Free-Weight Lifting helps a LOT for Low Back Pain

The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. Welch N, Moran K, Antony J, Richter C, Marshall B, Coyle J, Falvey E, Franklyn-Miller A. BMJ Open Sport Exerc Med. 2015 Nov 9;1(1) [FREE FULL TEXT] QUOTES: … Read more

Pain in the Butt, Sacroiliac Pain as Tendinopathy?

I recently finished the 3rd edition Stuart McGill’s “Low Back Disorders.” I’ve followed his work since reading edition 2 and bulk of my back pain treatments are based on, or consistent with it and his more recent research. For those who don’t know, McGill is a Professor of Spine Biomechanics at the University of Waterloo … Read more

EMS, High-Frequency Fatigue and Pain, Particularly Headaches & Back Pain

I needed a break from fasting papers and, while I’m a big, BIG fan of EMS, and to a substantially lesser extent TENS, I am underwhelmed by high “kilohertz-frequency” alternating type currents as is commonly used in Russian stimulation for strength and interferential currents (IFC), sometimes used for both strength and pain. However, I thought … Read more

Neutral Spine Protects Against Axial Compression

Lumbar spine endplate fractures: Biomechanical evaluation and clinical considerations through experimental induction of injury. Curry WH, Pintar FA, Doan NB, Nguyen HS, Eckardt G, Baisden JL, Maiman DJ Paskoff GR, Shender BS, Stemper BD, J Orthop Res. 2015 Nov 26. AbstractLumbar endplate fractures were investigated in different experimental scenarios, however the biomechanical effect of segmental alignment … Read more

Retired Weightlifters, Wrestlers, DDD, and Back Pain

Low back pain among retired wrestlers and heavyweight lifters. Granhed H, Morelli B. Am J Sports Med. 1988 Sep-Oct;16(5):530-3. [FREE FULL TEXT] AbstractThe lifetime incidence and prevalence of low back pain among 32 retired wrestlers (ages 39 to 62 years) and 13 retired heavyweight lifters (ages 40 to 61 years) were evaluated and compared to the … Read more

Massive Herniated Discs and Low Back Pain, the Good News

Conservatively treated massive prolapsed discs: a 7-year follow-up. Benson RT, Tavares SP, Robertson SC, Sharp R, Marshall RW. Ann R Coll Surg Engl. 2010 Mar;92(2):147-53. AbstractINTRODUCTION:The natural history of a lumbar hernia of the nucleus pulposus (HNP) is not fully known and clear indications for operative intervention cannot be established from the literature. Several studies … Read more

Low Back Pain & Reverse Ergonomics: Fit the Person to the Job?

Evolving ergonomics? McGill SM. Ergonomics. 2009 Jan;52(1):80-6. Abstract The theme developed in this position paper follows the current evolution of injury prevention in the backs of workers. Job change or ‘fitting the task to the person’ has come far, but will probably not result in zero injury rates. This is because the cause of injury … Read more

Traction, Low Back Pain, Research Suggests it Doesn’t Work

Traction for low-back pain with or without sciatica. Wegner I, Widyahening IS, van Tulder MW, Blomberg SE, de Vet HC, Brønfort G, Bouter LM, van der Heijden GJ. Cochrane Database Syst Rev. 2013 Aug 19;8 Quotes from abstract (but I read the whole thing) We included 32 RCTs involving 2762 participants in this review. We considered … Read more

Spinal Manipulation in Physical Therapy, Death Throes in Research

Basis for spinal manipulative therapy: a physical therapist perspective. Bialosky JE, Simon CB, Bishop MD, George SZ. J Electromyogr Kinesiol. 2012 Oct;22(5):643-7. [Free Full Text] My comments: This paper has an extremely well referenced number of facts seemingly leading to one conclusion, that oddly appears to escape the authors. I think this paper was intended … Read more

Chiropractor Debunks Manipulation/Manual Therapy for Low Back Pain

Do manual therapies help low back pain? A comparative effectiveness meta-analysis. Menke JM. Spine (Phila Pa 1976). 2014 Apr 1;39(7) :E463-72. AbstractSTUDY DESIGN:Meta-analysis methodology was extended to derive comparative effectiveness information on spinal manipulation for low back pain. OBJECTIVE:Determine relative effectiveness of spinal manipulation therapies (SMTs), medical management, physical therapies, and exercise for acute and … Read more

Manipulation & Mobilization for Chronic Low Back Pain, Not Worth the Effort

Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review. Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spine (Phila Pa 1976). 2011 Jun;36(13) AbstractSTUDY DESIGN:Systematic review of interventions. OBJECTIVE:To assess the effects of spinal manipulative therapy (SMT) for chronic low-back pain. SUMMARY OF BACKGROUND DATA:SMT is … Read more

Manipulation vs Mobilization for Acute Low Back Pain, Neither Work

Spinal manipulative therapy for acute low-back pain. Rubinstein SM, Terwee CB, Assendelft WJ, de Boer MR, van Tulder MW. Cochrane Database Syst Rev. 2012 Sep 12;9 AbstractBACKGROUND:Many therapies exist for the treatment of low-back pain including spinal manipulative therapy (SMT), which is a worldwide, extensively practiced intervention. This report is an update of the earlier Cochrane … Read more

