An investigation of the relationship between low back pain and lumbar posteroanterior stiffness

To investigate the relationship between low back pain (LBP) and lumbar posteroanterior (PA) stiffness.

A repeated-measures design was used to measure lumbar posteroanterior stiffness on two occasions in subjects with and without LBP.

Twenty-five subjects with acute or subacute LBP and twenty-five pain-free subjects participated. Pain subjects reported pain on the application of a manual PA force to the lumbar spine and had no contraindication to PA stiffness testing. Pain-free subjects reported no history of LBP requiring treatment, and obtained a score of 0 on the McGill Pain Questionnaire.

PA stiffness was measured in subjects with LBP when (a) they first presented with pain and (b) when pain had resolved by more than 80%. Pain-free subjects, matched with pain subjects on gender, age, vertebral level to be tested and time between tests, were also measured on two occasions, to control for the effects of repeated stiffness testing and the passing of time.

In subjects with low back pain stiffness decreased by 1.21 N/mm between test 1 and test 2. A paired t test found a significant difference between the tests (t = 3.04, df = 24, p = .006). In subjects without pain, there was an increase in stiffness of 0.74 N/mm between test 1 and test 2; a paired t test found no significant difference between the tests (t = -1.673, df = 24, p = .107).

Subjects with LBP showed increased PA stiffness compared with when they had little or no pain, whereas pain-free subjects showed unchanged PA stiffness over time.