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A hands-on approach to low back pain
By
Elizabeth Boyle
Sept.
30, 2011
You’re not alone if
you’ve ever sought
health care for back
pain. The ailment is
the
number two reason
Americans visit
their physicians.
It’s also the focus
of a new
Ohio University
Heritage College of
Osteopathic Medicine
study that looks at
manual therapy, a
common strategy used
to treat the
ubiquitous problem.
Despite the
widespread use of
manual
therapy―including
osteopathic
manipulation
treatment (OMT)―the
researchers say
little is known
about the processes
that take place when
it’s applied. Funded
by a $94,000
American Osteopathic
Association
grant, the team of
researchers from the
medical school and
the
College of Health
Sciences and
Professions will
work to understand
both neurological
and biomechanical
responses in
patients who receive
manual therapies for
low back pain.
“By understanding
the mechanisms
underlying these
treatments, we can
help with the
development of
strategies for how,
when, and what type
of manipulation
should be used in
treating individuals
with this kind of
pain,” said
principal
investigator
Brian Clark
Ph.D.,
associate professor
of physiology at
OU-HCOM and director
and principal
investigator of the
Ohio Musculoskeletal
and Neurological
Institute
(OMNI).
The project follows
a series of recent
OMNI studies on
manual therapy. The
most recent
investigation,
published in BMC
Musculoskeletal
Disorders
in July, focused
on what happens
during spinal
manipulation that
results in a “pop”
sound during
treatment. It found
a 20 percent
decrease in a
subject’s low back
muscle stretch
reflexivity if the
therapy resulted in
an audible sound.
The finding could
indicate that
manipulation lessons
the spasm effect
experienced by some
back pain patients,
Clark said.
Building on that
study, this latest
project looks at a
form of manual
therapy in which a
physician mobilizes
soft tissue to
alleviate pain. The
researchers will
conduct two
experiments on both
healthy individuals
and those with
chronic low back
pain.
The first experiment
will help the
researchers
understand
neurological changes
that may happen with
treatment. It uses a
noninvasive brain
stimulation device
housed at OMNI to
measure the cortical
and stretch reflex
excitability of each
subject. After the
initial testing,
each subject will
undergo a manual
therapy session
administered by
co-investigator
Stevan Walkowski,
D.O., an
assistant professor
in the department of
family medicine who
specializes in
manual medicine.
Immediately
following the
therapy, each
subject will undergo
another test to
observe any
neurological
changes.
The second
experiment will take
place in the lab of
co-investigator and
Associate Professor
of Physical Therapy
James Thomas, P.T.,
Ph.D. Each subject
will be seated in a
specially designed
device that pulls
him or her in one of
six random
directions. Sensors
placed on the
subject’s torso
allow Thomas to
measure the
reflexive responses
of the back and
stomach muscles to
the various
unexpected motions
both before and
after a manual
therapy session
delivered by
Walkowski.
Thomas, who is also
an OMNI principal
investigator, said
that many low back
pain patients become
injured when
responding to
unexpected events or
sudden movements.
This experiment will
help the researchers
understand whether
manual therapy helps
normalize an
individual’s
reaction to
unanticipated
challenges to their
trunk.
“Back pain has a
staggeringly
negative impact on
our society in terms
of medical expenses,
disability and
individual
suffering,” Clark
said. “This work
will provide
critical information
on the biology of
these therapies used
to treat it.”
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