Mechanical low back pain (LBP) stems from spinal structures or surrounding tissues, often caused by overuse or trauma, and is prevalent globally with high recurrence rates. Key contributing factors include biomechanical, psychological, and social elements. The latissimus dorsi (LD), along with other back muscles, plays a crucial role in lumbar stability via the thoracolumbar fascia. Stretching the LD has shown positive effects in reducing pain and improving function in chronic LBP patients. Physical therapy treatments include manual therapy, core stabilization, and flexibility exercises. Muscle Energy Techniques (MET), particularly targeting the LD, can enhance flexibility and spinal mobility when applied correctly.
Patients had low back pain for more than 3 months Moderate disability (20 to 40 %) determined through Oswestry Disability Index Subjects with pain ranging 3 to 8 on NPRS Able to perform ROM of lumbar spine (flexion and extension) within range of pain Patient were not under any medical treatment (analgesics etc) both male and female
presence of any red flags (i.e tumor , metabolic disease, rheumatoid arthritis , osteoporosis , history of use of steroids ) SLR test positive Muscle weakness or paralysis of lower extremity Prior surgery of lumbar spine and pregnancy Any psychological problem
Parallel
Conservative physical therapy
Procedure/SurgeryHot pack + TENS (10 min), followed by a structured program of warm-up, 20-minute core/back strengthening, stretching (hip flexors, hamstrings, lumbar extensors), and cool-down exercises.
Post-facilitation stretch of latissimus dorsi with conservative physical therapy
Procedure/SurgeryReceives the same conservative physical therapy as the control group plus Latissimus Dorsi Muscle Energy Technique (isometric contraction for 10seconds, relaxation 2-3seconds, followed by 10seconds stretch, applied bilaterally each session).
Low back pain
Numeric Pain Rating Scale will be used. An 11-point scale comprising a number from 0 through 10; 0 indicates "no pain", and 10 indicates the "worst imaginable pain". Patients are instructed to choose a single number from the scale that best indicates their level of pain.
Functional Disability of back
Oswestry disability index will be used. To evaluate the functional impact of low back pain on a person's daily life. It consists of 10 items on the degree of severity to which back (or leg) trouble has affected the ability to manage in everyday life. The 10 sections cover the pain and the daily function (including pain intensity, personal hygiene, lifting, walking, sitting, standing, sleeping, sexual activity, social activity, and traveling). Each item is rated on a 6-point scale (0-5); the higher score means the higher level of disability related to LBP. The present study used the traditional Chinese version of the ODI 2.1
Range of motion of low back.
Dual Inclinometer will be used. It is a handheld, circular, fluid-filled disc that has a weighted gravity pendulum attached to it that is maintained in the vertical direction. It is graduated by 0.5 degree intervals over 360.
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