Chiropractic and Exercise for Seniors with Low Back Pain   Sponsor     Health Services Research Administration (HRSA)   Principal Investigator     Gert Bronfort, DC, PhD, Northwestern Health Sciences University   Berman Center Investigator     Richard Grimm, MD, MPH, PhD   Description     This study seeks to identify effective therapies for low back pain, and to discover the best methods for enhancing health and functional capacity, in patients 65 years of age and older, with low back pain of more than 6 weeks duration. The study compares three treatments for reduction in patient ratings of low back pain after 12 weeks of therapy and one year after therapy ends. The three treatments are chiropractic manipulation and home exercise, supervised rehabilitative exercise and home exercise, and home exercise alone.   Role of the Berman Center     Berman Center investigators serve on the study’s Steering Committee and provide advice on recruitment and data management strategies.   Basic enrollment information     Participants must be 65 years or older, have primary complaint of low back pain for at least 6 weeks, and have not had any of the study treatments within the previous 3 months.   Abstract     Low back pain (LBP) is a significant health problem for geriatric individuals, particularly since conditions associated with LBP, such as impaired strength and flexibility, can have very serious consequences for an older individuals’ independence and overall health. Chiropractic and exercise treatments have demonstrated their potential in younger individuals with LBP. However, these promising treatments have yet to be rigorously evaluated in elderly LBP sufferers.     The broad, long-term objective of this study is to identify effective therapies for low back pain, and to discover the best methods for enhancing health and functional capacity, in patients 65 years of age and older with low back pain of more than 6 weeks duration. The study will compare the relative clinical effectiveness of:     • chiropractic manual treatment and home exercise • supervised rehabilitative exercise and home exercise • home exercise alone     These will be compared with a variety of outcomes assessed 12 & 52 weeks after treatment begins. The primary outcome is self-reported pain. Secondary outcomes include low back disability, general health status, patient satisfaction, improvement, and medication use.