Simple Exercise Key to Improving Back Pain in Older Adults
Primary results from a randomized clinical trial demonstrated that the addition of spinal manipulative therapy or a supervised exercise program to home exercises alone did not result in statistically significant improvement in the long-term (1-year follow up). They did, however, result in greater pain reduction immediately after the 12 weeks of study treatment, an important consideration for chronic episodic conditions like back pain. A patient responder analysis showed that 69% of those receiving a combination of spinal manipulative therapy and home exercise program achieved a clinically important reduction in back pain severity, compared with 53% of those in the home exercise alone group.
Low back pain is one of the leading causes of musculoskeletal related disability for older adults, impacting their ability to age in place and remain active in their communities. “Given the increase in opioid misuse among older adults and the potential for adverse events with medications, non-drug therapies for back pain have never been more important,” says Michele Maiers, DC, MPH, PhD, co-author and Executive Director of Research and Innovation at NWHSU. “Self-care and at home exercises are an important component to the management of back pain at any age. This research reminds us that it is important for older adults as well.”
The average study participant was 73 years old, with moderately severe back pain for more than a decade. Study treatment included reassurance and, as well as simple ergonomic information to assist activities of daily living. Home exercises focused on a combination of stretching, endurance, and balance, tailored to individual ability. Spinal manipulative therapy was primarily high velocity, low amplitude, and delivered by experienced Doctors of Chiropractic. There were no serious adverse events related to treatment in the study.
This study, funded by the Health Resources and Services Administration, was conducted at the Wolfe-Harris Center for Clinical Studies at Northwestern Health Sciences University. It builds on other research conducted by Maiers and others at NWHSU that focuses on musculoskeletal conditions in an older adult population. “While the use of SMT seems to be more advantageous for neck pain than back pain in older adults, consistent themes in our research show that 1) even older adults with chronic spinal pain and degenerative disease can experience relief with non-drug therapies, and 2) every provider should incorporate positive messaging and simple exercises into care for of older adults with back pain.”
June 5, 2019 | By NWHSU