BACKGROUND: Patellofemoral Pain Syndrome (PFPS) is a common cause of anterior knee pain. Some practitioners believe that sacroiliac and lumbosacral manipulative therapy added to patellar mobilization may enhance relief in PFPS. OBJECTIVE: To determine efficacy of combined spinal manipulation and patella mobilization compared to patella mobilization in the management of PFPS. PATIENTS: Sixty volunteers randomized into 2 groups of 30 subjects each. OUTCOME MEASURES: Numerical Rating Scale 101, Algometer, Patient-Specific Functional Scale, Patellofemoral Joint Evaluation Scale, and the Short-Form McGill Pain Questionnaire utilized. DESIGN: A prospective randomized clinical trial. Statistical analysis using SPSS utilized the t, Mann-Whitney U and Wilcoxin's signed rank tests at a 95% confidence level with alpha = 2 and p <= 0.025. RESULTS: Power analysis to detect differences between groups was not performed, therefore statistical significance could not be determined. CONCLUSIONS: Although there appeared to be promising effects suggesting either protocol may provide short-term relief for PFPS, use of a small convenience sample, lack of a blind observer or scales solely validated for PFPS additionally make tentative conclusions regarding this trial. In light of these findings, it remains prudent to combine manipulative therapy with standard care (exercise). Further research is merited and planned.

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