Treatment of Low back pain with Whole Body Vibration Therapy: A paradox

July 30, 2008 · 3 Comments

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.

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3 responses so far ↓

  •   rehabilitate back muscles // Aug 21st 2008 at 5:26 am

    I really appreciate for explaining in detail about the whole body vibration therapy,which helps in curing muscular pains.There are so many therapies but we should go for the treatment which have a permanent solution

  •   antonia // Apr 4th 2009 at 4:12 pm

    I am interested in this therapy. I am in fairly good shape, and have been exercising regularly,after about one year of having a total hip replacement of right hip. What is the effect on a hip prosthesis in using WBV?

  •   Dr. Jasper Sidhu // Apr 6th 2009 at 10:22 am

    Hi Antonia, with respect to a hip replacement, may people are using vibration exercise to maintain and increase strength flexibility. Before starting any exercise program, I do recommend you talk to your chiropractor, physician or therapist. The trend towards using vibration for hip replacements is evolving. Previously, it was recommended to start vibration after 2 years from the date that you had your hip replacement. However, this is a relative contraindication, meaning it depends on many factors, such as the clinical judgment of your therapist or doctor, and the fitness level of the patient.

    The trend now points to using vibration earlier than the 2 years. Its best to work with a certified trainer that has the skills necessary to put you in the right positions and the right intensity levels. Therapists are now using vibration a few months after hip replacements. Initially they are primarily using it as a way to get circulation and distal strength gains occurring. Gradually, as you can tolerate it, there are more hip strength exercises that can be integrated.

    Hope this answers your question and good luck with your program!

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