Chiropractic management of chronic lower back pain in older adults: A randomized clinical trial

BACKGROUND:

The identification of safe and effective interventions for chronic lower back pain (CLBP) in the older adults is critical in view of its high prevalence, negative impact on quality of life and the treatment risks associated with chronic medication use. In 1998, published guidelines from the American Geriatric Society listed chiropractic management (CM) among the non-pharmacologic strategies for treating chronic pain in older adults. Despite the general clinical acceptance of CM and satisfaction with chiropractic services, evidence on the potential benefit and safety of CM for lower back pain in older adults is lacking.

METHODS:

Patients are being randomized into one of two treatment groups, CM (Spinal manipulative therapy (SMT) and/or Flexion distraction (FD)) or Sham intervention (detuned ultrasound). The patients will undergo eight treatments over a thirty five day period. Outcome measures include; Timed up and go, Oswestry Disability Index, Visual analogue scale and Short Form 36. These will be collected at; baseline, one week and three months post intervention. Adverse event, patient expectation and patient satisfaction data will also be collected and analyzed.

RESULTS:

This VA Merit Review grant funded study is currently underway. Preliminary data will be presented at the meeting including; number of patients currently recruited and preliminary outcome data.

DISCUSSION:

The results of this study will contribute to the current knowledge base in regard to the safety and effectiveness of specific conservative interventions for older adults with CLBP. Future studies will specifically investigate the effectiveness of the individual treatment methods SMT or FD.