Background: Low back pain is a common condition among older adults that significantly influences physical function and participation. Compared to their younger counterparts, there is limited information available about the clinical course of low back pain in older people, in particularly those presenting for chiropractic care. Improving our understanding of this patient population and the course of their low back pain may provide input for studies researching safer and more effective care than is currently provided.
Objectives: The primary objectives are to examine the clinical course over one year of pain intensity, healthcare costs and pain, functional status and recovery rates of low back pain in people 55 years and older who visit a chiropractor for a new episode of low back pain.
Methods: An international prospective, multi-center cohort study with one-year follow-up. Chiropractic practices are to be recruited in the Netherlands, Sweden, United Kingdom and Australia. Treatment will be left to the discretion of the chiropractor. Inclusion/Exclusion criteria: Patients aged 55 and older who consult a chiropractor for a new episode of low back pain, meaning low back pain for the first time or those patients who have not been to a chiropractor in the previous six months. This is independent of whether they have seen another type of health care provider for the current episode. Patients who are unable to complete the web-based questionnaires because of language restrictions or those with computer literacy restrictions will be excluded as well as those with cognitive disorders. In addition, those with a suspected tumor, fracture, infection or any other potential red flag or condition considered to be a contraindication for chiropractic care will be excluded. Data will be collected using online questionnaires at baseline, and at 2 and 6 weeks and at 3, 6, 9 and 12 months.
Discussion: This study, to our knowledge, is the first large-scale, prospective, multicenter, international cohort study to be conducted in a chiropractic setting to focus on older adults with low back pain consulting a chiropractor. By understanding the clinical course, satisfaction and safety of chiropractic treatment of this common debilitating condition in the aged population, this study will provide input for informing future clinical trials.
Trial registration: Nederlandse Trial Registrar NL7507
Author keywords: Ageing — Chronic pain — Epidemiology — Low back pain — Aged — Elderly — Spinal manipulation — Chiropractic
Author affiliations: ADJ, MvT, SMR: Department of Health Sciences and Amsterdam Movement Science, Faculty of Science, Vrije Universiteit, Amsterdam, The Netherlands; TH: Department of Health Sciences and Amsterdam Public Health research institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands; IA: Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; KdL, SDF: Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia; JF: Back Active, Private Practice, Southsea, Portsmouth, England; DN: AECC University College, Bournemouth, England; JH: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; JH: Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; BK: Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands; BK: Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark; MvT: Department of Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
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