A total of 100 patients with lumbago or sciatica were allocated alternately to two groups; all received standard drug treatment and physiotherapy and underwent manual examination twice a week. In the manual treatment group, after each examination traction, mobilisation and/or manipulation were applied to all parts of the spine with functional movement restriction and soft tissue reflex changes. In 60% of patients there was concomitant neck pain. Blockages of the cervical segments were found in 95% of patients, the atlanto-occipital segment being the one most frequently affected. In the manual treatment group the treatment period was shorter, and posture, intensity of pain and neurological signs showed greater improvement both on discharge and 6 months later. Patients with concomitant neck pain experienced more pronounced improvement of their neurological symptoms, but those without neck pain had better posture after manual treatment.

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