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J Man Manip Ther. 2017 May;25(2):66-73. doi: 10.1080/10669817.2016.1184435. Epub 2016 Jun 23.

Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial.

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Department of Biomechanics, Medical School, University of Ioannina, Ioannina, Greece.
Department of Orthopedic Surgery, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece.
Department of Physiotherapy, School of Health and Caring Professions, Technological Educational Institute of Central Greece, Lamia, Greece.
Department of Physiotherapy, School of Health and Caring Professions, Technological Educational Institute of Athens, Athens, Greece.



The aim of the study was to examine the efficacy of spinal mobilization in subjects with low back pain (LBP) and associated spinal disk degeneration.


Seventy-five subjects suffering from chronic LBP (>3 months) were randomly allocated into 3 groups of 25 subjects each. Each group received five treatment sessions with the first group receiving manual therapy (MT) (spinal mobilization), the second a sham treatment, and the third conventional physiotherapy (CP) (stretching exercises, transcutaneous electrical nerve stimulation, and massage). Subjects were assessed for their pain intensity using the numerical pain rating scale and for their self-reported disability using the Oswestry and Roland-Morris Questionnaire at baseline and after the completion of the five treatment sessions.


Paired t-tests showed a significant improvement for all outcome measures in the MT and CP group (p < 0.05). Analysis of covariance revealed that the MT group had significant improvement in all outcome measures in comparison with the sham and CP group (p < 0.05), whereas no significant difference was observed between the sham and CP group (p > 0.05).


MT is preferable to CP in order to reduce the pain intensity and disability in subjects with chronic LBP and associated disk degeneration. The findings of this study may lead to the establishment of spinal mobilization as one of the most preferable approaches for the management of LBP due to disk degeneration.




Intervertebral disk degeneration; TENS; chronic low back pain; hamstring stretching; manual therapy; massage; physiotherapy; spinal mobilization

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