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Home » Posts » Musculoskeletal » spinal conditions » Cortical remapping interventions for chronic low back pain

Cortical remapping interventions for chronic low back pain

39 Responses »
May 28 2015
Profile photo of Chris Seenan
Posted by
Chris Seenan
shutterstock_113237944

The elves have heard people talking about treatments that aim to change the wiring in your brain and this sparked our interest in whether they work for chronic low back pain. We found this useful systematic review of cortical remapping interventions for pain and disability in chronic low back pain. I will talk you through what the authors did and found.

Here’s what they did

The authors searched electronic databases up to September 2013 for studies in any language that included adults with chronic low back pain (CLBP), defined as low back pain persisting longer than 3 months.

Treatment interventions included graded motor imagery (GMI), mirror visual feedback therapy (MVF) and sensory discrimination retraining (SDR) or similar and could be delivered together.

The effects of these intervention were compared with current practice and the primary outcomes measured were pain, disability and cortical imaging as a measure for cortical remapping.

Here’s what they found

  • 5 studies were included in the review (183 participants) – 3 randomised controlled trials (RCTs), 1 randomised cross‐over study, and 1 multiple case study design.
  • Sensory discrimination retraining: no difference in pain, physical, emotional functioning or disability after 12 or 24 weeks of intervention
  • Mirror visual feedback therapy: reductions in pain intensity and duration with repeated lumbar movements using mirrors
  • Graded motor imagery: changes in the motor cortex mapping towards what is seen in healthy participants
  • Combination approach: reduction of pain intensity, pain interference and disability after 10 weeks and this was maintained at 20 weeks follow-up but only evidence from 3 participants

The authors concluded

Management strategies such as sensory discrimination retraining, graded motor imagery, and mirror visual feedback which specifically aim to drive adaptive cortical neuroplasticity to redress these changes have been shown to be effective in other pain conditions.

shutterstock_192981251

Cortical remapping interventions have an effect on pain and disability in chronic low back pain

The Musculoskeletal Elf’s view

The Musculoskeletal Elf

We know chronic low back pain is a debilitating condition associated with changes within the brain (cortocal remapping). Strategies have emerged that focus on reducing these changes within the brain and the basic science is encouraging. Further high quality studies are required to fully examine the effect of these strategies on chronic low back pain, specifically trials that rigorous recruitment, randomisation and blinding of a suitable sample.

What do you think?

  • Do you have experience of cortical remapping interventions?
  • What are your views on this type of intervention?

Send us your views on this blog and become part of the ever expanding Musculoskeletal Elf community. Post your comment below, or get in touch via social media (Facebook, Twitter, LinkedIn, Google+).

Do you know that there is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses? This is called the Preferred Reporting Items for Systematic Reviews and Meta-Analyses or PRISMA statement and can be accessed through the website of the EQUATOR Network. The Elves use the PRISMA statement for critical appraisal of systematic reviews, although it is not a quality assessment instrument to gauge the quality of a systematic review.

Links

  • Daffada PJ, Walsh N, McCabe CS, Palmer S. The impact of cortical remapping interventions on pain and disability in chronic low back pain: a systematic review.Physiotherapy. 2015 Mar;101(1):25-33. doi: 10.1016/j.physio.2014.07.002. [abstract]
  • PRISMA statement
  • EQUATOR Network
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Tagged with: Chronic pain, cortical remapping, graded motor imagery, low back pain, mirror visual feedback, sensory discrimination, systematic review
Profile photo of Chris Seenan

Chris Seenan

I am based at Glasgow Caledonian University, Scotland, UK and am an established Lecturer, Researcher and Chartered Physiotherapist with a specialised interest in pain science, vascular disease, amputee management and the psychosocial aspects of health and disease. My principal research interests lie in the field of physiotherapy management of chronic pain and exercise as a treatment for cardiovascular disease and disorders. I am currently investigating the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on pain and function in patients with Peripheral Arterial Disease (PAD) and Intermittent Claudication (IC). My future research plans are to further examine and improve the management of painful conditions, including PAD and IC. I have particular expertise and interest in low-cost, non-invasive, client-centred interventions for pain relief and the effects on function, quality of life and the psychosocial aspects of chronic pain conditions.

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Last reply was May 29, 2015
Sanika Summer liked thisStefano Respizzi liked thisChris Seenan liked thisLyndsay Alexander liked thisAbiodun T. Adefolarin liked thisTracey Shaw liked this
  1. @MSK_Elf
    View May 28, 2015

    Cortical remapping interventions for chronic low back pain http://t.co/a6CWORgFe3

    SportsInjurySco retweeted thisTrigracie17 retweeted thisHHLibService retweeted this
    Reply
  2. @MSK_Elf
    View May 28, 2015

    Cortical remapping interventions for #chronic #LowBackPain http://t.co/qLw6oyauEe @theCSP @thecspstudents

    ProfTraceyHowe retweeted thisbarnes_johnson retweeted thisGCUPhysio retweeted thisRRIO_news retweeted thisAHP_Highland retweeted thisFraserAHP retweeted thischrisseenan retweeted this
    Reply
  3. @GCUPhysio
    View May 28, 2015

    @GCUPhysio very own @chrisseenan blog post at @MSK_Elf Cortical remapping interventions for chronic low back pain https://t.co/ica9h1hDHz

    chrisseenan retweeted this_kathryn_savage retweeted thisMSK_Elf retweeted this
    Reply
  4. @MSK_Elf
    View May 28, 2015

    Cortical remapping interventions for #chronic #LowBackPain http://t.co/qLw6oyauEe @PhysioPainAssoc @painPhysio @PhysioMACP

    ProfTraceyHowe retweeted this
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  5. @ProfTraceyHowe
    View May 28, 2015

    #chronic #LowBackPain & Cortical remapping interventions http://t.co/I4VNEEaJIw @CochraneBack @CochraneConsumr

    MSK_Elf retweeted thisCochraneAus retweeted thisCochraneBack retweeted thislynzalexander retweeted thislink_physio retweeted this
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  6. @MSK_Elf
    View May 28, 2015

    #chronic #LowBackPain & Cortical remapping interventions http://t.co/qLw6oyauEe @BackPainToolkit @PhysioTalk

    ProfTraceyHowe retweeted thisphysiotalk retweeted thisKTRobert2 retweeted thisJingInstitute retweeted this
    Reply
  7. @MSK_Elf
    View May 28, 2015

    #chronic #LowBackPain & Cortical remapping interventions http://t.co/qLw6oyauEe @CochranePaPaS @CochraneMSK

    ProfTraceyHowe retweeted thisSportsInjurySco retweeted thisCochranePaPaS retweeted this
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