Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial

Stacie A Salsbury; Cynthia R Long; Jacob McCarey; Anthony J Lisi; Anna Steward; Robert B Wallace; Christine M Goertz

doi:10.1186/s12998-025-00613-z

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Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial

Stacie A Salsbury, Cynthia R Long, Jacob McCarey, Anthony J Lisi, Anna Steward, Robert B Wallace and Christine M Goertz

Chiropractic & manual therapies, Vol.33(1), 44

10/13/2025

DOI: 10.1186/s12998-025-00613-z

PMCID: PMC12516875

PMID: 41084026

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Abstract

Veteran Response to Dosage in Chiropractic Therapy (VERDICT) was a pragmatic randomized trial testing chiropractic dosage effects in 766 veterans with chronic low back pain (CLBP) of ≥ 3 months. This cross-sectional analysis compares baseline characteristics of younger (18-to-64 years) and older veterans (≥ 65 years). Data were collected from February 22, 2021 to May 21, 2025 via electronic health records and REDCap questionnaires. Descriptive statistics and tests of group differences were performed using SAS. VERDICT enrolled 188 older veterans (25%; mean 72 years) and 578 younger veterans (75%; mean 44 years). More female (24.7% vs. 10.6%, p < .001), Black (18.9% vs. 12.2%), and Hispanic (11.8% vs. 3.7%, p = .001) veterans comprised the younger cohort. Employment differed (p < .001) with older veterans retired (78.2% vs. 14.2%) and younger veterans employed (59% vs. 16.5%). About 14% lived rurally and period of military service was similar. Pain profiles were similar between younger and older veterans for > 5 years duration (78.4% vs. 73.4%), high-impact chronic pain (64.5% vs. 62.2%), mean pain interference [63.8(4.8) vs. 63.2(5.0)], and mean back-related disability (primary outcome) [11.9(5.2) vs. 13.3(4.9)]. Younger veterans scored significantly higher than older veterans for depression (44.8% vs. 31.4%, p = .001), anxiety (41.5% vs. 20.7%, p < .001), post-traumatic stress (38.4% vs. 17.6%, p < .001), sleep disturbance (57.1% vs. 34.6%, p < .001), and high-risk alcohol use (25.4% vs. 18.1%, p = .05). Previous chiropractic use was similar (younger 75.4% vs. older 80.3%). Medications in past 3 months differed with younger veterans reporting cannabis (25.8% vs. 12.8%, p < .001) and muscle relaxants (31.7% vs. 17.6%, p < .001) and more older veterans reporting acetaminophen (63.3% vs. 49.3%, p < .001) and gabapentin (34% vs. 20.1%, p < .001). NSAIDs use was highest among both younger (62.8%) and older (56.9%) veterans. While two-thirds had tried exercise in the past 3 months, only 16% reported exercising for their pain condition, with older veterans more likely to report providers encouraging physical activity. Similar pain profiles were reported among older and younger veterans seeking chiropractic care for CLBP within a clinical trial. However, potentially important age differences were noted in demographics, mental health and substance use, and CLBP treatments. ClinicalTrials.gov: NCT04087291. Date of Registration: 9/12/2019. Enrollment Duration: 2/22/2021 (first participant enrolled) through 5/10/2024 (last participant enrolled).

Adolescent

Adult

Age Factors

Aged

Chronic Pain - epidemiology

Chronic Pain - therapy

Cross-Sectional Studies

Female

Humans

Low Back Pain - epidemiology

Low Back Pain - therapy

Male

Manipulation, Chiropractic - methods

Manipulation, Chiropractic - statistics & numerical data

Middle Aged

Veterans - statistics & numerical data

Young Adult

Details

Title: Subtitle: Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial
Creators: Stacie A Salsbury - Palmer College of Chiropractic
Cynthia R Long - Palmer College of Chiropractic
Jacob McCarey - Palmer College of Chiropractic
Anthony J Lisi - VA Connecticut Healthcare System
Anna Steward - Palmer College of Chiropractic
Robert B Wallace - University of Iowa
Christine M Goertz - University of Iowa
Resource Type: Journal article
Publication Details: Chiropractic & manual therapies, Vol.33(1), 44
DOI: 10.1186/s12998-025-00613-z
PMID: 41084026
PMCID: PMC12516875
NLM abbreviation: Chiropr Man Therap
ISSN: 2045-709X
eISSN: 2045-709X
Publisher: BMC
Grant note: U24AT009769 / National Center for Complementary and Integrative Health (NCCIH), the Office of Disease Prevention (ODP), the Office of Behavioral and Social Sciences Research (OBSSR), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) UH3AT009761 / National Center for Complementary and Integrative Health (NCCIH) and the Office of Research on Women's Health (ORWH)
Language: English
Date published: 10/13/2025
Academic Unit: Epidemiology; Injury Prevention Research Center
Record Identifier: 9985014875302771

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