Dysfunction of the Neuro-Muscular System in the Presence of Low Back Pain—Implications for Physical Therapy Management

This paper comprehensively reviews the literature regarding evidence of neuro-muscular dysfunction associated with low back pain (LBP). From this review it is clear that neuro-muscular dysfunction occurs in the presence of LBP, although the manner of the dysfunction is variable. LBP is sometimes associated with a loss of strength and often a loss of endurance of the trunk muscles. LBP is commonly associated with varied and complex patterns of neuro-muscular dysfunction both between and within trunk muscle synergies. This results in disrupted patterns of co-contraction and co-ordination between and within trunk synergists and appears to reflect altered patterns of neuro-motor control. There is also evidence that the muscles commonly affected are those whose primary role is to provide segmental control and dynamic stability to the spine. Implications for the treating therapist regarding the management and rehabilitation of patients with LBP are broadly discussed.