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Low Back Pain


Low Back Pain

LowBack Pain

The Core of

All health professionals know that lower back pain is a prevalent problem

in modern society and is one of the most common musculoskeletal problems

seen by GPs and physiotherapists.

There are various treatment options

open to physiotherapists for low back

pain. In the past few years, musculoskeletal

research has increasingly focused on the

deep muscles of the trunk, and findings

suggest that these ‘deep muscles’ are very

important in providing stability of the

spine and should be addressed during

rehabilitation.The studies have shown

that the deep core muscles become

dysfunctional in the presence of low back

pain and that they don’t necessarily

recover when the pain resolves.This may

predispose the individual to recurrence

of symptoms.The research also suggests

that these muscles, if dysfunctional, can

be effectively retrained with specific

stabilisation exercises.

Physiotherapists are experts in the field of

exercise rehabilitation and helping patients

to retrain the deep core muscles is a key

component of rehabilitation. Activating the

core muscles correctly can be quite difficult

and it requires good body awareness.

Because of this, patients often find it hard

to understand or to know if they are

working the right muscles in the right way.

The London Bridge Hospital Physiotherapy

Department has recently acquired a

Real-Time Ultrasound Imaging (RTUI)

machine specifically for helping patients

to retrain the deep core muscles. Using

the RTUI machine to retrain muscle

function is termed ‘Rehabilitative RTUI’.

Few physiotherapy clinics are fortunate

enough to have access to these machines

for muscle retraining. For the first time,

London Bridge Hospital physiotherapy

patients can benefit from the use of

rehabilitative RTUI. Patients can now view

the deep core muscles that they are trying

to activate, gaining valuable visual feedback.

In addition, the physiotherapist can have

confidence that the patient is doing the

exercises correctly.

With the increasing popularity of

rehabilitative RTUI, several

research studies on its use

have emerged.

The data suggests that the visual

feedback provided by RTUI training

significantly improves the ability of the

individual to activate the deep trunk

muscles compared to those who

trained without it.The results also

suggest that the training improvement

is retained at follow-up, more so than in

those who did not use RTUI for their

stability training.

In physiotherapy we often see patients

who have been doing core strengthening

exercises or Pilates for a long time, yet

they attend for low back pain.When

asked to demonstrate their core exercises,

often it is performed incorrectly and

inappropriate muscles are used.With RTUI

we can now show patients if they were not

recruiting the deep core muscles as well

as they had thought, and teach them more

appropriate strategies.

Rehabilitative RTUI is a great tool for

physiotherapists who have been trained

in its use and emerging research supports

its effectiveness in aiding core muscle


To refer your patients for highly

specialised physiotherapy, please call:

T: 020 7234 2500

F: 020 7234 2815