Manual Therapy Effects on Low Back Pain

Abstract

Low back pain (LBP) is a common complaint in the adult population. A study in 2002 found that the percentage of people reporting LBP over a 3-month period corresponded to over 54 million American adults. 1,2 Popular treatment methods for LBP include manual therapy, stretching and core stabilization. 3 Manual therapy is a form of conservative treatment with the aim to reduce pain and increase function through handson techniques by a clinician. 4 Manual therapy treatments include soft tissue massage, traction, stretching, joint mobilization, instrument assisted soft tissue mobilization (IASTM) and muscle energy techniques (MET). 5 One cause of LBP that can be treated with manual therapy occurs from a unilateral innominate rotation. A unilateral innominate rotation can occur when musculature of the abdomen, hip flexors, hip extensors, and back extensors are unbalanced. 6,7 If a patient presents with a unilateral anterior innominate rotation, the ipsilateral hip flexors are often tight and shortened, while the ipsilateral hip extensors are weak and lengthened. In a unilateral posterior innominate rotation, the ipsilateral hip flexors are weak and lengthened, while the ipsilateral hip extensors are tight and shortened. 8 For example, in a unilateral anterior innominate rotation, the ipsilateral rectus femoris and erector spinae are inflexible. 6

Effects of Muscle Energy Technique on Daily Activities and Lumbar Stiffness in Women With Sacroiliac Joint Dysfunction: A Randomized Controlled Clinical Trial Study

“…In our study, we tried to homogenize the patients by categorizing sacroiliac joint dysfunctions and used eight clinical tests to separate anterior innominate from posterior innominate dysfunctions. Although many studies have emphasized the increase in muscle length and range of motion after MET, we did not see any significant differences in lumbar stiffness disability after this intervention [22,24,25].…”

“…One study done by Selkow and others supports the findings of our research by concluding that manual therapy is effective in decreasing pain in patients with acute low back pain [12]. Another study by Dale et al describes that the soft tissue manipulation and neuromuscular technique can reduce pain, muscle rigidity, and lengthen muscle fibers [22]. These could be reasons for decreasing an individual's disability in daily activities and improve function after MET.…”