Spinal Manipulation for Seniors with Low Back Pain

Spinal Manipulation for Seniors with Low Back Pain

Low back pain is a common problem among older adults and is one of the top three reasons they see a doctor. Despite this, low back pain among seniors often persists for longer than three months, and in the presence of multiple comorbidities (which is often the case with advancing age), low back pain may be under treated or mismanaged. While guidelines for the management of low back pain often emphasize conservative approaches first and foremost, older patients tend to be underrepresented in the studies used to formulate such recommendations.

A 2022 study examined the effects of spinal manipulative therapy in older adults with chronic low back pain. The research identified ten studies consisting of a total of 786 individuals over 55 years of age, of which 261 were between 65 and 91 years old. The types of spinal manipulation included in this study are high-velocity low-amplitude (HVLA) techniques and mobilization or low-velocity low-amplitude (LVLA) techniques. In particular, the research team looked at how these manual therapies fared with respect to improvements in pain and function against other approaches, including standard medical care and exercise therapy, in the short-, medium-, and long-term.

In their final analysis, the authors concluded there is moderate-quality evidence that spinal manipulative therapy results in similar outcomes (compared to usual medical care and exercise therapy) for pain and functional improvement, and it should be considered a non-pharmacological treatment option for this patient population . This is important as up to 80% of older adults already take multiple prescription medications . Therefore, spinal manipulative therapy can be a safe alternative to pharmacological treatments for chronic low back pain in older adults.