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Pain perception, trunk mobility in flexion, extension, and lateral flexion,and apparent diffusion coefficient (ADC) within nucleus pulposus of all lumbardiscs were collected before and after posterior-to-anterior mobilization in 16adults with acute low back pain. ADC was computed from diffusion maps and 3specific portions of the nucleus pulposus were investigated: anterior (ADCant), middle (ADCmid), and posterior (ADCpost ), and their mean as ADCall , asummary measure of ADC within nucleus pulposus. Pain ratings were significantlyreduced after mobilization, and mobility of the trunk was significantlyincreased. Concomitantly, a significant increase in ADCall values was observed.The greatest ADCall changes were observed at the L3-L4 and L4-L5 levels andwere mainly explained by changes in ADCant and ADCpost . The simultaneousreduction in pain and increase of water diffusion within nucleus pulposus hashas been previously observed in subjects with chronic conditions and exists inthe acute phase of the disease. Since the largest changes in ADC were observedat the periphery of the nucleus pulposus, and taken together with paindecrease, our results suggest that increased peripheral random motion of watermolecules is implicated in the modulation of the intervertebral discnociceptive response.

Apparent diffusion in nucleus pulposus is associated with pain and mobility improvements after spinal mobilization for acute low back pain