Manual Therapy Effective for Back Pain in Older Adults

In a recent study, researchers sought to compare the effects of two different types of lumbar spinal manual therapy: thrust manipulation (TM) and non-thrust manipulation (NTM), on older adults with low-back pain.

Participants were aged 55 to 88 years old. Among research about treating back pain, studies of this kind with subjects in this age range are lacking. These patients were treated with either TM or NTM at least twice. All participants also completed a standardized home exercise program for at least the first two sessions, modified by a physical therapist if needed.

Although researchers were looking to compare the two types of manual therapy on older patients, they found no significant difference between the outcomes of the thrust and non-thrust spinal manipulation methods. What was noted was the overall benefits of both types of manual therapy. Patients treated with either type experienced significant pain reduction, a greater rate of recovery, and lower disability.

It was also discovered that although the oldest group of participants (those between 70 and 88) did experience positive results, they did not have the same level of treatment success as those aged under 70 years old. This oldest group did not have as much reduction in disability ratings, were less likely to recover from back pain, required more total visits, and did not report as great a pain reduction as the subjects aged 55 to 69. These differences were slight, however, and all participants benefited from manual therapy.

More research will be needed. The study authors cautioned that their analysis did not compare a control group.

With our world's aging population, we hope to see more research about how older adults benefit from chiropractic treatments. Research has revealed that over half of American seniors are in regular pain, and another study highlighted how chiropractic can provide holistic care for older patients. The more we understand about this growing and important population of patients, the more we can help them with their pain and whole body wellness.


Learman K, Showalter C, O'Halloran B, Cook C. Thrust and nonthrust manipulation for older adults with low back pain: an evaluation of pain and disability. Journal of Manipulative and Physiological Therapeutics 2013; 36(5): 284-291, doi: 10.1016/j.jmpt.2013.05.007.