Inclusion Criteria:  Is at least 65 years of age Is a current member or patient of the healthcare system Visited a health care provider for low back pain within the past 12 months Received primary care at one of the participating health care systems Has back pain that is uncomplicated with or without radicular pain Back pain at least 3 months General activity question from PEG (Pain, Pain Interference with Enjoyment, General Activity scale) at least 3 Primary care provider provides permission to contact patient Willing and able to provide consent (Callahan cognitive impairment screener at least 3)  Exclusion Criteria:  Specific types of back pain (metastatic cancer or bone cancer or secondary cancers, vertebral fractures, spinal infection, active inflammatory disease) Low back surgery within past 3 months Receiving workers compensation or involved in litigation related to chronic low back pain Acupuncture within the last 6 months Does not speak or write English or Spanish Major psychosis, dementia Current cancer treatment Red flags of serious underlying illness (a fever most days in the last month; recent unexplained weight loss of 10 lbs or more) Living in a nursing home, on Hospice, or palliative care Non-speaking deafness Non-reliable transportation