Elderly Back Pain: Comparing Chiropractic to Medical Care

Condition(s) targeted: Subacute Low Back Pain; Chronic Low Back Pain

Intervention: Spinal manipulation (Other); Spinal manipulation (Other); Usual medical care (Celebrex, Aleve, Bextra, Naproxen) (Drug)

Phase: Phase 2

Status: Completed

Sponsored by: Palmer College of Chiropractic

Official(s) and/or principal investigator(s):
William C Meeker, DC, M.P.H., Principal Investigator, Affiliation: Palmer Chiropractic College
Maria A Hondras, DC, MPH, Study Director, Affiliation: Palmer College of Chiropractic

The purpose of this study is to compare the clinical effectiveness of two types of chiropractic spinal manipulation to conservative medical care for patients at least 55 years old with sub-acute or chronic low back pain (LBP).

Official title: Elderly Back Pain: Comparing Chiropractic to Medical Care

Study design: Treatment, Randomized, Single Blind (Outcomes Assessor), Active Control, Parallel Assignment, Efficacy Study

Primary outcome: Roland Morris Disability Questionnaire(RMDQ).

Secondary outcome:

Fear Avoidance Beliefs Questionnaire, physical subscale

Visual Analogue Scale for Pain

Postural Sway

SF-36, v1, Physical Function subscale

Posteroanterior Spinal Stiffness

Sit-to-Stand Maneuver

Spinal Manipulation

Detailed description: Despite the high prevalence of LBP and the associated economic costs, disability, and lost productivity, and despite the development of several treatment guidelines, one of which recommends chiropractic spinal manipulation for some subgroups of patients with pack pain, the management of LBP remains controversial and highly variable across professions and geographic regions. Although one recent publication describes the design of chiropractic and exercise for seniors with low back or neck pain, no published studies to our knowledge, have assessed the effectiveness of chiropractic manipulation compared to medical care for older adults with sub-acute or chronic low back pain.

Minimum age: 55 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Age 55 or older

- Idiopathic low back pain (LBP) of at least four weeks duration

- Meet the diagnostic classification of 1, 2, or 3 according to the Quebec Task Force on

Spinal Disorders

Exclusion Criteria:

- Low back pain (LBP) not meeting Quebec Task Force Diagnostic Classifications 1, 2 or

3, especially LBP associated with: frank radiculopathy, altered lower extremity reflex, dermatomal sensory deficit, progressive unilateral muscle weakness or motor loss, symptoms of cauda equina compression, and CT or MRI evidence of anatomical pathology (e. g. abnormal disc, lateral or central stenosis.

- Co-morbid conditions or general poor health that could significantly complicate the

prognosis of LBP, including pregnancy, bleeding disorders, extreme obesity, and clear evidence of narcotic or other drug abuse.

- Major clinical depression defined as scores greater that 29 on the Beck Depression

Inventory - Second Edition

- Bone or joint pathology that contraindicate spinal manipulative therapy of joint

pathology that contraindicate spinal maniuplative therapy of the arthropathies and significant osteoporosis

- Pacemaker, because there are safety issues with equipment used to collect data in the

biomechanical testing laboratory

- Current or pending litigation related to current episode of LBP.

- Receiving disability for any health-related condition

- Spinal Manipulative care for any reason within the past month

- Unwilling to postpone use of manual therapies for LBP except those provided in the

study for the duration of the study period.

- Unable to read or verbally comprehend English.

Palmer Center for Chiropractic Research, Davenport, Iowa 52803, United States

The University of Iowa, Iowa City, Iowa 52242, United States

Palmer Center for Chiropractic Research, Davenport, Iowa 52803, United States

Starting date: July 2004
Ending date: March 2007
Last updated: January 25, 2008