McKenzie Method as Lackluster as Back School for Back Pain

Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Garcia AN, Costa Lda C, da Silva TM, Gondo FL, Cyrillo FN, Costa RA, Costa LO. Physical Therapy. 2013 Jun;93(6):729-47. AbstractBACKGROUND:Back School and McKenzie methods are popular active treatment approaches that include both exercises and information … Read more

Vertebral Fractures after Yoga in Women with Osteopenia

Yoga spinal flexion positions and vertebral compression fracture in osteopenia or osteoporosis of spine: case series. Sinaki M. Pain Pract. 2013 Jan;13(1):68-75. [FREE FULL TEXT with good pics] AbstractOBJECTIVE:The objective of this report is to raise awareness of the effect of strenuous yoga flexion exercises on osteopenic or osteoporotic spines. We previously described subjects with … Read more

Emetophobia and the Biopsychosocial Model of Low Back, Neck Pain

Exposure therapy for emetophobia: a case study with three-year follow-up. J Anxiety Disord. 2013 Jun;27(5):527-34. Maack DJ, Deacon BJ, Zhao M. AbstractEmetophobia, also referred to as a specific phobia of vomiting, is a largely under-researched and poorly understood disorder with prevalence estimates of ranging between 1.7 and 3.1% for men and 6 and 7% for … Read more

Low Hip Strength Associated with Increased Spine Motion

Relationship between hip strength and trunk motion in college cross-country runners. Med Sci Sports Exerc. 2013 Jun;45(6):1125-30. Ford KR, Taylor-Haas JA, Genthe K, Hugentobler J. Abstract PURPOSE: Hip strength may directly relate to abnormal running mechanics and contribute to the high incidence of overuse injuries in distance runners. The purpose of this study was to … Read more

Physical Therapy After Vertebroplasty and Kyphoplasty

Significantly fewer refractures after vertebroplasty in patients who engage in back-extensor-strengthening exercises. Huntoon EA, Schmidt CK, Sinaki M. Mayo Clin Proc. 2008 Jan;83(1):54-7. AbstractOBJECTIVE:To determine whether patients with osteoporotic compression fractures would have decreased fracture recurrence or a longer time before refracture after percutaneous vertebroplasty (PVP) if they also participated in the Rehabilitation of Osteoporosis … Read more

So Called “Trunk Stabilization” Exercises are Anything but…

Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Physical Therapy. 2005 Mar;85(3):209-25. Koumantakis GA1, Watson PJ, Oldham JA. AbstractBACKGROUND AND PURPOSE:The purpose of this randomized controlled trial was to examine the usefulness of the addition of specific stabilization exercises to a general … Read more

Kinesio Tape Smells Like Placebo

Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother. 2014 Mar;60(1):31-9. Parreira Pdo C, Costa Lda C, Hespanhol Junior LC, Lopes AD, Costa LO. AbstractQuestions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition … Read more

Low Back Pain, Hip Strength, and IT Band Tightness

The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropractic & Osteopathy. 2010 Jan 13;18:1. Arab AM, Nourbakhsh MR. Abstract BACKGROUND: Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with … Read more

Decreasing Low Back Pain While Driving

Seat inclination, use of lumbar support and low-back pain of taxi drivers. Scand J Work Environ Health. 2005 Aug;31(4):258-65. Chen JC, Dennerlein JT, Chang CC, Chang WR, Christiani DC. AbstractOBJECTIVES:Epidemiologic evidence supporting optimal seating is limited and inconsistent. This cross-sectional study was conducted to examine the association between seat inclination, use of lumbar support, and … Read more

Reversing Disc Protrusions, McKenzie Mostly Correct in Theory

Disc prolapse: evidence of reversal with repeated extension. Scannell JP, McGill SM. Spine (Phila Pa 1976). 2009 Feb 15;34(4):344-50. AbstractSTUDY DESIGN:A basic science study that used a porcine cervical spine model to produce disc prolapse subsequently exposed to an extension protocol.OBJECTIVE:This study investigated whether extension or combined extension and side flexion could move the displaced portion … Read more

How to Herniate a Disc, and How Not to

Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clin Biomech (Bristol, Avon). 2001 Jan;16(1):28-37. Callaghan JP, McGill SM. AbstractOBJECTIVE:To determine whether repeated motion with low magnitude joint forces, and flexion/extension moments consistently produce herniation in a non-degenerated, controlled porcine spine motion segment.DESIGN:Combined loading (flexion/extension motions and … Read more

Central Sensitization and Chronic Pain

Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-15. Woolf CJ. [FREE FULL TEXT] AbstractNociceptor inputs can trigger a prolonged but reversible increase in the excitability and synaptic efficacy of neurons in central nociceptive pathways, the phenomenon of central sensitization. Central sensitization manifests as pain hypersensitivity, particularly dynamic tactile allodynia, secondary … Read more

