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UPMC seeking elderly with chronic low-back pain for study


February 10, 2004

The University of Pittsburgh Medical Center's (UPMC) Pain Evaluation and Treatment Institute is seeking men and women age 65 and older with chronic low-back pain to participate in a research study involving acupuncture, general conditioning and aerobic exercise.

More than 17 million people over the age of 65 in the United States have experienced at least one episode of low-back pain during the past year, according to Debra Weiner, M.D., associate professor of medicine, psychiatry and anesthesiology at the University of Pittsburgh School of Medicine, and principal investigator of the study.

“When low-back pain becomes chronic, it leads to functional and emotional impairment, decreased quality of life and greater health care costs because of the increased use of services. While medication, physical therapy and sometimes surgery are favorable treatment options that may provide improvements for many younger people, frail older adults may have limited therapeutic alternatives because they may not be able to tolerate traditional treatments due to their other health conditions and the intolerable side effects,” said Dr. Weiner

In this study, Dr. Weiner's team will explore the efficacy of an alternative non-drug treatment modality for older adults with chronic low-back pain: Percutaneous electrical nerve stimulation (PENS), a neuro-anatomically guided form of electro-acupuncture. The researchers will test the effectiveness of PENS in reducing pain intensity as well as the effectiveness of combining PENS with a general conditioning and aerobic exercise (GCAE) program to improve pain-related disability and physical and psychosocial functioning.

The study calls for the enrollment of 200 men and women age 65 and older with chronic low-back pain, who will be assigned randomly to one of four experimental groups: one of two forms of PENS, with or without a GCAE program. The PENS and GCAE experimental sessions will occur twice a week for six weeks. Prior to the first session, immediately after the last session and six months later, the researchers will assess pain intensity, physical function, disability, sleep, mood, balance and health care utilization. 

“What we expect to find in the study is that the PENS will help reduce pain, which will help promote exercise adherence. Exercise has pain-relieving effects but its primary effect is reduction in disability. The pain-relieving effects of exercise are more gradual and accumulate over time, provided the patient adheres to the exercise routines,” said Dr. Weiner.

“Our study design will allow us to examine the impact of PENS on chronic low-back pain, using a comprehensive multi-dimensional model of outcome that includes assessment of pain intensity, physical and psychosocial function, and the impact of reduction in pain intensity on these critical functional domains,” she said.

The study is the first well-controlled, comprehensive examination of an alternative medicine intervention for chronic low-back pain in older adults. The study is being funded by a four-year, $1.4 million grant from the National Center for Complementary and Alternative Medicine and the National Institute on Aging.

For more information about this study or enrollment in the study, call (412) 665-8052 or (412) 665-8055.


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