Effects of using Maneevej to adjust structural balance in non–specific low back pain patients

Abstract

Introduction and Objective: Non–specific low back pain can occur in individuals of all ages and significantly impacts daily physical activities. Structural body balancing through Maneevej (a traditional Thai manual therapy) offers an alternative approach for alleviating this condition. This study aimed to investigate the effects of Maneevej–based structural body balancing on the relief of non–specific low back pain.

Methods: A quasi–experimental, one–group repeated–measures design was employed. A total of 30 participants with a confirmed diagnosis of non–specific low back pain or musculoskeletal structural imbalance, recruited from King Narai Hospital in Lopburi Province, underwent a 14–day Maneevej self–care protocol. The intervention comprised three key elements: self–awareness of structural body balance, maintenance of postural equilibrium during routine daily activities, and a set of Mani Vet–specific physical exercises. Evaluations were conducted at baseline (Day 0), Day 7, and Day 14 using the following outcome measures: Postural Oswestry analysis for structural balance, the Short–Form McGill Pain Questionnaire for pain assessment, and occiput–to–wall distance (OWD) measurement. Comparative analysis of repeated measures across the three time points was performed using the Friedman test.

Results: Thirty participants were enrolled in the study, with a mean age of 55.65 ± 6.93 years. Normality testing using the Shapiro–Wilk test indicated that the data for both pain scores and occiput–to–wall distance (OWD) violated the assumption of normal distribution (p < 0.05). A Friedman test revealed significant differences in pain scores across the three assessment time points (Day 0, Day 7, and Day 14) (p < 0.001). Pain scores progressively decreased from a baseline mean of 6.87 to 3.17 at Day 14. Regarding OWD, the Friedman test also demonstrated significant overall differences (p = 0.020), with statistically significant reductions observed between Day 0 and Day 7, as well as between Day 0 and Day 14 (p < 0.05), corresponding to a decrease from 2.41 cm to 1.94 cm. The overall satisfaction level with the program was rated as moderate, with a mean score of 2.63 out of 5.

Discussion: The results suggest that the Maneevej self–care program produces significant therapeutic benefits in terms of pain reduction and improved postural alignment within a two–week intervention period. The observed analgesic effect may be explained by the Maneevej exercises reducing mechanical loading on the lumbar spine and relieving myofascial tension in the lower back musculature. In addition, the decreased OWD values indicate effective stretching of shortened pectoral and anterior neck muscles, which likely contributed to the restoration of optimal head and cervical spine alignment, thereby improving overall postural balance.

Conclusion and Recommendation: The findings demonstrate that the Maneevej self–care program significantly alleviates pain and enhances structural body balance in individuals with non–specific low back pain over a 14–day intervention period. Accordingly, the program should be promoted for broader application among working–age adults and the elderly as a preventive strategy against low back pain. Additionally, it has the potential to be further developed as a cornerstone for building health literacy and empowering individuals to adopt sustainable self–care practices.