Muscle control the best option for back pain

Australian researchers have found that people suffering with lower back pain can significantly reduce their pain and disability by learning to control their trunk muscles.

Back pain is a problem which affects millions worldwide and carries an enormous economic and social burden.

Researchers have for decades been searching for new ways to manage the all too common problem and to improve the health and quality of life for sufferers struggling to cope with this condition.

The Australian researchers conducted a systematic review which included 14 trials - 7 compared motor control exercise with minimal intervention or evaluated it as a supplement to another treatment - 4 compared motor control exercise with manual therapy - 5 compared motor control exercise with another form of exercise and 1 compared motor control exercise with lumbar fusion surgery.

The review found that motor control exercise was the best option as it demanded minimal intervention and offered longer-term benefits.

The review found that by learning to control their trunk muscles using motor control exercises known as specific stabilization exercises and used along with other forms of therapy patients can improve their lower back pain and significantly reduce pain and disability.

According to the researchers patients with persistent lower back pain, as well as feeling less pain, were able to be more physically active and experience positive effects over a longer period of time than those who received other treatments.

According to researcher Luciana G Macedo, PT, MSc, a PhD student at The George Institute motor control exercise is a new form of exercise for back pain that has attracted the attention of researchers and health practitioners over the last decade, but until now there was no clear evidence on whether or the exercises were more effective.

The exercise system focuses on regaining control of the trunk muscles, also known as the transversus abdominis and multifidus, which support and control the spine - research has shown that patients with low back pain are unable to properly control these muscles.

The motor control exercise programme teaches patients how to isolate and 'switch on' these muscles and then incorporate these movements into their normal activities.

Macedo says this programme of exercise is different from going to the gym or going for a walk and must be taught by a physical therapist who identifies the specific trunk muscles that are the problem - by working with patients the therapist teaches them how to get the muscles working properly again.

The patient first learns to control these specific muscles in simple postures, then later in more challenging activities with the ultimate goal of enabling the patient to get the muscles to work to control and support the spine in those activities that previously caused pain.

Macedo says improving the health and quality of life of individuals who struggle with this condition is critical.

The research is published in the January issue of Physical Therapy (PTJ), the scientific journal of the American Physical Therapy Association (APTA).