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Chiropr Man Therap. 2018 May 17;26:16. doi: 10.1186/s12998-018-0185-z. eCollection 2018.

Spinal manipulation in the treatment of patients with MRI-confirmed lumbar disc herniation and sacroiliac joint hypomobility: a quasi-experimental study.

Author information

1Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
2Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
3School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Abiverdi 1 St,Chamran Blvd., P.O. Box 71345-1733, Shiraz, Iran.



To investigate the effect of lumbar and sacroiliac joint (SIJ) manipulation on pain and functional disability in patients with lumbar disc herniation (LDH) concomitant with SIJ hypomobility.


Twenty patients aged between 20 and 50 years with MRI-confirmed LDH who also had SIJ hypomobility participated in the trial in 2010. Patients who had sequestrated disc herniation were excluded. All patients received five sessions of spinal manipulative therapy (SMT) for the SIJ and lumbar spine during a 2-week period. Back and leg pain intensity and functional disability level were measured with a numerical rating scale (NRS) and the Oswestry Disability Index (ODI) at baseline, immediately after the 5th session, and 1 month after baseline.


A significantly greater mean improvement in back and leg pain was observed in the 5th sessions and 1 month after SMT. Mean changes in ODI in the 5th session and 1 month after treatment also showed significant improvement. The MCIC for NRS and ODI scores in the present study were considered 20 and 6 points, respectively. Therefore, the mentioned improvements were not clinically significant in the 5th session or at 1-month follow-up.


Five sessions of lumbar and SIJ manipulation can potentially improve pain and functional disability in patients with MRI-confirmed LDH and concomitant SIJ hypomobility.

Trial registration: (Identifier: IRCT2017011924149N33), registered 19 February 2017 (retrospectively registered).


Back pain; Lumbar disc herniation; Sacroiliac joint; Spinal manipulation

Conflict of interest statement

Approval was granted by the Shiraz University of Medical Sciences Ethics Committee (approval code: CT-88-4614).Written informed consent was obtained from the patients for publication of their individual details and accompanying images in this manuscript. The consent form is held by the authors and is available for review by the Editor-in-Chief.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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