Z-Joint Changes in Low Back Pain Following Adjusting
Mechanical Low Back Pain
About this trial
This is an interventional treatment trial for Mechanical Low Back Pain focused on measuring spinal manipulation, zygapophysial joints
Eligibility Criteria
Inclusion Criteria: Twenty-one to 69 years of age (21 years to ensure fully developed Z joints and <70 years to tolerate side posture MRI scans) Females equal to or less than 160 pounds; males equal to or less than 200 pounds. Hip width measurement that is equal to or less than 36cm.(to ensure optimum MR image quality) Pain related to the low back (lower lumbar region, L4/L5 and/or L5/S1 region -this criterion will be determined by the examining physician through subjective complaint and description, as well as objectively, using inspection, palpation, motion assessment, and standard orthopedic and neurologic tests No history of LBP lasting for more than two weeks, or no more than 3 episodes of brief back pain (1 - 2 weeks) in the past year. Exclusion Criteria: Presence of lumbar scoliosis of greater than 5 degrees (Cobb's angle) (due to difficulty in imaging the Z joints) Presence of radiculopathy (This criterion will be evaluated by the examining physician by using patient history, standard screening tests, and the results of a detailed orthopedic/neurologic evaluation). No pain related to L4/L5 and/or L5/S1 region (This criterion will be determined by the examining physician through subjective complaint and description, as well as objectively using inspection, palpation, motion assessment, and standard orthopedic tests such as, Kemp's, Milgram's, Yeoman's, straight leg raise, and Valsalva maneuver.) Pregnancy or currently breast feeding (for MRI, even though no known risk, and in the event an x-ray is needed to screen for contraindications to manipulation) Intolerance to MRI procedures (including claustrophobia and inability to lie on one's side for 15 minutes). This criterion can also be evaluated at any time throughout the first two weeks of a subject's care. Claustrophobia will also be evaluated before and during the first and second MRI scans. Significant pathology discovered on MRI scans. This criterion will be evaluated during the first MRI visit, immediately after the first MRI scan is taken. (Such pathologies constitute contraindications to chiropractic adjusting.) Absence of acute low back pain
Sites / Locations
- National University of Health Sciences
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Active Comparator
Active Comparator
No Intervention
Group 1: N; SPP; N
Group 2: N; SMT; N
Group 3: N; SMT; SP
Group 4: N and SP
N = neutral MRI; SP = side posture MRI; SPP = side posture position; SMT = side posture manipulation
N = neutral MRI; SP = side posture MRI; SPP = side posture position; SMT = side posture manipulation
N = neutral MRI; SP = side posture MRI; SPP = side posture position; SMT = side posture manipulation
N = neutral MRI SP = side posture MRI SPP = side posture position SMT = side posture manipulation