Clinical Correlates of Pressure Pain Thresholds in Back and Leg Pain

SM used by the practitioner was the chiropractic side posture pisiform contact push move with a P-A thrust isolated to the lumbosacral joints and applied to the side of primary back and/or leg pain. Patients presenting with spondylolisthesis received a side posture distraction type maneuver instead of a P-A thrust. As pain began to subside during subsequent visits patients were transitioned to bilateral application of SM, rather than continuing treatment only on the side of back pain or radiculopathy.

Core spine stretch and strength training throughout the course of care.

Therefore, during each treatment session when patients reported pain they received pretreatment with cryotherapy using a reusable ice pack (Polar Ice, Pelton/Shepherd Industries, Stockton, California) wrapped in 2 layers of headrest paper, but otherwise applied directly to the skin vertically along the lumbosacral spine, for 5 minutes.

When patients no longer reported leg pain, spinalator intersegmental traction at \~10 lb/F, while the patient was lying supine with an ice pack between the traction table and the lumbar spine, was permitted as a pretreatment to side posture lumbar manipulation.