Mohamed Nabil Fiaad, Wadida H. Elsayed, Mary Kamal Nassif Takla, Aly M. El Zawahry

Abstract

Background: Non-specific low back pain (NSLBP) is characterized by reduced mobility associated with pain during the functional activity of unknown etiology. Objective: To compare the effects of spinal manipulation (SM) and Mulligan-mobilization with movement (MWM) in NSLBP. Method: Forty-five participants with chronic NSLBP were randomly allocated into three equal groups (fifteen patients each); group A (control group) received conventional physical therapy program including superficial heating and spinal stabilization exercises (SSE). Group B received the SSE and SM techniques. Group C received SSE and MWM technique. The treatment was applied for 3 sessions per week for 4 consecutive weeks. Outcome measures: Pain intensity level, Functional impairment, and Lumbar flexion ROM were measured by Visual Analogue Scale (VAS), Oswestry disability scale, and Inclinometer respectively. The measurements were taken pre-treatment and post-treatment.  Results: There were statistical differences between the 3 groups, where group B showed a greater improvement in pain intensity level, functional impairment, and spinal mobility than the other two groups. Conclusion: Manual therapy techniques, as well as SSE, were effective in increasing lumbar flexion ROM, decreasing pain intensity level, and improving function. Nonetheless, SM with SSE was shown to be superior over the MWM and SSE in terms of reducing pain intensity level, increasing ROM, and improving function in NSLBP.