Comparative Effectiveness of Mulligan and Maitland Mobilization Techniques Among Patients with Lumbar Facet Joint Syndrome

Abstract

Background: Facet joint syndrome is a prevalent cause of low back pain (LBP), contributing significantly to disability and economic impact. The incidence of lumbar facet joint pain ranges from 7.7% to 75% among LBP patients, highlighting the need for effective treatment options. Objective: This study aimed to compare the effects of Mulligan's Sustained Natural Apophyseal Glide (SNAG) and Maitland's posteroanterior (PA) glide on pain, range of motion, and functional disability in patients with lumbar facet joint syndrome. Methods: A single-blind randomized controlled trial was conducted in the outpatient physiotherapy department. Thirty male patients aged 24-60 years with lumbar facet joint syndrome were randomly assigned to two groups: Maitland PA glide and Mulligan SNAGs, each comprising 15 participants. Interventions were administered three times per week for one month. Outcomes were assessed using the Modified Oswestry Disability Questionnaire (MODQ), Numeric Pain Rating Scale (NPRS), and goniometer measurements. Data were analyzed using SPSS 25. Results: The Maitland group showed significant improvements in MODQ (13.07 ± 3.53, p = 0.023) and NPRS (2.87 ± 1.13, p = 0.025) scores compared to the Mulligan group. Lumbar flexion and extension also improved significantly in the Maitland group (p < 0.05). Conclusion: The Maitland PA Glide technique demonstrated superior efficacy in reducing pain and improving functional outcomes compared to the Mulligan SNAGs technique in patients with lumbar facet joint syndrome.