Real-Time Ultrasound Imaging

The Core of Low Back Pain

All health professionals know that lower back pain is a prevalent problem in modern society and it is one of the most common musculoskeletal problems seen by GP’s and Physiotherapists.

Various treatment options are open to the physiotherapist for low back pain and musculoskeletal research in the past few years have increasingly focused on the deep muscles of the trunk. The findings suggest that these deep ‘core muscles’ are very important in providing stability of 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.

Our physiotherapy department has recently acquired a Real-Time Ultrasound Imaging (RTUI) machine specifically for the purpose of 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, physiotherapy patients at London Bridge 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 have emerged on its use. 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 are recruiting the deep core muscles as well as they had thought, and to 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 rehabilitation. For further information please click here

To refer your patients for highly specialised physiotherapy, please call 020 7234 2500.