Pressure Pain Thresholds in Patients With Uncomplicated Back and Leg Pain: A Consecutive Case Series

The purpose of this study was to determine whether tenderness would improve after chiropractic manipulative therapy (CMT) in patients with lower back pain.

This study was a consecutive case series of 98 patients who completed an initial trial of CMT (1-6 weeks of care) in a private practice from 2018-2021. Charts were retrospectively reviewed. Variables included algometric measurement of L5 paraspinal pressure pain thresholds (PPTs), Modified Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) pain ratings for location and maximum intensity of self-rated back and/or leg pain, as well as level and location of pain reported during posterior oblique trunk movement (operationalized Kemp Test). Statistical analysis included Wilcoxon Signed Rank Test and the Repeated Measures Correlation Test.

Statistically significant improvements (P < .05) for 13 of 15 clinical measures included back and leg pain, ODI, PPT asymmetry and thresholds, and Kemp Test provocation. ODI scores were inversely associated with increases in paraspinal PPTs both on the right [r_rm = -0.59] and left [r_rm = -0.61] and Kemp Test provocation correlated moderately and inversely with PPTs at L5 both before and after CMT.

Findings suggest that there were correlations between tenderness, back and leg pain, ODI, and clinical tests after CMT.