• Gary L Shum, Bonnie Y Tsung, and Raymond Y Lee.
• Faculty of Health, Education and Society, School of Health Professions, Plymouth University, Plymouth, United Kingdom. gary.shum@plymouth.ac.uk
• Arch Phys Med Rehabil. 2013 Apr 1;94(4):673-9.

ObjectiveTo study the immediate effect of posteroanterior mobilization on back pain and the associated biomechanical changes in the lumbar spine.DesignAn experimental between-group study.SettingA biomechanics laboratory.ParticipantsSubjects with low back pain (n=19) and healthy subjects (n=20).InterventionsGrade III posteroanterior mobilization (3 cycles of 60s) was applied at the L4 level in people with or without back pain on 1 occasion.Main Outcome MeasuresPain intensity, active lumbar range of motion, the magnitude of the posteroanterior mobilization loads, bending stiffness of the lumbar spine, and the lordotic curvature of the lumbar spine before and after 3 cycles of posteroanterior mobilization.ResultsThe magnitude of pain of the patients was found to decrease significantly after posteroanterior mobilization treatment. There was also a significant decrease in the bending stiffness of the lumbar spine of the patients, which was derived from the posteroanterior load and the associated change in spine curvature. The stiffness was restored to a level that was similar to that of the asymptomatic subjects. A strong correlation was found between the magnitude of pain and the bending stiffness of the spine before (r=.89) and after posteroanterior mobilization (r=.98).ConclusionsPosteroanterior mobilization was found to bring about immediate desirable effects in reducing spinal stiffness and the magnitude of back pain. The restoration of the mechanical properties of the spine may be a possible mechanism that explains the improvement in pain after manual therapy.Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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