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Geriatr Orthop Surg Rehabil. 2014 Dec;5(4):154-64. doi: 10.1177/2151458514544956.

Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans: A Prospective, Randomized, Placebo-Controlled Trial.

Author information

1
Canandaigua Veterans Affairs Medical Center, Canandaigua, NY, USA ; New York Chiropractic College, Seneca Falls, NY, USA ; University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
2
New York Chiropractic College, Seneca Falls, NY, USA ; University of Rochester School of Medicine and Dentistry, Rochester, NY, USA ; State University of New York College at Buffalo, Buffalo, NY, USA.
3
New York Chiropractic College, Seneca Falls, NY, USA ; VA Western New York Healthcare System, Buffalo, NY, USA.
4
Canandaigua Veterans Affairs Medical Center, Canandaigua, NY, USA.
5
University of Toronto, Toronto, Canada ; Baycrest Geriatric Centre, Toronto, Canada.

Abstract

INTRODUCTION:

Chronic lower back pain (CLBP) is problematic in older veterans. Spinal manipulative therapy (SMT) is commonly utilized for CLBP in older adults, yet there are few randomized placebo-controlled trials evaluating SMT.

METHODS:

The purpose of the study was to compare the effectiveness of SMT to a sham intervention on pain (Visual Analogue Scale, SF-36 pain subscale), disability (Oswestry Disability Index), and physical function (SF-36 subscale, Timed Up and Go) by performing a randomized placebo-controlled trial at 2 Veteran Affairs Clinics.

RESULTS:

Older veterans (≥ 65 years of age) who were naive to chiropractic were recruited. A total of 136 were included in the study with 69 being randomly assigned to SMT and 67 to sham intervention. Patients were treated 2 times per week for 4 weeks assessing outcomes at baseline, 5, and 12 weeks postbaseline. Both groups demonstrated significant decrease in pain and disability at 5 and 12 weeks. At 12 weeks, there was no significant difference in pain and a statistically significant decline in disability scores in the SMT group when compared to the sham intervention group. There were no significant differences in adverse events between the groups.

CONCLUSIONS:

The SMT did not result in greater improvement in pain when compared to our sham intervention; however, SMT did demonstrate a slightly greater improvement in disability at 12 weeks. The fact that patients in both groups showed improvements suggests the presence of a nonspecific therapeutic effect.

KEYWORDS:

chronic lower back pain; older adults; randomized placebo controlled trial; spinal manipulative therapy; veterans

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