Mulligan mobilization versus traction in lumbar facet joint syndrome: randomized controlled trial

Abstract

The aim of this study wasto investigate and compare the effect of Mulligan mobilization, lumbar traction and their combination on pain, functional disability and facet tropism in patients with facet joint syndrome.Sixty patientswith facet joint syndromefrom both sexes and aged 30 to 50 years participated in the randomized controlled trialdesign. They were referred from orthopedic and neurological clinics and divided into four groupsas follows:group A received Mulligan mobilization and conventional treatment, group Breceivedlumbar tractionand conventional treatment,group CreceivedMulligan mobilization in combination with lumbar traction in addition to conventional treatment, while group D(control group) received the conventional treatment only.All participants received 3 treatment sessions per week for one month.The assessmentswere donebefore and after one month of treatment using Visual Analogue Scale (VAS) for pain,OswestryDisability Index (ODI) for functional disability, and magnetic resonance image (MRI) for facet joint tropism.Statistically significant improvement was found in pain and functional disability in all four groups post-treatment(p<0.05),compared to pre-treatment,withthe study groups (A, B and C)havinga higher improvement than the control group (D).The improvement in group C wassignificantly higher than in groups A and B (p<0.05), and the improvement in group A was significantly higher than in group B (p<0.05).Regarding thefacet joint tropism, there wasa statistically significant improvement in the four groups post-treatment (p<0.05) compared with pre-treatment,with higher significant improvementsin the study groups (A,B,C) in comparison with the control group (D). There was no statistically significant difference in tropism between groups A, B andC.The combination of Mulligan mobilization and lumbar traction (group C) wasthe mosteffective treatment for relievingpain and functional disability in patientswith facet joint syndrome. Regarding facet tropism, there was a statistically significant improvement with all the treatments, but the conventional treatment produced the lowest improvement