A Twist on Low Back Pain

Worldwide, back pain is the single leading cause of disability, resulting in people to miss work as well as other everyday activities. Even as medical advancements progress, and the knowledge of the spine increases, half of all working Americans report having back pain symptoms (1). People seek numerous methods such as surgery, injections or physical therapy to rid themselves of this pain (2), and all come with their respective costs and benefits.

Low back pain is often caused by spinal instability (5), therefore, a key to resolving this vulnerability is through spinal segmental stabilization. To achieve best achieve stabilization, an effective method is core exercise routines to strengthen the surrounding muscles. Furthermore, pressure biofeedback units (PBU) are a necessary instrument to ensure that patients learn to train their core muscles effectively and complete their exercises correctly.

Specifically, pressure biofeedback devices work to aid in the re-training of stabilizing muscles via the use of specific exercises. The transversus abdominis is an important spinal stabilizer because of its anatomical characteristics, provide stability to the thorax, and increase the tension of the thoracolumbar fascia to control the spine (6). Contraction of this muscle is done through the abdominal drawing-in maneuver, which re-educates the functions of this muscle and is effective at relieving pain and dysfunction (6). A PBU is able to detect movements of the spine through an air-filled reservoir (4), if the spine is moving, then the patient is not utilizing their core muscles properly.

One study found, in a comparison between core stabilizing exercises and pressure biofeedback, the participants that trained with the PBU device saw a greater reduction in pain and disability after 30 days (3). Furthermore, these devices greatly reduce the need for regular office visits. A physical therapist is not needed as he or she is replaced by the device guiding the patient. Home exercise is proven effective in this manner, but the devices have lengthy set up times, and do not always provide real time feedback to ensure the patient completes the exercises accurately. Another concern is that the device is too dependent upon the skill of the operator (4), indicating that these devices need to be simpler to use.

The need for a ready to use pressure biofeedback system is evident to meet the gaps and help more people return to a pain free life. The Biostabilizer is a pressure feedback device, with one step set up, that guides patients through exercises with timed beeps and concurrent audio feedback to correct improper form. Furthermore, this device gives clear terminal feedback, to summarize the temporal progression during the exercises, and this is reviewed by the physical therapist and discussed with a patient to monitor progress.

What do you like about PBU’s and what advancements would make PBU’s more useful for you and beneficial for your patients?

1. https://www.acatoday.org/Patients/What-is-Chiropractic/Back-Pain-Facts-and-Statistics
2. https://www.mayoclinic.org/diseases-conditions/back-pain/diagnosis-treatment/drc-20369911
3. https://d1wqtxts1xzle7.cloudfront.net/40020113/1508-4511-1-PB.pdf?1447593797=&response-content-disposition=inline%3B+filename%3DEFFECT_OF_LUMBAR_STABILIZATION_EXERCISES.pdf&Expires=1592788438&Signature=XT1u11FhO4xrXGeX91xAMb7zYPb~oBaiv0~P94kK-y5C3m9GkgLvz0hBmIXSoX3zMsZFCseM0-ZrXCu8~04uSJ5gHoaKuUowJBsC8y~cceRqh46ODbTtVV0kecRBqy~lqsJJll25uXA~Jfh8Ds8lh16Rq3rmOzXk0OHEi~aauhfiS9Jr~FIgCznUo4tFwn95b441dAG44IdCBT52JI7pMb8NBemlK9aDsEAevJm~UjWncMcwRm0a-10CXigDlGXzM-5dzZybW59JF37kJOPkl5-blkYlSl3qb9WFVDPqfYX3S4j9ijjZX7TUMPmBSiMgLxv5gWMXp3jrj674PYuTdg__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
4. https://www.sciencedirect.com/science/article/pii/S0031940605611558?casa_token=4Q-90fV5ossAAAAA:jk5r26UjmUWOra2UEFiLUGY7xV0yLVmjHFYb024aRBK4JHssgiFd9l3f9mIv-e1MuHK8irjBbg
5. https://www.sciencedirect.com/science/article/pii/S1050641103000440?casa_token=OQcSSiNLOvgAAAAA:U6yI3AMbZ5BdTx5JiXRN_NJitOmxarwJH5CU5oHp0g3R187wFBOp9NwcUpnUqawW7KWVjRIeqQ
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804982/