Manual Therapy Techniques For The Lumbar Spine

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Original Editors - Jenny Arnatt, Tabitha Eddleston, Tori Jovcic, Lizzie Wakeham

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Background

Mobilisations

Spinal mobilisation has always had its efficacy described in terms of improving mobility in areas of the spine that are restricted (Korr 1977). Such restriction may be found in joints, connective tissues or muscles. By removing the restriction - by mobilisation - the source of pain is reduced and the patient experiences symptomatic relief (Maitland 1986).

Mobilisations of the Lumbar Spine

Central Posteroanterior (PA) Mobilisation Technique

For this manual therapy technique, the patient is often positioned in prone with their arms by their side and a pillow under their abdomen for comfort (Powers et al, 2009). A PA mobilization is then performed by a physiotherpist by placing their thumb or pisiform over the spinous process of a vertebrae and applying a posteroanterior force.

PAs are a commonly used manual therapy technique that has shown to be effective at reducing pain in patients with low back pain (LBP) (Shum, Tsung and Lee, 2012). So far, evidence suggests immediate pain relief following treatment, and also some evidence suggests an increased range of movement (ROM) of lumbar extention (McCollam and Benson, 1993, Shum, Tsung and Lee, 2012,  and Powers et al, 2009)

N.I.C.E guidlines (2009) therefore suggest lumbar mobilizations should be included in a 12 week course of manual therapy for patients with non-specific LBP.

References

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