About 20 years ago, Gregory Hicks started a research journey that few people in the United States were exploring at the time: studying long-term lower back pain in people over 60 years old.
Today, although research on back pain has grown, studies that focus specifically on older adults are still quite rare.
Hicks, who is now a Distinguished Professor of Health Sciences at the University of Delaware, wants to change that. He believes that older people deserve just as much care and attention as younger people when it comes to back pain and other muscle and joint problems.
He compares the lack of attention to older adults in medical research to other kinds of health disparities, such as those based on race or ethnicity.
With support from the National Institute on Aging, Hicks led a clinical trial called the MASH Trial—short for Manual Therapy and Strengthening the Hip.
This study, done in partnership with Duke University and the University of Pittsburgh, was the first of its kind. It focused on a group of older adults who not only had chronic lower back pain but also suffered from hip pain and weak hip muscles.
Between November 2019 and April 2022, 184 participants took part in the trial. They were randomly placed into two groups. One group received physical therapy that focused on the hips.
The other group received therapy that focused on the spine. Each person got eight weeks of treatment at different research centers, including one on the University of Delaware’s STAR Campus.
The researchers measured how much the treatments helped by looking at pain, walking ability, and how easily people could get up from a chair. The results, published in The Lancet Rheumatology, showed that both types of therapy helped people walk faster.
But the hip-focused therapy stood out. Right after the treatment, people in this group had bigger improvements in disability caused by back pain. They also did better in chair-rise tests and had greater walking endurance. However, the benefits didn’t stay stronger after six months, when both groups showed similar results.
This study builds on earlier work by Hicks, who previously followed older adults with back pain for a year and found that many had hip-related problems. His main idea is that not all back pain is the same.
By identifying smaller groups of patients with similar symptoms, doctors can offer more personalized treatments. This is similar to “precision medicine,” where care is tailored to each person’s needs.
Hicks is using tools like artificial intelligence to create models that can sort people with chronic back pain into different groups. He plans to keep running new trials to improve hip-focused therapies and create better treatments for other types of back pain.
His work shows how important it is to include older adults in research. Back pain is the leading cause of disability around the world, and Hicks’s research offers hope to many seniors who are often overlooked in medical studies.
If you care about pain, you may also want to learn more about krill oil and its potential to improve muscle health in older people. Other recent studies also discuss how to manage arthritis and explore how a traditional Native American plant could help reduce diarrhea and pain.
If you care about pain, please read studies about vitamin K deficiency linked to hip fractures in old people, and these vitamins could help reduce bone fracture risk.
For more information about wellness, please see recent studies that Krill oil could improve muscle health in older people, and eating yogurt linked to lower frailty in older people.
The findings from this study were published in The Lancet Rheumatology.
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