Hip-spine Intervention for Older Adults With Chronic Low Back Pain

Inclusion Criteria:

1. Age 60-85

2. Low Back Pain for ≥ 3 months with pain of at least moderate intensity every day or
almost every day that requires activity modification.

3. Presence of at least 1 hip impairment denoted by the American College of Rheumatology
as potential indicators of hip osteoarthritis: hip pain, pain on hip internal rotation
or morning stiffness of the hip of <60 minutes.

Exclusion Criteria:

1. Previous hip fracture repair or total hip replacement

2. Prominent component of radicular pain: CLBP with distal radiation below the knee

3. Known spinal pathology other than osteoarthritis: (e.g., a history of back surgery or
recent trauma, spinal stenosis, vertebral compression fractures, ankylosing
spondylitis, carcinoma metastatic to the spine)

4. Non-ambulatory, or severely impaired mobility (i.e., require the use of a wheelchair)

5. Folstein Mini-Mental State Examination score of <24

6. Severe visual or hearing impairment.

7. Red flags indicative of a serious disorder underlying the LBP: Red flags that would
require specialized medical attention include fever, significant unintentional weight
loss, a sudden recent change in the character or intensity of pain, trauma that
preceded the onset of pain, or signs and symptoms of caudae equinae (i.e. loss of
sensation over saddle region, significant disturbances in bowel and bladder function).

8. Significant pain in parts of the body other than the back or acute LBP.

9. Acute, ongoing illness.

10. Inability to participate in the study for the full six months for any known
reason.(i.e. moving away, extended vacation)

11. Received physical therapy for their LBP within in the last 3 months.