Trends of low back pain research in older and working-age adults from 1970 to 2022: A bibliometric analysis

Introduction: Low back pain (LBP) is a leading contributor to disability burden globally. Although research activities focusing on working-age adults with LBP (LBP-W) has been growing, there is no overview of the trends/focuses of these activities. Given the aging population, it is also important to understand whether sufficient studies have investigated the health needs of older adults with LBP (LBP-O). Therefore, we conducted a bibliometric analysis to uncover changes in publication patterns and research trends among LBPO and LBP-W over the last 52 years to help guide research priorities and foster collaborations among
researchers.
Methods: Peer-reviewed LBP-O and LBP-W articles published between 1970 and 2022 were identified and retrieved from Web of Science. Only original articles/reviews were included, without language restrictions. Patterns of annual publication volume as well as prominent authors, journals, institutions, countries, and
disciplines were identified by Web of Science. VOSviewer software was used to depict author collaboration networks and detect common keywords. CiteSpace software was used to identify the emerging trends based on the latest burst keywords with a dramatic increase in co-occurrence frequency.
Results: A total of 3,934 LBP-O-related and 50,210 LBP-W-related articles were included in the analysis. There were strong correlations between the annual publication volumes and the years for both LBP-O and LBP-W (R2=0.85 to 0.90, p<0.05). Compared to the annual publication volume in 1970, the annual numbers of LBP-O-related and LBP-W-related articles increased by 18,150.0% and 16,683.3% over the last 52 years, respectively. The United States has the highest number of prominent researchers and institutions that published relevant articles in both populations, followed by China and the United Kingdom. The journal Spine published the highest number of relevant articles for LBP-O and LBP-W combined, followed by Pain Medicine for LBP-O and European Spine Journal for LBP-W. Articles in both populations fell into the Neurosciences & Neurology and Orthopedics disciplines. The common keywords for LBP-O were related to surgery and medications, whereas those for LBP-W were associated with exercise or physical rehabilitation. We identified an emerging trend of increasing rates of physical activity-related research in LBP-O, and of surgery and intervertebral disc degeneration in LBP-W publications. Prominent researchers in the LBP-O and LBP-W fields seldom collaborated.
Conclusions: This is the first bibliometric analysis to systematically analyse the publication patterns and research trends in LBP-O and LBP-W over the last five decades. The discrepancy in the publication volume between LBP-O and LBP-W highlights the insufficient research attention/resources to LBP-O in the past. The shift in the research trend in LBP-O from surgery and drugs to physical activity suggests the recognition of the
importance of physical activity in managing LBP among older adults. Conversely, the growing emphasis on spine surgery and intervertebral disc degeneration in LBP-W research may highlight that intervertebral disc problems remain a common focus among LBP-W. Because the research trends in both populations are dynamic and may affect each other, it is essential to strengthen the collaborations among researchers in both fields to optimize evaluation and management of LBP across the lifespan.