• Minicozzi SJ
• Russell BS

• Adult
• Female
• Low Back Pain / diagnosis
• Low Back Pain / physiopathology
• Open Access Document
• Pelvis / physiology

Background: This report discusses the pelvic tilt therapeutic exercise as an examination procedure for low back pain (LBP). In the authors’ experience, most patients with mechanical LBP attain some relief from posterior tilting of the pelvis. This report describes 2 patients who experienced increased pain from the maneuver.

Case presentation: Two patients presented to the principal author with pain in the low back and right lower extremity. They had similar orthopedic, neurologic, and MRI examination findings, and received similar conservative chiropractic care, including drop-assisted manipulation, Active Isolated Stretching and Strengthening, and instruction in a home exercise program. One substantially improved, while the other went on to surgery. The pelvic tilt maneuver was a convenient method for monitoring patient response in both cases.

Discussion: In some ways this report simply evokes the mystery of why some patients improve and others, seemingly similar, do not. The authors do not claim to definitively answer the question; rather, we offer a useful examination tool. One objective is to inspire other practitioners to use the pelvic tilt maneuver and investigate further.

Conclusions: With patients who demonstrate an increase in symptoms during a pelvic tilt maneuver, clinical decisions may be aided by repeated use of the maneuver to monitor patient progress. Additional investigation could clarify whether it can be a reliable indicator and with which patients.

Author keywords: Lordosis; lumbar region; low back pain; chiropractic

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