Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain

MacDonald, D., Moseley, G. L. and Hodges, P. W. (2009) Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain. Pain, 142 3: 183-188. doi:10.1016/j.pain.2008.12.002


Author MacDonald, D.
Moseley, G. L.
Hodges, P. W.
Title Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain
Journal name Pain   Check publisher's open access policy
ISSN 0304-3959
1872-6623
Publication date 2009-04-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.pain.2008.12.002
Open Access Status Not yet assessed
Volume 142
Issue 3
Start page 183
End page 188
Total pages 6
Editor Dr. Allan I Basbaum
Place of publication Amsterdam, The Netherlands
Publisher Elsevier BV
Language eng
Subject 110603 Motor Control
110317 Physiotherapy
1103 Clinical Sciences
C1
920201 Allied Health Therapies (excl. Mental Health Services)
110314 Orthopaedics
Abstract Approximately thirty-four percent of people who experience acute low back pain (LBP) will have recurrent episodes. It remains unclear why some people experience recurrences and others do not, but one possible cause is a loss of normal control of the back muscles. We investigated whether the control of the short and long fibres of the deep back muscles was different in people with recurrent unilateral LBP from healthy participants. Recurrent unilateral LBP patients, who were symptom free during testing, and a group of healthy volunteers, participated. Intramuscular and surface electrodes recorded the electromyographic activity (EMG) of the short and long fibres of the lumbar multifidus and the shoulder muscle, deltoid, during a postural perturbation associated with a rapid arm movement. EMG onsets of the short and long fibres, relative to that of deltoid, were compared between groups, muscles, and sides. In association with a postural perturbation, short fibre EMG onset occurred later in participants with recurrent unilateral LBP than in healthy participants (p = 0.022). The short fibres were active earlier than long fibres on both sides in the healthy participants (p < 0.001) and on the non-painful side in the LBP group (p = 0.045), but not on the previously painful side in the LBP group. Activity of deep back muscles is different in people with a recurrent unilateral LBP, despite the resolution of symptoms. Because deep back muscle activity is critical for normal spinal control, the current results provide the first evidence of a candidate mechanism for recurrent episodes. © 2008 International Association for the Study of Pain Published by Elsevier B.V.
Keyword Low back pain
Recurrence risk
Paraspinal muscles
Electromyography
Lumbar spine
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID ID 456328
Institutional Status UQ

 
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Created: Thu, 03 Sep 2009, 18:20:11 EST by Mr Andrew Martlew on behalf of School of Health & Rehabilitation Sciences