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APA to Manage Chronic Low Back Pain in Older Adults

APA to Manage Chronic Low Back Pain in Older Adults

Chronic low back pain (cLBP) is the most common pain condition diagnosed in patients 65 years or older in the United States. While new interventions are being developed, they often cost more, require additional diagnostic tests, and increase visits to health care providers (HCP). Older adults often have additional healthcare issues and need more assistance to access HCP, which delays treatment and further increases cost. Analgesics are often prescribed, yet they can be costly and have particularly troublesome side effects in this already vulnerable population.

Auricular point acupressure (APA) applies an acupuncture-like stimulation to
ear acupoints without using a needle (i.e., seeds are taped to the acupoints) to treat illness/symptoms. APA is particularly well-suited for current challenges of unmet cLBP management. We propose a randomized controlled trial to (1) determine the efficacy of APA in relieving cLBP and (2) examine the physiologic mechanisms of the APA effect on cLBP. We will determine the efficacy of a 4-week APA therapy for adults 60 years or older with cLBP. Guided by the multidimensional model of pain our primary outcomes will be measures of functional improvement and pain reduction. We will also measure psychological, behavioral, personal and social factors that may moderate or mediate the effects of APA. We also believe inflammatory cytokines may partially explain the mechanism of action of APA for pain relief and improved back-specific physical function and plan to measure these.

This study will identify a novel approach to manage cLBP in older adults, which is an innovative, non-invasive, low-cost, self-manageable, non-pharmacological approach as an adjunctive therapy for cLBP, with minimal side effects. If successful, the paradigm of pain management will shift from a traditional medical model to a larger integrative medicine and self-management paradigm to avoid unnecessary evolution towards prolonged disability.

Participant Eligibility

Age 60 years or older

Chronic lower back pain that has persisted at least 3 months and pain on at least half of the days for the previous 6 months

Have intact cognition (Mini-Mental State Examination, MMSE > 24)

Willing to commit to 4-weekly in-person study visits and up to 12-months follow-up.

Able to apply pressure to the seeds with tapes on their ears


Kate Turkot
(202) 813-9525

Additional Study Details

Full Study Title
Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults

Study ID: IRB00175409
Start Date: 07/30/2019
End Date: 12/31/2021

Dr. Chao Hsing Yeh
Dr. Paul Christo

Accepts Healthy Volunteers?

Study Site(s)

Johns Hopkins School of Nursing

525 N Wolfe St
Baltimore, Maryland 21205


Use the link below to send a message to the study coordinator, or call the number above to speak directly with a study representative.

I am interested in this research study.