The Immediate Hypoalgesic Effects of Mobilization and Manipulation in Patients with Non-Specific Chronic Low Back Pain: A Cross-Over Randomized Controlled Trial.

Manual therapy techniques, including mobilization and manipulation, are commonly used for chronic low back pain (CLBP), with clinical guidelines recommending their use. This study aimed to compare the immediate hypoalgesic effects of mobilization and manipulation in patients with non-specific CLBP, evaluating their impact on pain sensitivity and range of motion. A cross-over randomized controlled trial was conducted with 27 participants with non-specific CLBP. Participants received either mobilization or manipulation on two different intervention days. Outcome measures included pressure pain thresholds (PPTs) assessed with a digital algometer, pain intensity using a numeric rating scale, and lumbar range of motion (ROM) measured with a digital inclinometer. The results indicated no statistically significant differences between mobilization and manipulation for any outcome measures (all > 0.05). However, significant within-intervention improvements were observed, including pain reduction, increased PPTs, and enhanced ROM of the lower back. Our findings suggest that both mobilization and manipulation provide similar immediate benefits for patients with CLBP. The choice between these techniques should be based on therapists' clinical reasoning and individualized risk stratification, considering the potential benefits and risks of each approach for a specific patient.