstrakt Syfte Syftet med studien var att undersöka förekomsten av ländryggsbesvär inom Storstockholms brandförsvar. Metod En webbaserad enkät utformades och skickades ut till all operativ personal inom Storstockholms brandförsvar, totalt 530 personer. Enkäten var inte validitets- eller reliabilitetstestad. Frågorna i enkäten hade bestämda svarsalternativ och hade modifierats efter urvalsgruppens ålder, antal år i yrket samt utifrån ett validerat och reliabelt frågeformulär, Örebro Musculoskeletal Pain Screening Questionnaire. För att stärka studiens interna validitet gjordes en pilotstudie. Till den statistiska analysen användes programmet SPSS och resultatet analyserades med Spearmans icke parametriska test samt Chitvåtestet. Resultat Totalt 66 % av den operativa personalen besvarade den webbaserade enkäten och av dessa angav 79 % att de upplevt ländryggsbesvär någon gång under de senaste 12 månaderna. Det fanns inget samband mellan ländryggsbesvär och ålder eller antal år i yrket. Samband fanns vid ländryggsbesvär och upplevd negativ påverkan i arbetet (p<0.05). Totalt 11 % hade någon gång under det senaste året rapporterat frånvaro från arbetet på grund av ländryggsbesvär. Totalt 32 % hade under de senaste 12 månaderna sökt vårdgivare för sina ländryggsbesvär. De mest sökta vårdgivarna var naprapater eller kiropraktorer (p<0.05). Slutsats Studien påvisar att majoriteten av den operativa personalen inom Storstockholms brandförsvar upplevt ländryggsbesvär under de senaste 12 månaderna. Studiens resultat visade inget samband mellan ländryggsbesvär och ålder eller antal år inom yrket. Samband fanns vid ländryggsbesvär och upplevd negativ påverkan i arbetet samt vid frånvaro från arbetet. Naprapater eller kiropraktorer var de mest sökta vårdgivarna vid ländryggsbesvär. Framtida studier bör inkludera fler faktorer och orsaker som påverkar förekomsten av ländryggsbesvär.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Low back pain (LBP) is a growing health and socio-economic problem worldwide, affecting humans from adolescent to adult age. In developed countries, more than 80% of adults are at risk of suffering a disabling episode of LBP at one point during their life time. In developing countries, particularly in Africa, the life time prevalence of LBP varies in population groups, but the disability due to LBP is increasing. The aetiology of LBP is multifactorial, and there is still no consensus on the exact cause and contributing factors to LBP. In addition, little is known about patients' knowledge and beliefs on the contributing factors to their LBP. The current study therefore, aimed to identify patients' knowledge, attitudes and beliefs on the contributing factors to LBP, among patients attending physiotherapy outpatient departments in Malawi. / South Africa

Magister Scientiae (Physiotherapy) - MSc(Physio) / Low back pain among high school children is perceived to be uncommon in the clinic setting. However, previous studies have suggested that it may be an important and increasing problem to be managed in this age group. The overall aim of this study was to determine the prevalence, the predisposing factors and management of low back pain among high school children in Nyamasheke district in Rwanda. A cross– sectional descriptive study was conducted using a combination of quantitative and qualitative research methods. The study included a population of 10 330 high school children aged 13- 21 years old registered in high schools of Nyamasheke district. In addition, 13 service providers involved in addressing low back pain were included in the study. The study was conducted in ten schools selected randomly, four schools from nine urban schools and six schools from 15 rural schools. The sample size included 1 000 participants selected by a simple random sampling method and six service providers selected by purposive sampling method. A self-administered questionnaire was given to high school learners. Semi-structured interviews amongst service providers were conducted to validate information given by high school learners. The software SPSS version 19.0 for windows and Microsoft Excel package 2010 were used to analyze the quantitative data. Descriptive statistics using frequencies, percentages, means, and standard deviations and inferential statistics using chi-square and correlation tests were calculated to examine the association between variables. For qualitative findings, audiotaped interviews were transcribed and translated from Kinyarwanda into English, and the expressed ideas were coded and reduced into themes and categories. Permission to conduct this study was obtained from the Senate Research Grants and Study Leave Committee at the University of the Western Cape, and the concerned authorities in Rwanda. Individual participants and their parents/guardians were informed of the study through an information sheet and written informed consent or assent was then obtained from the participants. The mean age of the quantitative study sample was 17 years, and 48.2% were females compared to 51.8% of males. The response rate was 96.2%. The low back pain prevalence was found to be 66.1%. The mean age of the first occurrence of low back pain was 14.5(SD = 2.28). One year prevalence was found to be 25.4% whereas the one month prevalence was 13.7%. Males were the most to