الفهرس 
Anatomy of lumbar spineOnly 14 pages are availabe for public view
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Abstract
Background: Low back pain (LBP) is a widespread and costly health problem. As much as 97% of LBP are duo to mechanical causes. Despite the high prevalence of LBP and the numerous conventional medical treatments used for this problem, few treatments are supported by strong scientific evidence. Spinal manipulation (SM) as a treatment for back pain has been practiced for centuries. It has been documented in numerous systematic reviews and practice guidelines, most of which have reached discordant results on the effectiveness of SM for LBP. There is a continuous debate whether or not SM constitutes to effective treatment for different subgroups of LBP. The aim of the study: is to evaluate spinal manipulation in the treatment of LBP. Material and methods: This study included 109 patients with mechanical LBP who were classified, into three main groups; group I (lumbar disc prolapse [LDP]), group II (lumbar spondylosis), and group III (lumbar strain). Patients in each group were assigned into one of two matched subgroups (A & B). Patients in subgroups (A) treated with SM while patients in subgroups (B) treated with sham SM. Patients were evaluated before treatment, after one month of treatment and after 12 weeks follow-up. The evaluation included assessment of lumbar spine movements, tenderness, and assessment of visual analogue scale (VAS) for pain and assessment of back pain-specific functional status using Roland-Morris LBP and Disability Questionnaire (RDQ) and Oswestry LBP and Disability Index (ODI). Results: The results of this study indicated that patients with LDP, lumbar spondylosis, and lumbar strain who received SM or Sham SM displayed clinical improvement in pain when comparing with pre-treatment level. Improvement in back pain-specific functional status was observed in patient with LDP and lumbar strain but no significant changes were observed in spondylosis patients. Conclusion and Recommendation: Comparison of patients treated with SM and those treated with sham SM displayed statistically significant better outcomes in favor of SM in cases of LDP and lumbar strain but no significant differences were observed in spondylosis patients. Further studies of SM are recommended. The future studies should consider inclusion of larger number of patients, and assessment of longer-term outcome