PT News: Innovative Physical Therapy Relieves Back Pain
An innovative physical therapy technique may relieve back pain even when all other treatments fail.
The technique, called Souchard's global postural re-education -- or GPR for short -- employs a series of gentle movements to realign spinal column joints and strengthen and stretch muscles that have become tight and weak from underuse.
"GPR corrects the patient's posture and decompresses the spinal canal," says Conrado Estol, MD, PhD, of the Neurologic Center for Treatment and Rehabilitation in Buenos Aires, Argentina. He presented his study at the American Academy of Neurology 57th Annual Meeting.
Return to Daily Activities
"In our study, nine in 10 people with chronic back pain due to disc disease significantly improved and were able to return to their usual daily activities -- usually within five months."
GPR can also help the 95 percent of adults who will suffer acute back pain injury at some point in their lives, he tells WebMD.
Developed in France, GPR is only now being introduced in the United States.
Patient, Therapist Work Together
A person with chronic back pain is in too much discomfort to perform the exercise on his own. A physical therapist guides the process, stretching the muscles along the spinal column while the patient is in the specified positions.
There are two basic positions: standing up and lying down with the knees bent. While in each of these positions, the patient places his arms at his side and tries to open them wider and wider.
"The therapist helps you to find the level you're comfortable with, as you keep increasing the range of motion," Estol says.
When Back Pain Treatments Fail
Estol says medications and surgery for severe and chronic back pain typically have limited or no benefit.
That's why he decided to try the new method on 102 patients with chronic back pain associated with severe degenerative disc disease of the spine. Patients with degenerative disc disease can experience back pain so debilitating that they can't bend, stretch or, sometimes, even get out of a chair without help.
Five Months of Treatment
The participants had severe pain for an average of seven months; 82 had lower back pain and 20 had neck pain. About half were women.
"The patients had tried almost all combinations of treatments you could think of, including regular physical therapy, bed rest, anti-inflammatory medications, acupuncture, and epidural injections," Estol says. "Quite a few had already had surgery and others were scheduled for surgery when we treated them."
Importantly, three-fourths couldn't walk more than 10 blocks without stopping, he says. Thirty-five percent had pain so severe they couldn't walk more than five blocks and had to stop working or playing sports.
The treatment included two GPR sessions during the first week, then one session a week for an average of five months. Participants also practiced breathing techniques and were given a home exercise program.
Back Pain Relieved in Nearly All
The findings showed that 92 of the 102 people reported pain relief and were able to return fully to their daily activities.
For 85 percent of the patients, the improvement was noted after just three weeks of treatment. And after an average of almost two years, the pain has not recurred, Estol says.
Cautious Optimism
Other researchers at the meeting were cautiously optimistic.
Albert Lo, MD, PhD, assistant professor of neurology at Yale University in New Haven, Conn., and a moderator of the session at which the findings were presented, says a success rate of 90 percent in patients with chronic back pain "is very unusual and begs for further investigation."
"If the findings are reproducible in [future studies], GPR could be a very exciting adjunctive therapy for patients with chronic neck and back pain," he tells WebMD.
By Charlene Laino, reviewed by Michael W. Smith, MD
SOURCES: American Academy of Neurology 57th Annual Meeting, April 9-16, 2005, Miami Beach, Fla. Conrado Estol, MD, PhD, Neurologic Center for Treatment and Rehabilitation, Buenos Aires, Argentina. Albert Lo, MD, PhD, assistant professor of neurology, Yale University, New Haven, Conn
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