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Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation

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Maladaptive coping behaviors when presented with an acute lumbar lateral shift: a case study.

Kevin Percuoco¹, Keith Walder¹, Thomas Klopcic¹

¹Palmer Chiropractic Clinics, Palmer College of Chiropractic, Davenport, IA, USA.

The Journal of Manual & Manipulative Therapy

|June 3, 2025

Summary

Maladaptive coping behaviors significantly worsen acute lumbar lateral shifts, prolonging pain and disability. A biopsychosocial approach combining manual correction and graded exercises effectively reduced pain and catastrophizing in a patient refractory to other treatments.

Keywords:

Chiropractic coping behavior low back pain manual therapy

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Area of Science:

Chiropractic care
Pain management
Biopsychosocial health

Background:

Acute low back pain with lumbar lateral shift can be challenging to manage.
Passive coping behaviors, influenced by cognitive and emotional factors, can impede recovery.
Previous treatments, including chiropractic care and medication, were ineffective for the patient.

Purpose of the Study:

To describe the influence of maladaptive coping behaviors on the clinical presentation and management of an acute lumbar lateral shift.
To highlight the effectiveness of a biopsychosocial approach in managing such cases.

Main Methods:

A case study of a 39-year-old male with acute low back pain and lumbar lateral shift.
Implementation of a biopsychosocial pain model.
Integration of manual shift correction and graded exposure exercises.
Utilized Revised Oswestry Low Back Pain Disability Index and Yellow Flag Risk Form for assessment.

Main Results:

Significant reduction in pain and pain catastrophizing was observed within five days.
Disability scores improved from 82% to 0% at discharge and 2% at six months.
Yellow Flag Risk scores decreased from 96 to 8 at discharge and 34 at six months, indicating reduced psychosocial risk.

Conclusions:

Manual shift correction is an effective biomedical procedure for lumbar lateral shifts.
Maladaptive coping behaviors significantly influence the presentation and management of lumbar lateral shifts.
A biopsychosocial approach combined with targeted exercises offers a favorable outcome for patients with lumbar lateral shifts and associated psychosocial factors.