Low Back Pain: Manipulation or Stabilization?
Physical Therapists treat low back pain (LBP) patients with a wide range of increased and decreased motion in the spine. Treatment choice is often based on the idea that a spine with too much motion (hypermobility) should be treated with stabilization exercises.
And the reverse idea is also put into practice. Patients with a stiff spinal segment are treated with mobilization exercises. A stiff spine segment (not enough motion) is hypomobile. Therapists at the University of Utah tested these treatment ideas.
They used a special test called the posterior-anterior (PA) mobility test to look for hypermobility or hypomobility. One group of LBP patients was treated with manipulation and stabilization exercises. Results for patients in this group were compared with results of a stabilization exercise program used in a second group of LBP patients.
As they suspected, patients with hypermobility had much better results when treated with stabilization exercises. Patients with hypomobility responded better to a program of manipulation and stabilization.
The authors conclude using the PA mobility test can help direct treatment of LBP patients.
Julie M. Fritz, PhD, PT, ATC, et al. Lumbar Spine Segmental Mobility Assessment: An Examination of Validity for Determining Intervention Strategies in Patients with Low Back Pain. In Archives of Physical Medicine and Rehabilitation. September 2005. Vol. 86. No. 9. Pp. 1745-1752.