Treatment for the central sensitization component of lower back pain using systemic manual therapy

IF 1.2 Q3 REHABILITATION

JOURNAL OF BODYWORK AND MOVEMENT THERAPIES Pub Date : 2025-01-17 DOI:10.1016/j.jbmt.2025.01.016

Andres Aponte MS, PTA, Adi Halili PT, DPT, NCS

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引用次数: 0

Abstract

Objective

The purpose of this study was to analyze treatments for central sensitization (CS) and other contributors to chronic lower back pain (CLBP), using systemic manual therapy (SMT) protocols based on the temporal model for CS (TMCS).

Design

Cohort retrospective multivariate analysis.

Methods

This study analyzed episode of care and rate of improvement data in 1053 patients, evaluating 715 protocol combinations of SMT.

Results

While 682 (68%) patients reported improvement in overall symptoms, only 583 (53%) reported improvement in the lower back pain complaint. Comorbidities with statistically significant (p < 0.05) association with worse lower back pain outcomes were statin use, anxiety, depression, digestive and urinary issues, smoking and prior surgery.

A significantly higher rate of improvement resulted from the use of 43 protocol combinations, which were composed of 19 protocols, a group that includes five protocols including urinary-drainage (UD), Diaphragm-cranial-sinus (DCS), Barral-abdominal-motility (Barral), lower-abdominal-urogenital (LAUG), and Cardiac-cervical-cranial-vascular (CCCV), which were all predicted to treat CS by the TMCS.

Discussion and conclusions

The results of this study support the use of SMT to treat CLBP and reinforce the TMCS hypothesis defining CS as a functional, multifaceted neurophysiological state rather than a purely structural adaptation of the CNS. The lower rate of improvement in CLBP compared to overall improvement and the correlations of worse outcome with certain comorbidities suggests that, in addition to SMT, a multimodal approach for CLBP should favor lifestyle improvements such as smoking cessation, lifelong exercise habits, and a balanced diet over medications and surgery.

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来源期刊

JOURNAL OF BODYWORK AND MOVEMENT THERAPIES REHABILITATION-

CiteScore

2.80

自引率

0.00%

发文量

133

审稿时长

321 days

期刊介绍： The Journal of Bodywork and Movement Therapies brings you the latest therapeutic techniques and current professional debate. Publishing highly illustrated articles on a wide range of subjects this journal is immediately relevant to everyday clinical practice in private, community and primary health care settings. Techiques featured include: • Physical Therapy • Osteopathy • Chiropractic • Massage Therapy • Structural Integration • Feldenkrais • Yoga Therapy • Dance • Physiotherapy • Pilates • Alexander Technique • Shiatsu and Tuina