Objective: To determine the prevalence of back and neck pain (BNP) in Parkinson’s Disease (PD) patients and the proportion of patients seeking invasive treatments for this pain.

Background: Pain has long been known to be a prominent and disabling feature of PD. Studies have shown that in PD patients, BNP is more common and less responsive to commonly used pain treatments compared to controls, potentially driving PD patients to disproportionally pursue invasive treatment options. The use of these treatments has not been well studied in the PD population.

Method: This was a retrospective cohort study utilizing data from the One Florida Consortium Database, which contains data on 15 million patients from 11 Florida health systems. ICD9/10 codes were used to determine the prevalence of BNP in PD patients compared to controls. To determine if the rate of BNP differed between PD and controls and to account for confounding variables including age and other comorbidities associated with pain, we used logistic regression to calculate the odds ratio (OR) of having BNP and the corresponding 95% confidence interval (CI). We explored the secondary outcome of undergoing an invasive procedure for pain (spinal surgery and/or injections) with sub-data analysis. Similar analyses were performed to investigate disparities in race, ethnicity, and sex.

Results: A total of 35,778 PD patients (mean age 76; 46.4% female) and 294,745 controls (mean age 62; 57.6% female) were included in the analysis. Of those, 12,902 (36.1%) of PD patients and 80,437 (27.3%) of controls had BNP, and 1,179 PD patients with BNP (9.1%) and 6,232 controls with BNP (7.8%) underwent an invasive procedure. PD patients were significantly more likely to have a concurrent diagnosis of BNP (OR 1.16; 95% CI 1.13-1.19). However, there were no significant differences found in the rate of invasive procedures between the groups. Among PD patients, females (OR 1.30; 95% CI 1.23-1.36) and Hispanics (OR 1.29, 95% CI 1.20-1.39) were significantly more likely to have a diagnosis of BNP, but not to undergo an invasive procedure.

Conclusion: PD patients, particularly female and Hispanic patients, are more likely to suffer from BNP; however these groups are not more likely to pursue invasive pain procedures. Given the prevalence of BNP in PD, next steps will involve investigating variations in pain severity, the impact of invasive procedures on PD progression, and the source of the disparities observed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-back-and-neck-pain-in-parkinsons-disease-the-pd-pain-study/