Low Back Pain as a Risk Factor for Recurrent Falls in People with Knee Osteoarthritis


Knee osteoarthritis (OA) has been suggested to increase the risk of falls. Low back pain (LBP) is a potential risk factor for falls in people with knee OA, but this has not been addressed adequately in previous studies. This study aimed to investigate the relationship between LBP and falls in people with knee OA in a 12-month period.


Participants with knee OA (Kellgren and Lawrence [K&L) grade ≥ 1) completed questionnaires for LBP and falls that occurred in the preceding 12 months. Binary and ordinal logistic regression analyses were performed to assess the relationship between LBP or moderate-to-severe LBP (numeric rating scale ≥ 4 points) and any fall (≥ 1 fall) or recurrent falls (≥ 2 falls) after adjustment for age, sex, K&L grade, knee pain severity, and quadriceps strength. Sensitivity analyses were performed excluding people with sciatica, non-chronic LBP, K&L grade 1, and those receiving pain medications.


We included 189 participants (age: 61-90 years, 78.3% women) in this study. Of these participants, 41 (21.6%) reported falls in the preceding 12 months. People with any LBP (n = 101) and those with moderate-to-severe LBP (n = 45) had 2.7 and 3.7 times higher odds of recurrent falls, respectively. Sensitivity analyses revealed a strong correlation between moderate-to-severe LBP and recurrent falls.


Thorough investigation of LBP as a risk factor for recurrent falls in people with knee OA may provide a novel insight into the pathomechanics of recurrent falls in this population.

 2020 Jan 7. doi: 10.1002/acr.24136. [Epub ahead of print]