Q: I've had all kinds of treatment for my low back pain. I've tried massage, acupressure, trigger point therapy and beyond. None of those work as well as the spinal mobilization my physiotherapist does. Yet when the mobs are being done, I hardly feel a thing. Am I imagining this or is it for real?

A: Spinal mobilization is one of many conservative treatments therapists use for low back pain. In this method, the therapist applies a low velocity, repetitive movement to the spine. It's a passive treatment so the patient doesn't usually participate in any way.

The theory behind spinal mobilization for back pain is that it can decrease joint stiffness and reposition joints that are slightly off center. Adhesions or fibrous tissue around the joints can keep the joint from moving. Mobilization can help free these up. Mobilization can also have a pain reducing effect.

The exact effect of spinal mobilization is unknown. Acupressure massage and trigger point therapy are applied in slightly different ways. These methods of treatment have different ways of affecting the tissues. In all of these techniques studies need to be done to show what works and why.

Jeremy S. Lewis, PhD, PT, et al. A Randomized Clinical Trial Comparing Two Physiotherapy Interventions for Chronic Low Back Pain. Spine. April 1, 2005. Vol. 30. No. 7. Pp. 711-721.