Effects of neuromodulation in chronic low back pain v2.0
Research type
Research Study
Full title
The effect of neuromodulation on muscle size, local trunk dynamic stability and chronic low back pain
IRAS ID
236346
Contact name
Helen Lumbard
Contact email
Sponsor organisation
London South Bank University
Duration of Study in the UK
1 years, 1 months, 29 days
Research summary
Disability from chronic low back pain (CLBP) (back pain persisting for longer than 3 months) has been described as a 21st century epidemic with significant socio-economic consequences. Further research is required into how CLBP can be effectively treated and managed, in order to reduce the prevalence of this condition and the burden it imposes.
Muscles of the lower back contribute to the control of spinal motion and stability. These muscles initiate and control movements of the vertebral column, and protect the underlying spinal structures from strain. Whilst all muscles play a critical role in the function of the lumbar spine, multifidus can be identified as a key stabiliser. Over time, the spinal muscles in those with CLBP will change structurally and functionally - multifidus wastes and becomes smaller, muscle recruitment patterns change and muscle fatigue is accelerated. The result is impaired dynamic spinal stability, and an established cycle of ongoing low back pain.
Neuromodulation is an intervention utilised to treat CLBP that is unresponsive to other forms of management. The intended effect is to rehabilitate multifidus by electrically stimulating the medial branch of the dorsal ramus through an implanted device, and directly activating the muscle.
This longitudinal study will explore the morphological and functional changes in those receiving neuromodulation as well as in CLBP patients receiving medical management only. These changes will be considered in relation to pain and disability.
The study will be based at St Thomas’ hospital pain management and neuromodulation centre in collaboration with London South Bank University. Muscle size, local stability and dynamic movement, will be assessed using non-invasive measures in a CLBP population, pre- and post-intervention/medical management. The study will provide detail on muscular/stability changes following neuromodulation, how these relate to pain and disability, and the usefulness of this protocol in the treatment of CLBP.
REC name
London - Surrey Research Ethics Committee
REC reference
18/LO/0969
Date of REC Opinion
26 Jul 2018
REC opinion
Further Information Favourable Opinion