Therapeutic effect of manual therapy in the treatment of chronic lumbar facet joint pain

Abstract

Background: Lumbar facet joint osteoarthritis (LFJOA) is a degenerative joint disease and a common cause of chronic lower back pain. Despite its clinical prevalence, LFJOA has received limited research attention compared to other spinal pathologies. It is characterized by joint space narrowing, cartilage degeneration, and osteophyte formation, often associated with mechanical stress and age-related changes. The integration of traditional Mongolian medicine especially osteopathic techniques has shown promising results in managing musculoskeletal conditions. Among these, the technique of traction combined with acupoint alcohol spray and manual osteopathic manipulation is increasingly applied in clinical practice. Aim: This study aims to evaluate the clinical effectiveness of lumbar traction combined with acupoint alcohol spray and osteopathic manipulation in alleviating symptoms of LFJOA, improving lumbar function, and enhancing quality of life. Materials and Methods: A randomized controlled trial was conducted involving 60 patients diagnosed with LFJOA. Participants were randomly assigned to either a treatment group (n=30) receiving combined therapy or a control group (n=30) receiving standard spine rehabilitation exercises. Pain intensity was measured using the Visual Analog Scale (VAS), and Oswestry Disability Index (ODI), and Working Ability Index (WAI) questionnaire. Data were collected before and after a four-course treatment regimen and analyzed using SPSS 26.0. Results: In the treatment group, the Visual Analog Scale (VAS) score for chronic low back pain decreased from 5.60 to 0.33, indicating an approximately 94.1% reduction in pain. In the control group, the VAS score decreased from 5.60 to 4.33 (p=0.001). Oswestry Disability Index (ODI), the treatment group showed a decrease from 38.10 to 12.43, representing an approximately 67.4% reduction (p<0.001). In the control group, the ODI score decreased from 37.27 to 33.17, corresponding to an approximately 11.0% reduction. The Work Ability Index (WAI) score in the treatment group increased from 25.37 to 38.23, demonstrating an approximately 50.7% improvement (p<0.001). In the control group, the WAI score increased from 25.33 to 27.67, corresponding to an approximately 9.2% increase. Conclusion: Manual therapy in the treatment of chronic lumbar facet joint pain has been shown to reduce pain, significantly decrease limitations in muscle function, and improve work capacity with statistically significant results.