Part 1: Preventing and Reversing Fibrogenesis (Fascial Distortions)
At Muscle IQ, WE LOVE TREATING LOW BACK PAIN. And, we work hard to achieve a successful recovery for all our patients. The most common problem we treat is low back pain. More often than not, our patients come to us after suffering for years with low back pain. We have developed what we feel is the best physical therapy system for treating chronic back pain. This blog will discuss what I believe are three very important factors that are necessary in a rehab program in order to ensure the highest rate of successful outcomes for our chronic back pain patients.
The National Institutes of Health (NIH) define chronic back pain as “... pain that continues for 12 weeks or longer…” Their website also states, “In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.”
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
It is not readily apparent what factors differentiate those who recover from chronic back pain and those who do not. That is why success rates for recovery from chronic low back pain varies so much. Is there something going on in the low back that increases the likelihood of back pain becoming chronic? A recent study looked at the differences in the deep muscles of the low back between acute back pain surgery patients and chronic back pain surgery patients. What did they find? The biggest difference between the two patient groups was the growth of fibrous tissue, or fibrosis, in the deep muscles of the low back. What was their conclusion?
“...increased efforts should be made to prevent or reverse fibrogenesis to improve patient function in this population.”
Preventing and Reversing Fibrosis
So, one thing that is different about low back pain that has just come on recently (Acute) and low back pain that has lingered for a long time (Chronic) is the thickening of the tissues (fibrosis) in and around the low back muscles; hardening of the fascia in and around the muscles. I see this and feel this all the time in my low back pain patients. It sometimes presents as a hardened area, or trigger point. Sometimes it presents as a long band of hardened tissue that is shown by the patient as they are indicating where they feel their pain. It can also feel like a general tightening of the entire surface in an area in the back, or a hardened layer. At Muscle IQ our treatment is guided by the Fascial Distortion Model, which is a perfect fit for the treatment of this aspect of chronic back pain. (See our website for a full description www.MuscleIQ.com )
A successful outcome from chronic low back pain cannot happen without identifying and treating the fibrotic changes (fascial distortions) in the low back that occur with chronic back pain. In my next blog I will discuss the second aspect that is necessary in treating chronic back pain; restoring normal muscle response (restoring normal spinal cord excitability and reducing muscle inhibition).