Specific Treatment Of Problems of the Spine (STOPS) Trials: Manual Therapy Group

INTERVENTION: Ten 30 minute sessions of physiotherapy over a 10‐week period. This will involve a well defined manual therapy program, including mobilisation and or manipulation, and core lumbar stabilising exercises. These involve gentle contractions of the pelvic floor, lower abdomen and deep paraspinal muscles and will be taught in positions of side‐lying, 4 point kneeling and standing. Treatment will take place twice weekly to begin with, then move to weekly and finally to fortnightly over the ten week period. CONDITION: Subacute low back pain with or without leg pain PRIMARY OUTCOME: Back pain intensity on a 0‐10 Numerical Rating Scale Back‐specific function (Oswestry Low Back Pain Disability Questionnaire) Leg pain intensity on 0‐10 numerical rating scale SECONDARY OUTCOME: 7‐point global perceived effect scale Interference with work/housework in the last week, measured on a 5 point scale from "not at all" to "extremely". Number of work days missed in the last 30 days Orebro Musculoskeletal Pain questionnaire Participant satisfaction (with treatment and outcome) measured on a 5 point scale from "very dissatisfied" to "very satisfied" Quality of Life (EuroQOL) Rate and nature of adverse events (therapist reporting and open questions to participants). Examples may include increase or new onset of musculoskeletal or neurological symptoms, muscular soreness associated with exercise, and any others that are observed. Sciatica Frequency and Bothersomeness Scale INCLUSION CRITERIA: Low back pain with or without leg pain that will respond to manual therapy, with a 6 week to 6 months duration. Able to understand and read English