Chronic Lower Back Pain and Joint Position Sense
This is a mini-blog with the intent of giving the user of the Motion Guidance visual feedback product insight into a researched-based approach to using the product for the diagnosis of chronic lower back pain (CLBP). People with chronic pain have been found to demonstrate poor touch discrimination. Stated a different way, their brain has difficulty recognizing normal stimulus and discerning it, likely because of prolonged maladaptive changes in the tissue and pain. This has been shown in a 2015 study by Louw. A link can be found here. Louw has also been quoted as referring to this phenomenon as “smudging” of the sensorimotor homunculus (Louw and Puentedura, 2013). Lorimer Moseley published articles in both 2009 (here) and 2008 (here) hypothesized that retraining laterality and tactile discrimination can “sharpen” or “refocus” the homunculus and lead to decreased pain.
So, it appears that a primary component of chronic lower back pain may be the loss of ability to both sense and move the lower back. This was confirmed by Tong et al in a 2016 Systematic review, in which they stated, p atients with CLBP have impaired lumbar proprioception compared with controls when measured actively in sitting positions. Clinicians should consider the relationship between sitting and proprioception in CLBP and subgroup patients to guide management.
This is a video using the Motion Guidance device that provides an option for assessment and treatment of the lumbo-pelvic area.
We hope this helps guide the use of your Motion Guidance visual feedback device to improve your evaluation and treatments in your clinic setting.
The Motion Guidance team
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