Can Altering Motions, Postures and Loads Provide Immediate Low Back Pain Relief. Ikeda DM, McGill SM. (Aug. 2012)

In a recent study (see abstract below) co-authored by Dr. Stuart McGill (Spine 8/6/2012)1, Ms. Diane Ikeda and Dr. McGill concluded that "immediate pain reduction can be achieved by altering muscle activation and movement patterns". Since early 2002, this has been the foundation of the unprecedented remarkable outcomes clinicians have leaned to expect when applying the ATM® Concept and ATM2® treatment techniques. Specifically, clinicians can expect pain elimination (during the intervention), followed by a lasting 50%-100% reduction in pain and or increase in pain-free ROM, immediately after the ATM2® session.

Dr. McGill further concluded that "the combination for optimal success appears to be different for every individual". Our experience over the past ten years has taught us that the "combination for optimal success" not only "appears to be different for every individual", as Dr. McGill correctly suggests, but also different for the same individual over time.

Dr. McGill finaly suggests that "patient classification schemes may need more refinement to address this heterogeneity". Over the past ten years, we have already refined a patient classification scheme that addresses not only the differences between patients but also within the same patient. This classification scheme is so precise that it allows clinicians to predict patient outcomes within just a few single minutes.

Can Altering Motions, Postures and Loads Provide Immediate Low Back Pain Relief: A Study of Four Cases Investigating Spine Load, Posture and Stability.

Ikeda DM, McGill SM.
*Spine Biomechanics Laboratory, Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo.   PMID:22872216 [PubMed - as supplied by publisher]

Abstract
Study Design. A quantitative biomechanical analysis of mechanism of pain alteration in four cases of low back pain.

Objective. The purpose of this study was to investigate the contributions of a number of biomechanical factors associated with pain alteration.

Summary of Background Data. Some clinicians use mechanically based manual interventions in attempt to reduce low back pain. However, the mechanism of pain alteration remains unknown.

Methods. A sample was formed with four low back pain patients seeking consults for pain relief. All could produce "catches" of pain with movement. Manual interventions involving coached changes in motion and muscle activation attempted to reduce pain. EMG and kinematic data were collected prior to and post intervention. These data were input to an anatomically detailed spine model that calculated muscle force, joint compression and shear, and spine stability.

Results. Using a clinically significant criterion of pain reduction greater than or equal to 2, three of four subjects reduced pain immediately upon the intervention. Using a change of 10% as a criterion for biological significance for kinematic and kinetic variables, each subject demonstrated a different reaction. For example, subject 1 increased stability, subject 2 increased ML shear, subject 3 increased ML shear and decreased spine flexion and subject 4 increased stability. The pain reducing interventions required to obtain these results were also different for each individual.

Conclusion. Immediate pain reduction can be achieved by altering muscle activation and movement patterns. However, the combination for optimal success appears to be different for every individual. Pain provocation tests help to "tune" the intervention. This also suggests that patient classification schemes may need more refinement to address this heterogeneity.