For which symptoms should central posterior-anterior (PAs) mobilizations be performed?

Central posterior-anterior (PAs) mobilizations are particularly effective for addressing midline symptoms, as these techniques are designed to apply forces centrally in the spine, targeting the vertebral bodies and the intervertebral discs. When patients present with midline symptoms, such as pain or discomfort directly over the spinal column, PAs can help improve spinal mobility and reduce pain by enhancing the movement of the spinal segments along the central axis.

In contrast, unilateral symptoms typically indicate a problem on one side of the spine, which might be better addressed through lateral or unilateral mobilizations rather than central forces. Distal limb symptoms usually suggest a peripheral problem that may not respond well to central mobilizations, and localized pain may not directly indicate the need for a central approach, as it could arise from various sources, including soft tissue or joint issues that may require different treatment strategies. Therefore, midline symptoms are the most appropriate indication for performing central PAs during mobilization therapy.