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ABSTRACT
Low back pain due to facet joint arthritis can give rise to a sliding dysfunction of the lumbar nerve roots. This could be attributed to a decrease in the joint space as a result of inflammation or fibrosis and hypertrophy; giving rise to pain and reduction in range of motion i.e. dysfunction of the lumbar spine.
Maitland's joint mobilization aims to improve the mechanics of facet joints i.e. the mechanical interface which is primarily affected. This in turn would probably improve the neurodynamics.
On the other hand Shacklock's neurodynamic mobilization techniques are directed to improve the mechanics of the mechanical interface i.e. facet joints along with neural tissue which may be secondarily affected due to the primary affection of facet joints.
Hence the objective of this study is to compare the effects of Maitland's joint mobilization versus Shacklocks neurodynamic mobilization in patients with low back pain.
50 subjects in the age group of 30-55 years with sub-acute low back pain having capsular pattern of restriction were randomly divided in two groups:
Group A: Maitland's Joint Mobilization
Group B: Shacklock's Neurodynamic Mobilization
Treatment was given on alternate days for 3 weeks with follow-up on week 4.
The study showed that Maitland's Joint Mobilization and Shacklock's Neurodynamic Mobilization were effective in the treatment of low back pain with Group B showing a significant early improvement.
Keywords: Facetal Arthritis, Neurodynamic Mobilization, Maitland's Mobilization
INTRODUCTION
Low back pain (LBP) remains a universal condition in all countries and societies with a lifetime prevalence rate estimated to be 59% to 89 % 1; representing the single most common and most expensive industrial and occupational health problem.
LBP appears to cause the greatest problem in middle adult years with peak age at 40 years.2
There have been considerable advances in the understanding of spinal pain mechanisms which has ensured a better understanding of how this disabling condition can be effectively managed.
Bogduk and Twomey have cited studies that have clearly incriminated the zygaphophyseal (facet) joints, discs and dura mater as possible sources of LBP.3
The facet joints are true synovial joints with a joint space, hyaline cartilage, a synovial membrane and a fibrous capsule. They connect the posterior elements of the vertebral body to one another through the superior...