Vibration Exercise Therapy

Treating back pain with whole body vibration is both effective and time efficient for the doctor. However, it’s sometimes confusing to hear the words ‘whole body vibration’ and ‘back treatment’ in the same sentence! As Chiropractors, we are all well aware of the adverse effects of whole body vibration on back pain. However, new research is showing that when vibration is applied within specific safe frequencies, it has positive benefits on back pain. Since applications of vibration exercise with low back pain is the most requested topic I get, let’s go over the current literature and introduce some rehabilitation concepts that can be applied with vibration exercise.

It’s surprising how much new research is coming out for vibration therapy. Just five years ago, I would be hard pressed to see an article appear in a peer reviewed journal every few months. Currently, new research is being published in such journals as Spine, Stroke, American Journal of Clinical Rehabilitation, to name a few. It appears the focus is slowly shifting towards health benefits as opposed to the initial research in sports performance, although there’s significant research going on in that also.

Here’s a summary of 2 interesting articles about low back pain and vibration therapy that we can discuss:
Rittweger J, Just K, Kauthzsch K, Reeg P, Felsenberg D. Spine 2002: Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: 27; 1829 – 1834.

Findings: This was a randomized controlled trial that showed comparable results of reduction in pain sensation and pain-related disability when comparing back extension exercises to vibration therapy. The study also cites that poor lumbar muscle force is probably not the exclusive cause of chronic lower back pain. It is thought that vibration exercise may be activating muscles via reflexes.

In practice, we tend to see a lot of back pain patients. Our take on vibration exercise is that there is an increased proprioceptive effect due to the instability of the platform. This may be activating the deep muscles of the low back. Prior to vibration therapy, we would utilize rocker and wobble boards, based upon treating muscular imbalances through some of the methods taught by Janda. We found that vibration therapy tends to achieve similar results but in less time. Not only are we getting muscle activation, but increased strength gains in the lower extremities.

Belavy DL, Hides JA, Wilson SJ, Stanton W, Dimeo FC, Rittweger J, Felsenberg J, Richardson CA. Spine 2008. Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed – rest. 33: 121 – 131.

Findings: The resistive vibration exercise countermeasures reduced, but did not entirely prevent, multifidus muscle atrophy and passive spinal tissue deconditioning during bed-rest.

This is an interesting study and shows the importance of providing early rehabilitation for anyone with low back pain. It’s already been shown that after an attack of low back pain, there is atrophy of the multifidus muscle. Even after the back pain is gone, a group that did no exercise was still seen to have atrophy. Hence, the importance of exercise cannot be overstated. This study is reinforcing the positive effects of exercise. What makes vibration therapy so unique is that you can utilize it for patients that are unable to engage in conventional therapy either due to decreased mobility or increased pain. When I get an acute low back patient, or a chronic patient with limited mobility and pain avoidance behaviour, starting off their rehab program is as simple as lying down next to the vibration platform and putting two feet on it. Distal stimulation allows activation of the muscles in addition to increased circulation. In this situation, I use vibration therapy as an ‘early adoption of exercise.’ Achieving early strength and flexibility gains is crucial to progress the patient into a more functional program. We have found that vibration therapy allows us to begin this process early enough so that the patient does not fall into sedentary habits.