The chiropractic treatment of low back pain (LBP) has been reported to be very safe and highly effective. In fact, in 1994, guidelines were published recommending that chiropractic treatment of low back pain should be a first consideration / treatment of choice over other forms of back care health services. Since that time, more and more studies have been published showing continued advantages of chiropractic care over many other forms of LBP care.
Even though studies have shown that the peak prevalence of LBP occurs in the 5th decade of life, LBP is also a significant public health problem in older adults—with a prevalence ranging between 13% and 49%. So, what about care for the elderly—is chiropractic care equally safe and effective in this older population as it is in younger patients?
A recent study reported two types of spinal manipulation or adjustments verses minimal conservative medical care (MCMC) in patients with subacute or chronic, non-radiating LBP over 55 years of age. This included a total of 240 participants, of which 105 were women and 135 were men with an average age of 63 years. The two types of manipulation included a high-velocity, low-amplitude type (the classic "cracking" type of manipulation) and a low-velocity, variable-amplitude type (stretch—not associated with a "crack") treated twelve times over a six-week time frame. A 3rd treatment group (MCMC) served as a "control" to compare against the two manipulation approaches. All three groups received a half-hour exercise session at week three and outcomes were studied at 3, 6, 12, & 24 weeks. The results showed equally effective benefits to the two styles of manipulation over the MCMC group, with no serious adverse events associated with any of the treatment groups.
This study is important in a number of ways. First, it points out that two distinctive styles of manipulation frequently utilized in chiropractic and likely to be encountered by patients obtaining chiropractic care, are equally effective in a population exceeding 55 years of age. The type of manipulation ultimately decided upon can therefore be based on: 1) patient preference (as some patients just don’t like being "cracked") and 2) the chiropractor’s clinical experience.