report low back pain comparatively to females with 53.1% and 43.9% respectively. There was significant relationship between age group and low back pain (p = 0.000). High school children from the rural region were the most to report low back pain in comparison to those from urban region with 61.5% against 38.5% respectively. Regarding the predisposing factors to low back pain, a strong relationship was found between low back pain and posture (sitting and standing position) (p=0.000) with 83.2%. The findings of the interviews conducted among service providers showed that the main predisposing factors for low back pain could be posture/position in class and psychological factors. The study found that most of the participants do not attend medical services. The study highlighted that the impact of low back pain included medical costs, missing class when attending medical services and difficult to perform normal usual activities. It was found that the level of education in health promotion as preventive measures of low back pain is still at low level.

Lower back pain remains one of the most common problems in public health throughout the industrialized world (Strine and Hootman) (Shiri, Solovieva and K.). The prevalence is about 39-54% annually and 60-65% in a lifetime (Hillman, Wright and Rajaranam) (Leboeuf-Yde, N. and Lauritzen). In the United States, lower back pain is the second most common cause of disability, and is the highest cause of disability among men (Center for Disease Control, 2009). An individual quantitative physical examination to detect muscle deficiencies would be very useful for proper placement of workers in demanding physical jobs where back injuries are common. Trunk muscle extensor endurance might be the best approach for this issue.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-25T13:17:48Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃOOO.pdf: 2431467 bytes, checksum: 5fd4cac0b208f0602567479b027d240f (MD5) / Made available in DSpace on 2017-07-25T13:17:48Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃOOO.pdf: 2431467 bytes, checksum: 5fd4cac0b208f0602567479b027d240f (MD5) Previous issue date: 2016-09-30 / As modificações decorrentes do ciclo gravídico no corpo da mulher tornam-no mais sujeito a riscos como a lombalgia, sintomatologia que tem assumido relevante destaque pela sua alta incidência. Diante disto, objetivou-se avaliar a atuação do SUS por meio de sua rede preferencial, a Atenção Básica, quanto a efetivação da integralidade na atenção à lombalgia gestacional de mulheres residentes no Habitacional da Comunidade de Saramandaia – PE. Para tanto, foi aplicado um questionário a todas as gestantes residentes nesse habitacional, com ou sem referência de lombalgia. A partir da análise dos dados, verificou-se que, embora 95% das gestantes estivessem realizando pré-natal pela USF, houve uma prevalência de dor lombar de 75% atrelada às gestações atuais ou anteriores e a maioria das gestantes acompanhadas (78,94%) afirmou não receber orientações e 94,73% ainda não tinham sido encorajadas a praticar atividade física a fim de prevenir e tratar tal dor. Dentre as mulheres com lombalgia gestacional, 66,66% asseguraram piora do quadro no decorrer da gravidez e 100% das mulheres que referem dor lombar e que estão sendo acompanhadas pela USF declararam que os profissionais de saúde não estão atuando na sua dor e que ainda poderiam fazer mais pela mesma. Com base nesses dados, pode-se afirmar que a Atenção Básica tem se esvaído de sua responsabilidade em promover ações integrais no cuidado às mulheres gestantes da comunidade de Saramandaia – PE, pois estas não têm sido contempladas com a promoção de sua saúde, a prevenção e o tratamento da dor lombar, comprometendo suas possibilidades de viver o período gestacional de modo saudável. / The changes resulting from pregnancy cycle in a woman's body makes it more subject to risks such as low back pain, symptoms that has taken relevant highlighted by its high incidence. In view of this objective was to evaluate the SUS coverage through their preferred network, the Primary Care, as the realization of completeness in the care of gestational lumbago of women living in the Housing Saramandaia – PE community. To this end a questionnaire was administered to all pregnant women living in this housing, with or without reference lumbago. From the analysis of the data found that while 95% of pregnant women were performing prenatal by USF, there was a prevalence of low back pain 75% linked to current or previous pregnancies and the majority of women followed (78.94 %) said he did not receive guidance and 94.73% had not been encouraged to engage in physical activity to prevent and treat this pain. Among women with gestational lumbago, 66.66% assured picture worsens during pregnancy and 100% of women who reported back pain and being accompanied by USF declared that health professionals are not acting in their pain and still they could do more for the same. Based on these data it can be stated that Primary Care has been drained of their responsibility to promote comprehensive actions in caring for pregnant women Saramandaia – PE community because they have not been included with the promotion of their health, prevention and the treatment of low back pain, affecting their ability to live the pregnancy healthily.

