Low back pain (LBP) is a leading cause of musculoskeletal pain and disability, although research shows that in the majority of cases, the specific nociceptive source of LBP cannot be accurately identified. Spinal manipulative therapy (SMT) is one of the most common treatment modalities for LBP, with recent studies observing alterations in spinal biomechanics in patients who received SMT for LBP and subsequently report improvements in disability. These so-called “SMT responders” displayed several characteristics following treatment, including local biomechanical changes, rapid decreases in bulk stiffness, improvements in muscle contraction and increased disc diffusion (immediately) post-SMT.
These observations lead to questions about how to explain the effect of SMT on spinal stiffness and thus LBP in some, but not all, patients. In order to help explain this observation, these authors (including our colleagues Drs. Isabelle Pagé and Greg Kawchuk) sought to review the literature for evidence that would offer mechanistic explanations for the changes in spinal stiffness noted following SMT. To do this, they conducted a scoping review to identify existing research and provide details for potential avenues for further research…this is such an interesting area, with so many possibilities for future research and clinical application!
THIS WEEK'S RESEARCH REVIEW: “Potential Mechanisms for Lumbar Spinal Stiffness Change Following SMT”
This paper was published in Chiropractic & Manual Therapies (2020) and this Review is posted in Recent Reviews, SMT - Mechanisms of Action, Lumbar Spine - Manipulation/Mobilization and the 2021 Archive.
Spinal stiffness