Please select the eligibility criteria that correspond to the clinical trial below.
Title: Chiropractic and Exercise for Low Back Pain in Adolescents
Brief Summary: Recent research has confirmed that low back pain (LBP) is a significant health problem not only for adults, but also for children and adolescents. Given the enormous social and economic costs associated with LBP, it is critical that attempts be made to decrease the burden of LBP for patients and society.

The primary aim of this project is to determine the relative clinical effectiveness of 3 months of chiropractic care and supervised exercise versus supervised exercise in 184 adolescents with sub-acute recurrent, or chronic LBP. Relative effectiveness will be evaluated in the short, intermediate and long term using pain as the primary outcome measure. Secondary aims are to assess group differences in patient self-reported disability, quality of life, perceived improvement, satisfaction, activity levels, lumbar dynamic motion, and trunk muscle endurance. Patients' and caregivers' perceptions of treatment using qualitative interviews will also be assessed.


Options:
A: Inclusion Criteria:

* 2010 American College of Rheumatology (ACR) criteria based on the Widespread Pain Index (WPI) and Symptom Severity (SS) checklist.
* Functional Disability Score ≥13 indicating at least moderate disability
* Average pain intensity in the past week ≥ 4 on a 0-10 cm Visual Analog Scale.
* Access to mobile telephone/smartphone with text messaging plan in order to receive survey questions.
* Chronic symptoms such as fatigue, pain, bowel dysfunction, perceived cognitive impairment, or other non-specific symptoms persisting for 3-months or more, severe enough to have led to more than one visit to a medical provider. These symptoms must have not been found to be due to a definable general medical disorder despite adequate evaluation.

Exclusion Criteria:

* Diagnosis of an autoimmune or rheumatologic disease
* Current regular mindfulness meditation activity
* Serious illness (including mental illness/psychopathology) within 90 days prior to screening
* Inability or unwillingness of a parent to give consent/permission or child to assent
* Current use of opioid analgesics
* Current prescription for antidepressant medications
* Screening positive on the Columbia Suicide Screen (CSS)
* Active participation (weekly or more often) in a fibromyalgia or chronic disease support group
B: Inclusion Criteria:

* Adolescent boys/girls who are 10 to 17 years 11 months old;
* Have a diagnosis of MS, as per revised McDonald diagnostic criteria and International Pediatric MS Study Group criteria;
* Prescribed with an oral or injectable disease-modifying therapy for MS for at least six months.

Exclusion Criteria:

* Have non-specific white matter abnormalities and metabolic or infectious etiologies for white matter abnormalities. This is indicative of not having a true diagnosis of MS.
* Patients on IV DMT will not be included in the study.
* Non-English speaking patients
C: Inclusion Criteria:

* Age 12-21 years at the start of the study
* Complaints of chronic non-specific musculoskeletal pain of a duration \> 3 months
* Considerable activity limitations
* Fear of movement
* Indication for outpatient multidisciplinary rehabilitation treatment
* Adequate Dutch literacy to complete the assessments (which mainly comprise questionnaires)

Exclusion Criteria:

* Any suspicion of a medical (orthopaedic, rheumatic or neurological) disease, that can explain the current pain complaints
* Any suspicion of an (underlying) psychiatric disease, for which psychiatric treatment is better suited, according to the expert opinion of the consultant in rehabilitation medicine.
* Pregnancy
D: Inclusion Criteria:

* 12-18 years of age
* Stable prescription medication plan (no changes in prescription medications that affect musculoskeletal pain in the previous month)
* Primary complaint of low back pain \> 3 on 0 to 10 scale

Either:

* Recurrent, sub-acute low back pain defined as current episode of 2-12 weeks duration AND at least an additional 10 days of back pain in the past year OR
* Chronic low back pain defined as current episode \>12 weeks duration

Exclusion Criteria:

* Chiropractic care or exercise therapy in the previous month
* Ongoing treatment for low back pain by other health care providers
* Other serious physical or mental health care conditions (for example diabetes, cancer, etc.)
* Contraindications to study therapies including acute disc herniation, spondylolysis, spondylolithesis, or inflammatory arthritides
* Benign joint hypermobility syndrome

Answer: D