Devido a grande prevalência de lombalgia não-especifica, esse estudo buscou conhecer melhor sobre o uso do método Pilates no tratamento desta doença. Os objetivos foram descrever e comparar o padrão eletromiográfico da musculatura do core durante exercícios intermediários do Mat Pilates em pessoas saudáveis e com lombalgia não-específica, bem como relatar as diferenças entre os exercícios e a sequência de progressão de cada exercício para fins terapêuticos. A amostra foi composta por 32 pessoas (13 com lombalgia crônica não-específica e 19 saudáveis) com idade entre 18-45 anos e sem contato prévio com o Pilates. Os músculos multífido, oblíquo externo, oblíquo interno e reto abdominal foram avaliados eletromiograficamente e exercícios clássicos do repertório foram escolhidos (Single leg stretch, Criss-cross e Dead bug). Utilizou-se um eletromiógrafo de superfície de 8-canais, wireless, sincronizado com a variação angular de quadril e os dados coletados em 2 kHz. Analisamos (a) Root mean square (RMS) normalizado pela contração voluntaria máxima, (b) pico do envoltório normalizado pela contração voluntaria máxima; (c) tempo do pico de ativação e (d) co-contração entre a musculatura flexora e extensora (reto abdominal / oblíquo externo / oblíquo interno X multífido). Foram realizadas ANOVAs para medidas repetidas para comparar os exercícios entre si quanto as variáveis RMS e pico de ativação. E, ANOVAs 2 fatores para se comparar os grupos e exercícios para as variáveis tempo de pico de ativação e co-contração. Como resultados, obtivemos que o exercício criss-cross apresentou maiores valores de RMS para os flexores de tronco - reto abdominal, oblíquo externo e interno - quando comparado com os outros exercícios. Os maiores picos de ativação foram dos músculos oblíquo interno e externo no exercício Criss-cross, seguidos do Single leg stretch e do Dead bug, os quais se apresentaram mais similares entre si. O tempo do pico de ativação do reto abdominal e oblíquo externo mostraram-se mais adiantados para o Dead bug e Single leg stretch, enquanto que para o Criss-cross, foram mais atrasados em ambos os grupos. Tanto controles quanto lombálgicos apresentaram maiores índices de cocontração no exercício Dead bug e Single leg stretch, sendo que o Criss-cross apresenta o menor índice deles, com exceção da razão entre obliquo externo e multífido nos controles. Os grupos estudados foram semelhantes entre si em todos os exercícios em relação à co-contração, mas o tempo de pico do reto abdominal e do oblíquo externo dos lombálgicos apresentaram-se mais adiantados que os controles. Podemos concluir que os exercícios foram diferentes quanto a seu padrão de recrutamento do core mesmo tendo a mesma classificação dentro do método - intermediários- e que em termos de progressão clínica para o tratamento de lombalgia crônica, deveríamos iniciar com os exercícios menos desafiadores (Dead bug, Single leg stretch) e somente então evoluir para exercícios mais complexos que demandem de maior estabilização lombo-pélvica (Criss-cross). O método Pilates permitiu a ativação da musculatura estabilizadora lombo-pélvica mesmo em uma primeira sessão, tanto com indivíduos saudáveis quanto lombálgicos, podendo ser portanto indicado nos casos de reabilitação de indivíduos com lombalgia crônica não específica desde que com progressão adequada / Due to the high prevalence of non-specific low back pain, this study meant to learn more about the best use of the Pilates method in rehabilitation. The aims of the study were to describe and compare the core muscles electromyographic pattern during intermediate Mat Pilates exercises in healthy people and with low back pain. In addition, to report the differences between the exercise and the sequence of progression of each exercise for therapeutic purposes. The sample consisted of 32 people (13 with chronic non-specific low back pain and 19 healthy) aged between 18 and 45 years with no prior contact with Pilates. An electromyography analysis were done assessing the multifidus, external oblique, internal oblique and rectus abdominis muscles and exercises of the classical repertoire were chosen (Single leg stretch, Criss-cross and Dead bug). It was used