Short-term effect of spinal manipulation on pain perception, spinal mobility, and full height recovery in male subjects with degenerative disk disease: a randomized controlled trial

Arch Phys Med Rehabil. 2014 Sep;95(9):1613-9. doi: 10.1016/j.apmr.2014.05.002. Epub 2014 May 24.


Objective: To evaluate the short-term effect on spinal mobility, pain perception, neural mechanosensitivity, and full height recovery after high-velocity, low-amplitude (HVLA) spinal manipulation (SM) in the lumbosacral joint (L5-S1).

Design: Randomized, double-blind, controlled clinical trial with evaluations at baseline and after intervention.

Setting: University-based physical therapy research clinic.

Participants: Men (N=40; mean age ± SD, 38 ± 9.14 y) with diagnosed degenerative lumbar disease at L5-S1 were randomly divided into 2 groups: a treatment group (TG) (n=20; mean age ± SD, 39 ± 9.12 y) and a control group (CG) (n=20; mean age ± SD, 37 ± 9.31 y). All participants completed the intervention and follow-up evaluations.

Interventions: A single L5-S1 SM technique (pull-move) was performed in the TG, whereas the CG received a single placebo intervention.

Main outcome measures: Measures included assessing the subject's height using a stadiometer. The secondary outcome measures included perceived low back pain, evaluated using a visual analog scale; neural mechanosensitivity, as assessed using the passive straight-leg raise (SLR) test; and amount of spinal mobility in flexion, as measured using the finger-to-floor distance (FFD) test.

Results: The intragroup comparison indicated a significant improvement in all variables in the TG (P<.001). There were no changes in the CG, except for the FFD test (P=.008). In the between-group comparison of the mean differences from pre- to postintervention, there was statistical significance for all cases (P<.001).

Conclusions: An HVLA SM in the lumbosacral joint performed on men with degenerative disk disease immediately improves self-perceived pain, spinal mobility in flexion, hip flexion during the passive SLR test, and subjects' full height. Future studies should include women and should evaluate the long-term results.

Keywords: Intervertebral disc degeneration; Intervertebral disc disease; Manipulation, spinal; Rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Double-Blind Method
  • Humans
  • Intervertebral Disc Degeneration / complications
  • Intervertebral Disc Degeneration / rehabilitation*
  • Low Back Pain / diagnosis
  • Low Back Pain / etiology
  • Low Back Pain / prevention & control*
  • Lumbar Vertebrae / physiopathology*
  • Lumbosacral Region / physiopathology
  • Male
  • Manipulation, Spinal / methods*
  • Pain Measurement
  • Range of Motion, Articular*
  • Sacrum / physiopathology*
  • Treatment Outcome

Associated data

  • ANZCTR/ACTRN12613000430730