The effects of Unilaterally Applied Grade III Postero- Anterior (PA) Glide on Transverse Process of Lumbar Spine for Chronic Low Back Pain (LBP) Patients Showing Early Signs of Nerve Impingement- A Critical Literature Review

Abstract

Introduction : Joint mobilisations in the spine are used as an integral part of the treatment and rehabilitation to alleviate pain and reduce stiffness. Mobilisation has also been used to improve muscle strength as described in the literature. However, there is dearth of data exploring the effect of mobilisation on muscle strength in Chronic LBP. Physiotherapy treatment for patients with Chronic LBP consists of a variety of interventions which includes Spinal Manipulative Therapy (SMT), McKenzie exercises, Core Strengthening Exercises and so on. Specific and most effective treatment regimen for chronic LBP is still undiscovered in physiotherapy context. Aims&Objectives : To explore and present the evidence of the effectiveness of PA Lumbar mobilisation in the management of Chronic LBP in patients with early signs of nerve impingement and the techniques and the physiological effects of lumbar mobilisation through a literature based review. Search Method : All relevant medical databases like AMED, CINAHL, PUBMED, Academic search complete and Cochrane databases for systematic reviews were searched and evaluated to find the relevant researches on the topic. Results&Conclusions : Several studies were identified which supports the use of PA lumbar mobilisation (Grade III) in Chronic LBP patients. From the critical appraisal and looking at the evidences it is evident that Maitland's Postero-Anterior mobilisation of the lumbar spine is helpful in eradicating/reducing the Pain and improving the ROM in LBP patients. The technique definitely has some implications on the pathophysiology of LBP. It also tends to increase the pain threshold locally and creates a hypoalgesic effect. The mobilisation technique tends to produce both general as well neurophysiological effects which are illustrated by many researchers in the course of time.