a surface 8-channel electromyograph, wireless, synchronized with the hip angular variation and the data were acquired at 2 kHz. It were analysed: (a) Root mean square (RMS) normalized by maximum voluntary contraction, (b) peak of the linear envelope normalized by maximum voluntary contraction; (c) time of peak activation and (d) co-contraction of the flexor and extensor muscles (rectus abdominis / external oblique / internal oblique X multifidus). ANOVAs for repeated measures were performed to compare between exercises using the variables RMS and peak activation. Moreover, two-way ANOVAs compared groups and exercises for the variables time of peak activation and co-contraction. We observed that the criss-cross exercise had higher RMS values for the trunk flexors - rectus abdominis, external oblique and internal oblique - when compared to other exercises. The highest peaks of activation were observed for the internal and external oblique muscles in Criss-cross exercise, followed by the Single leg stretch and the Dead bug, which presented similar behaviour to each other. The time of peak activation of the external oblique and rectus abdominis showed up anticipated for the Dead bug and Single leg stretch, while for the Crisscross, delayed in both groups. Both groups had higher co-contraction rates in the Dead bug and Single leg stretch exercises, and the Criss-cross had the lowest indexes, with the exception of the ratio of external oblique and multifidus in control group. Both groups were similar in all exercises for co-contraction, but the low back pain group presented earlier time of peak of rectus abdominis and external oblique of than controls. We conclude that the exercises were different as their recruitment pattern, even with the same classification in the Pilates method - as intermediate exercises - and in terms of treatment progression of chronic low back pain, we may start with the least challenging exercises (Dead bug, Single leg stretch) and only then progress to more complex exercises that require greater lumbopelvic stabilization (Criss-cross). The Pilates method allowed the activation of the lumbopelvic stabilizing muscles even in a first session for both groups, and may therefore be indicated in cases of chronic nonspecific low back pain rehabilitation with proper progression

Older adults (65+) are one of the fastest growing segments of the population in the United States. Chronic pain is common among this population, and chronic low back pain (CLBP) in particular is the number one pain complaint among older adults. In addition to larger societal and fiscal costs, CLBP is associated with a host of personal negative consequences such as physical disability, poor psychosocial functioning, and decreased quality of life. Despite being a leading health problem in older adulthood, little is known about how older adults actually experience this type of pain. Thus, the purpose of this dissertation was to understand older adults’ lived experience of CLBP. To improve understanding of CLBP in this understudied population, a qualitative study using a phenomenological method was conducted. Phenomenology, rooted in existential philosophy, is the study of the nature and meanings of phenomena, in which experiences related to the phenomena are the main source of insight. van Manen’s Phenomenology of Practice method specifically guided the investigation with regard to study conception, data collection, and data analysis. Participants were 21 older pain clinic patients living with CLBP who engaged in one-on-one in-depth interviews. Findings suggest that CLBP is an all-encompassing presence in participants’ lives. Seven main themes include: (1) Living a life full of pain; (2) Pain affects everything; (3) With others but a lone in my pain; (4) With pain comes sorrow; (5) Aging painfully; (6) Managing the incurable; (7) You just have to keep going. Implications for social work practice, research, and policy are discussed. By building a deeper understanding of older adult’s experiences and personal meaning of CLBP, social workers may be more able to provide meaningful and effective psychosocial services in the context of interdisciplinary CLBP management.