Low back pain (LBP) is a common health problem among the elderly, affecting up to 90% of the over 65 population, and accounting for nearly $1 billion per year in Medicare payments alone. By far the greatest single cause of low back pain in the elderly is mechanical derangements occurring within the confines of the lumbar spine as a consequence of chronic degenerative joint disease which, in itself, is often painless and of little or no clinical significance. Most of these cases (many of whom are presently being unsuccessfully treated in medical clinics and/or hospitals) would quite likely respond very well to routine office-based conservative chiropractic care. However, insofar as there is no conclusive data to support any particular method of chiropractic treatment for these cases, nor has there been any standardized procedures established by which such data might be collected for analysis, the issue is problematic inasmuch as most chiropractic physicians have had little training in clinical research methodology. Therefore, a “practitioner scientist” protocol was developed whereby selected office-based chiropractic physicians would collect the necessary data and provide treatment according to specified procedures under the direction of an experienced clinical researcher. Basic inclusion/exclusion criteria were chosen for a standardized approach to the diagnosis of mechanical low back pain in the elderly and its treatment by conservative chiropractic technics.
Inclusion criteria are as follows:
Exclusion criteria are as follows:
Reference: Paul J. Osterbauer, DC, Tom DeVita, DC, Arlan W. Fuhr, DC. Proceedings of the FCER’s Third Annual International Conference on Spinal Manipulation. Washington. D.C., April 12-13. 1991. pp. 230-1.