Clinical effects of short and long lever spinal thrust manipulation in non-specific chronic low back pain: A biomechanical perspective

Background: Non-specific chronic low back pain (nCLBP) is prevalent in 80% of low back pain patients and it is multi-dimensional illness. This study aims to test whether short lever or long lever spinal manipulation alleviates clinical symptoms of nCLBP in terms of pain and functional disability. Materials and Methods: Sixty aged 20-60 years with nCLBP were randomly assigned to three groups: the short lever manipulation group received only short lever manipulation (SLM); the long lever manipulation group (LLMG) received only long lever manipulation (LLM); and the control conventional exercises group received conventional exercises (CE). Baseline and after 1 month, 2 month and 6 month follow-up scores were measured with visual analogue scale (VAS) and self-reported functional disability with the Roland-Morris disability questionnaire (RDQ). Results: After treatment, the SLM, LLM, CE all had lower VAS and RDQ scores. Significantly higher reduction and improvement in VAS and RDQ scores were found in the SLM compared to the LLMG. Conclusion: The present study indicates that SLM is more effective than LLM in nCLBP patients in biomechanical perspective.