Table 1 Inclusion/Exclusion Criteria

Back-related leg pain > 3 (0-10 scale)

Ongoing treatment for leg or low back pain by other health care providers

Sub-acute or chronic back-related leg pain defined as current episode > 4 weeks duration

Progressive neurolo gical deficits or cauda equine syndrome

Back-related leg pain classified as 2, 3, 4, or 6 using the Quebec Task Force (QTF) Classification system[16]. This includes radiating pain into the proximal or distal part of the lower extremity, with or without neurological signs, with possible compression of a nerve root.

QTF 1 (pain without radiation), 5 (spinal fracture), and 11 (other diagnoses including visceral diseases, compression fractures, metastases). These are serious conditions not amenable to the conservative treatments proposed[16, 25, 110].

21 years of age and older

QTF 7 (spinal stenosis syndrome characterized by pain and/or paresthesias in one or both legs aggravated by walking)[16].

Stable prescription medication plan (No changes in prescription medications that affect musculoskeletal pain in the previous month.)

Uncontrolled hypertension or metabolic disease

Blood clotting disorders

Severe osteoporosis

Inflammatory or destructive tissue changes of the spine

QTF 8 and 9 (surgical lumbar spine fusion) or patients with multiple incidents of lumbar surgery. This is a subgroup of low back pain patients which generally have a poorer prognosis[111].

QTF 10 (chronic pain syndrome)

Pregnant or nursing women

Current or pending litigation. Patients seeking financial compensation tend to respond differently to treatment[112].

Inability to read or verbally comprehend English

Evidence of narcotic or other drug abuse

Unwillingness to postpone all other types of manual therapy treatment for LBP or BRLP except those provided in the study for the duration of the study period.