McKenzie Method, Diagnosis No Better Than Treatment

McKenzie lumbar classification: inter-rater agreement by physical therapists with different levels of formal McKenzie postgraduate training. Spine (Phila Pa 1976). 2014 Feb 1;39(3):E182-90.  Werneke MW, Deutscher D, Hart DL, Stratford P, Ladin J, Weinberg J, Herbowy S, Resnik L. Abstract STUDY DESIGN: Inter-rater chance-corrected agreement study. OBJECTIVE: The aim was to examine the association between … Read more

Muscle Spasms and Low Back Pain

This was a pair of studies by the same authors that have some great, real world implications with regards to prevention and physical therapy treatment of low back pain and neck pain. Short rest periods after static lumbar flexion are a risk factor for cumulative low back disorder. J Electromyogr Kinesiol. 2005 Feb;15(1):37-52. Courville A, … Read more

Abdominal Hollowing, Core / Spine Stabilization, and Low Back Pain

This study explains a lot with regards to differential, and failure to differentiate exercise outcomes in people with low back pain. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr Kinesiol. 2007 Oct;17(5):556-67. Vera-Garcia FJ1, Elvira JL, Brown SH, McGill SM. Abstract Much discussion exists … Read more

Not Just Strength but Also Neuromuscular Exercise and Counseling Decreases Low Back Pain.

Neuromuscular exercise and counseling decrease absenteeism due to low back pain in young conscripts: a randomized, population-based primary prevention study.   Spine (Phila Pa 1976). 2013 Mar 1;38(5):375-84.   Suni JH, Taanila H, Mattila VM, Ohrankämmen O, Vuorinen P, Pihlajamäki H, Parkkari J.   Abstract STUDY DESIGN: Controlled intervention with group randomization. OBJECTIVE: To investigate … Read more

Preventing Low Back Pain on Airline Flights

Lessons from this study make up what I think is about a third of the solution to effectively treating low back pain preventing future episodes of back pain.  That is, to avoid prolonged damaging posture particularly in spine flexion. Using a pneumatic support to correct sitting posture for prolonged periods: a study using airline seats. Ergonomics. … Read more

Periodized Resistance Training Works Better than Aerobic Training for Chronic Low Back Pain

A comparison of two forms of periodized exercise rehabilitation programs in the management of chronic nonspecific low-back pain. J Strength Cond Res. 2009 Mar;23(2):513-23. Kell RT, Asmundson GJ. From the study: Abstract The purpose of this study was to determine the influence of 2 different periodized exercise rehabilitation programs (resistance training [RT] and aerobic training … Read more

Strength Training, Function and Low Back Pain.

The influence of periodized resistance training on recreationally active males with chronic nonspecific low back pain. J Strength Cond Res. 2011 Jan;25(1):242-51. Jackson JK, Shepherd TR, Kell RT. From the study: Abstract The most common musculoskeletal health issue is chronic nonspecific low back pain (CLBP). CLBP increases pain and disability, which reduces quality of life … Read more

Hard Times for McKenzie Method, Low Back Pain

The McKenzie method for low back pain: a systematic review of the literature with a meta-analysis approach. Spine. 2006 Apr 20;31(9) Machado LA, de Souza Mv, Ferreira PH, Ferreira ML. From the study: “Eleven trials of mostly high quality were included. McKenzie reduced pain (weighted mean difference [WMD] on a 0- to 100-point scale, -4.16 … Read more

Low Back Pain: Use of Biopsychosocial Model Does Not Improve Outcomes

Twenty-five years with the biopsychosocial model of low back pain-is it time to celebrate? A report from the twelfth international forum for primary care research on low back pain. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2118-23. From the review: “The biopsychosocial model of back pain has become a dominant model in the conceptualization of the … Read more

Rotation Stretch Increases Low Back Pain and Decreases Spine Stability

Low back pain development response to sustained trunk axial twisting. Eur Spine J. 2013 Sep;22(9):1972-8. From the study:METHODS:Sixteen male pain-free university students volunteered for this study. The trunk axial twisting was created by a torsion moment of 50 Nm for 10-min duration. The axial rotational creep was estimated by the transverse camera view directly on … Read more

Low Back Pain: Cyclic and Static Spine Flexion Both Bad for the Back

Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain. Ann Biomed Eng. 2005 Mar;33(3):391-401. From the study: Abstract There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic … Read more

EMS Decreases Back Pain, Increases Core Strength, Endurance

“Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial. Rheumatol Int. 2009 Jun;29(8):947-54.” Right now this is my favorite electric muscle stimulation (EMS) study with regards to low back pain as I read it soon after I … Read more

Low Back Pain. Free Weights Good, Weight Machines and Stretching Bad — It’s Science.

Are flexibility and muscle-strengthening activities associated with a higher risk of developing low back pain? J Sci Med Sport. 2013 Aug 8 The researchers followed 4610 adults and compared their exercise program and incidence of low back pain over an average of 4.9 years. Quotes from the study:“CONCLUSIONS: In this sample, stretching or use of … Read more