The outcome of treatment of neck and back pain in elderly people over 65 by manipulation of the neck or back and exercises is just as positive after 36 weeks of treatment as it is after 12 weeks. That is the conclusion reached by a group of researchers including Jan Hartvigsen and Gert Brønfort in a paper published in the scientific publication Arthritis Care & Research.
The researchers reached their conclusion by conducting an RCT including 182 elderly people aged 65 and older. All the participants had experienced disability due to neck or low back pain for up to 12xweeks prior to the test. They were randomly divided into 2 groups which received 12 or 36 weeks of treatment respectively in the shape of manipulation of the back and supervised training.
On average, the participants in the 12-week group received 10 manipulations and 4 exercise instructions, while the 36-week group averaged 19 manipulations and 9 exercise instructions. Of these, on average 11 manipulations and 4 exercise instructions took place during the first 12 weeks of the test. Then activity went down and so did the number of weekly exercise sessions: During the first 12 weeks, the participants exercised 4 times a week, subsequently they lowered the number of exercise sessions to 3 times per week over the following 24 weeks.
Both groups experienced improving conditions. However, the researchers observed no statistical difference in the outcomes of the groups. They do, however, observe a bigger increase in general in the improvement of neck pain than of low back pain.
The study demonstrates that manipulation of the back and exercises are safe treatments for elderly people, whose neck or back pain causes disability. Furthermore, the outcome of the study supports evidence-based guidelines, which recommends that manual treatment and general and specific exercises ought to be considered for people with back and neck pain.
Short or long‐term treatment of spinal disability in older adults with manipulation and exercise. Michele Maiers, Jan Hartvigsen, Roni Evans, Kristine Westrom, Qi Wang, Craig Schulz, Brent Leininger, Gert Bronfort. Arthritis Care & Research, 2018. doi.org/10.1002/acr.23798