Abstract
Patients occur severe low back pain suddenly when they raise the trunk from a forward bent and rotatory position. They keep the lumbar spine in this position and can not move the lumbar spine for severe pain. It is not clear that Why this pain occurs and how to treat this kind of low back pain. In general, local anesthesia with or without steroid has been used but it isnot always effective. we considered it might be caused by impingement of loose connective tissue at facet joint. For the treatment, manipulation has been tried and good results were obtained. Manipulation is performed to patients with just low back pain with lumbar spine in forward and side flextion. An affected thigh is extended with hip in flextion and also lumbar spine is flexed and rotate to open the facet to release soft tissue out. Forced flexion should not be done by manipulation. Severe low back pain will be improved immediately after manipulation and lumbar spine become straight in most cases.
