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Open Access Open Badges Research article

Musculoskeletal pain in older adults at the end-of-life: a systematic search and critical review of the literature with priorities for future research

Alison Kate Lillie12*, Sue Read1, Christian Mallen2, Peter Croft2 and John McBeth2

Author Affiliations

1 Keele University School of Nursing and Midwifery, Clinical Education Centre, University Hospital of North Staffordshire, Stoke on Trent, ST4 6QG, Staffordshire, UK

2 Keele University, Research Institute for Primary Care & Health Sciences, Keele University, Keele, ST5 5BG, Staffordshire, UK

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BMC Palliative Care 2013, 12:27  doi:10.1186/1472-684X-12-27

Published: 25 July 2013



Pain is an important issue in end of life care. Although musculoskeletal pain is common in older adults, it is rarely associated with the cause of death and may be overlooked as death approaches. Hence a major target for improving quality of life may be being missed.


The aim of this study was to systematically search and critically review the literature on musculoskeletal pain at the end of life. Amed, Cinahl, Internurse, Medline, Psych Info, Web of Knowledge and Cochrane review databases were searched for relevant research up to September 2012. The search strategy combined key words expanding the terms ‘palliative’ for population, ‘musculoskeletal’ for exposure, and ‘pain’ for outcome. Predefined inclusion and exclusion criteria were applied.


Five relevant papers and one letter to the editor were found, including case studies and epidemiological research. Current evidence suggests musculoskeletal pain is common in older adults at the end of life and that it can have a substantial impact on individual experience. No information about community based treatment of musculoskeletal pain at the end of life was found.


Priorities for future research include high quality epidemiological studies to establish the prevalence, natural history, impact, assessment, patient priorities and outcomes associated with musculoskeletal pain in the end of life period, and intervention research that provides an evidence base for treatment.

Palliative; Pain; Musculoskeletal; End of life; Systematic review