In general , the diagnosis of back pain can be broken into three major categories: Mechanical ( Osteoarthritis , Spinal stenosis , Spondylolisthesis) ; Non- mechanical ( Tumor , Infection , Inflammatory arthritis ) and Miscellaneous (Osteoporosis , Psychosomatic disorders , neuropathic joints , visceral diseases ). Although 98% of LBP may be caused by mechanical factors, it is the other 2% caused by malignancy, infection, visceral diseases and other red herrings that must be considered most seriously.

The investigators have observed in their practice that lateral pressure on 5th lumbar vertebra sometimes gives rise to cervicothoracic pain and central PA pressure over cervicothoracic spines reproduce original low back and leg pain. So the question arises whether Cervico-thoracic dysfunction is associated with low back pain with or without radiation to lower extremities?

Inclusion Criteria:

• mechanical low back pain with or without radiation to lower limb.

Exclusion Criteria:

• any recent trauma or fractures to cervico-thoracic junction, osteoporosis, inflammatory arthritis, tuberculosis, bone disease, congenital deformity
• vascular disorders
• rapidly progressing neurological deficits
• sudden onset of neurological deficits and all red flags to manual therapy.

Persons with low back pain who had attended our hospital and sub centres with a complaint of low back pain