The immediate effect of posteroanterior mobilization on reducing back pain and the stiffness of the lumbar spine.

ABSTRACT

OBJECTIVE: To study the immediate effect of posteroanterior mobilization on back pain and the associated biomechanical changes in the lumbar spine. DESIGN: An experimental between-group study. SETTING: A biomechanics laboratory. PARTICIPANTS: Subjects with low back pain (n=19) and healthy subjects (n=20). INTERVENTIONS: Grade III posteroanterior mobilization (3 cycles of 60s) was applied at the L4 level in people with or without back pain on 1 occasion. MAIN OUTCOME MEASURES: Pain intensity, active lumbar range of motion, the magnitude of the posteroanterior mobilization loads, bending stiffness of the lumbar spine, and the lordotic curvature of the lumbar spine before and after 3 cycles of posteroanterior mobilization. RESULTS: The magnitude of pain of the patients was found to decrease significantly after posteroanterior mobilization treatment. There was also a significant decrease in the bending stiffness of the lumbar spine of the patients, which was derived from the posteroanterior load and the associated change in spine curvature. The stiffness was restored to a level that was similar to that of the asymptomatic subjects. A strong correlation was found between the magnitude of pain and the bending stiffness of the spine before (r=.89) and after posteroanterior mobilization (r=.98). CONCLUSIONS: Posteroanterior mobilization was found to bring about immediate desirable effects in reducing spinal stiffness and the magnitude of back pain. The restoration of the mechanical properties of the spine may be a possible mechanism that explains the improvement in pain after manual therapy.