SMT effective for older adults with chronic LBP - new, supportive high-level evidence!
- Dr. Shawn Thistle
Spinal manipulation is an effective option for older patients with low back pain! Combine SMT with patient-centred care including reassurance and exercise/movement/rehabilitation and we really have the capacity to make a difference for this growing patient population!
In randomized controlled trials assessing low back pain, older adults are often underrepresented (or simply excluded!). Studies have demonstrated that low back pain in older adults often lasts longer than 3 months and is usually undertreated or (unfortunately) mismanaged. As a result, it is important to identify treatment options that are safe and effective for older adults in order to help reduce the burden of disease. Guidelines advocate for non-pharmacological treatments for low back pain. Specifically, spinal manipulative therapy technique is used by many professions and systematic reviews suggest that it is an effective intervention for the reduction of pain and improvement in function.
One approach to examine the effectiveness of spinal manipulative therapy in older adults with low back pain is to perform an individual participant data meta-analysis. Compared to traditional meta-analyses, the individual data for each participant is accessed, allowing researchers to select specific individuals and correct for baseline covariates which may influence the results, enabling a more precise and thereby potentially more valid calculation of the effect estimates.
The objective of this individual participant data (IPD) meta-analysis is to assess the effectiveness of SMT compared to other interventions recommended by guidelines at 1, 3, 6 and 12-month follow-up in older adults with chronic low back pain.
THIS WEEK'S RESEARCH REVIEW: “Spinal Manipulation in Older Adults with Chronic Low Back Pain – Individual Participant Meta-Analysis”
This paper was published in the European Spine Journal (2022) and this Review is posted in Recent Reviews, Geriatrics, Lumbar Spine - Manipulation/Mobilization and the 2022 Archive.