Abstract
When passive lumbar extension is indicated in the treatment of low back pain and sciatica, it may be provided through exercises performed by the patient or by manual mobilization of the spine by the therapist. On occasion, however, a patient is not well suited to either approach. The patient with acute lumbar pain and sciatica may find position changes, the strain imposed by self-exercise, or the localized pressure of mobilization procedures quite painful. The patient with chronic lumbar pain may also be experiencing neck and upper back pain. The passive extension exercises advocated by McKenzie1 and others require that the patient lie prone and use the arms to “press up” the upper body, creating lumbar extension. This creates a certain amount of muscular strain and soreness in the shoulder, arms, and upper back and may be intolerable for such a patient.…
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