Spinal Coordination in Lower Back Pain Recovery: Insights from Recent Research
Chronic Back Pain
Lower back pain is a widespread problem that affects millions of people worldwide. While many individuals experience acute episodes of pain that resolve quickly, others develop chronic, persistent pain that can significantly impact their quality of life. A recent research study has provided valuable insights into the factors that influence the recovery of lower back pain patients, particularly the role of spinal coordination. In this blog post, we'll take a closer look at the study's findings, their implications for lower back pain treatment, and how we at Optimize Chiropractic have incorporated this into our care when it comes to helping individuals find relief from both chronic and acute lower back pain
Understanding Proprioception
To grasp the significance of the study's findings, it's essential to understand the concept of proprioception. Proprioception refers to our body's ability to sense its position and movement in space, which is crucial for maintaining balance, stability, and coordinated movement. This sense relies on specialized receptors called mechanoreceptors, which are found in our muscles, ligaments, and tendons. These receptors continuously provide feedback to the brain about the body's position and movement, allowing for precise adjustments and corrections.
When proprioception is impaired, as is often the case in individuals with lower back pain, it can lead to altered movement patterns, decreased spinal stability, and an increased risk of injury. This is where the multifidus muscles come into play.
The Multifidus Muscles: Small but Mighty
The multifidus muscles are a group of deep, segmental muscles that run along the length of the spine. Despite their small size, these muscles play a critical role in spinal stability and proprioception. The multifidus muscles are richly supplied with mechanoreceptors, particularly lamellated corpuscles (Pacinian corpuscles) and free nerve endings. These receptors are sensitive to changes in muscle tension, stretch, and pressure, providing valuable feedback to the brain about the position and movement of the spine.
Research has shown that the multifidus muscles are particularly susceptible to atrophy in individuals with chronic lower back pain. This atrophy can lead to decreased spinal stability, altered proprioception, and impaired motor control, creating a vicious cycle of pain, decreased activity, and further muscle weakness.
The Study's Findings: Coordination Matters
The research study in question, published in the European Spine Journal, followed 94 participants with acute lower back pain over a 6-month period. The researchers assessed participants' pain intensity, disability levels, and psychological factors using questionnaires. They also evaluated trunk postural control using an unstable sitting task, which involved tracking the motion of the spine and hip segments with reflective markers.
The study's results were striking. Participants who displayed poorer coordination of hip and spine motion during the early acute phase of pain were more likely to develop persistent pain and disability at the 6-month follow-up. Those who were unrecovered at 6 months showed a tendency to limit lumbar spine motion during the balance task, possibly as a protective response or due to proprioceptive deficits. They appeared to compensate by relying more on hip motion to maintain balance.
The researchers suggest that this restricted lumbar spine motion could have detrimental consequences, potentially maintaining nociceptive input (pain signals) and leading to excessive loading of spinal tissues. Over time, this suboptimal loading could contribute to the perpetuation of lower back pain.
Implications for Lower Back Pain Treatment
The findings of this research study have significant implications for the treatment of lower back pain, and they align well with the approach we take at Optimize Chiropractic. Our comprehensive assessment of spinal function includes evaluating range of motion, which provides valuable insights into the presence of restricted movement patterns that may contribute to chronic lower back pain. By identifying these limitations, we can tailor our treatment plans to address specific areas of dysfunction and promote improved spinal mobility.
In addition to range of motion assessments, we also utilize functional tests such as the modified clinical test of sensory integration and balance (mCTSIB) and the limits of stability test. The mCTSIB helps us evaluate how well a patient's sensory systems (visual, vestibular, and proprioceptive) are working together to maintain balance, while the limits of stability test assesses a patient's ability to control their center of gravity within their base of support. These tests provide crucial information about a patient's balance, proprioception, and motor control, all of which can be impaired in individuals with chronic lower back pain. By identifying these deficits, we can develop targeted interventions to improve sensory integration, balance, and stability.
At Optimize Chiropractic, we employ a multi-pronged approach to address the various factors that contribute to lower back pain. We utilize QSM3 Chiropractic techniques to reduce tensional stress on the body, allowing for improved joint mobility and decreased pain. Proprioceptive rehabilitation is a key component of our treatment plans, as it helps to restore the body's sense of position and movement, which is often impaired in individuals with chronic lower back pain. Balance training is another essential aspect of our approach, as it challenges the sensory systems and promotes better coordination between the spine, hips, and other body regions. Finally, we prescribe personalized rehabilitation exercises to strengthen the muscles supporting the spine and hips, improving overall spinal stability and reducing the risk of future episodes of pain. By addressing these multiple facets of lower back pain, our comprehensive approach aims to provide long-lasting relief and improve our patients' overall function and quality of life.
I hope you enjoyed this blog and feel free to reach out to me at drcoffman@optimizecolumbus.com with any questions. You can also click below to schedule a complimentary consultation to find out how we can help you.