Clinical examination procedures to determine the effect of axial decompression on low back pain symptoms in people with chronic low back pain.
METHODS
Observational.


OBJECTIVE
To assess the effects of spinal decompression procedures performed during a clinical exam on low back pain (LBP) symptoms.


BACKGROUND
Not all patients report an immediate or complete improvement in symptoms when the direction of lumbar motion or alignment is corrected according to principles of the movement system impairment (MSI) model. Axial compression of the spine may be responsible for the remaining symptoms.


METHODS
Seventy subjects (mean ± SD age, 41.9 ± 11.5 years; 38 females, 32 males) with chronic LBP were evaluated using a standardized MSI exam. Seven tests assessing the effects of spinal decompression on LBP were added to the exam if the subjects' symptoms were not alleviated with typical standardized corrections of movement and alignment. For each test of decompression, subjects reported their symptoms compared to a reference movement or position.


RESULTS
When decompression was performed during lateral bending to the right and left, 21 of 21 (100%) and 16 of 20 (80%) subjects, respectively, reported an improvement. When traction was applied to subjects in right and left sidelying, 6 of 11 (55%) and 7 of 9 (78%), respectively, reported an improvement. When patients performed a push-up in sitting, 36 of 51 (71%) reported an improvement. In subjects who had symptoms in unsupported sitting, 41 of 57 (72%) reported an improvement in supported sitting. In subjects who reported symptoms in standing, 33 of 47 (70%) reported an improvement in hook-lying.


CONCLUSIONS
Patients with chronic LBP consistently reported an improvement in symptoms with tests proposed to decrease the axial load on the spine. These tests are a quick and effective way to assess the contribution of axial decompression to LBP symptoms and potentially could be used as part of the plan of care.
Program in Physical Therapy, Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, MO, USA.
Gregory
G
Holtzman
Marcie
M
Harris-Hayes
Shannon L
SL
Hoffman
Dequan
D
Zou
Rebecca A
RA
Edgeworth
Linda R
LR
Van Dillen
D000328:Adult; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods