Getting Back Pain in the Bulls-EyeFind your center. Center of balance. Centering yourself. We talk vaguely about the "center" of our body when we talk about gaining physical and mental control of ourselves.
This study suggests that centering might also be a way to better understand low back pain. Researchers followed 23 people with acute low back pain for one year. Over the course of treatment, physical therapists did specific physical tests to identify pain locations. People were grouped as centralizers if pain was beginning to locate on or near the center of their low back. Noncentralizers continued to have more widespread back pain or radiating leg pain.
Patients with pain that centered toward their spine over a few weeks of treatment tended to have better results than people with pain that continued to radiate across their backs and hips or down their leg. At the one-year mark, the noncentralizers were less likely to be working and were more likely to have pain, problems with certain activities, and continuing medical care for their back pain. People with leg pain at the beginning of the study were also more likely to have continuing problems one year later.
The researchers also tested psychosocial factors as a way to predict chronic back problems. Some past research has found a link between certain psychosocial factors--for example, a lack of control over working conditions or weak social relations--and chronic back pain. This study showed no link between psychosocial factors and continuing problems with low back pain.
More study is needed to solidify physical tests that help predict chronic low back pain. Having a way to predict future problems could help doctors and therapists choose the best treatments for their patients with back pain. It would also help identify which patients need the help of other specialists early in the recovery period.
Mark Werneke, MS, PT, Dip MDT, and Dennis L. Hart, PhD, PT. Centralization Phenomenon as a Prognostic Factor for Chronic Low Back Pain and Disability. In Spine. April 1, 2001. Vol. 26. No. 7. Pp. 758-765.
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