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Are the changes in postural control associated with low back pain caused by pain interference?
G Lorimer Moseley1, Paul W Hodges
1The University of Queensland, Brisbane, Australia. l.moseley@fhs.usyd.edu.au
The Clinical Journal of Pain
|June 14, 2005
Summary
Altered trunk muscle adjustments during pain are not due to pain interference. Instead, individuals adopt a new strategy to limit movement, suggesting a learned response to pain.
Area of Science:
- Neuroscience
- Biomechanics
- Pain Management
Background:
- Voluntary limb movements trigger automatic postural adjustments in trunk muscles.
- Low back pain alters these adjustments, delaying deep muscles and augmenting superficial ones.
- This alteration may stem from pain interference or an adaptive strategy.
Purpose of the Study:
- To investigate the mechanism behind altered trunk muscle postural adjustments during pain.
- To differentiate between pain interference and adaptive strategy theories.
Main Methods:
- Recorded electromyographic activity of abdominal muscles (obliquus externus, transversus abdominis/obliquus internus).
- Voluntary arm movements were coupled with painful cutaneous stimulation.
- Compared muscle activity during pain, no pain, and control trials.
Main Results:
- During pain trials, a delay in transversus abdominis/obliquus internus and augmentation of obliquus externus occurred.
- These changes gradually normalized in no-pain trials.
- The effects did not diminish with repeated exposure, unlike pain interference.
Conclusions:
- Altered trunk muscle postural adjustments in pain are likely an adopted strategy, not pain interference.
- This strategy may limit trunk movement during arm actions when experiencing pain.