Diagnostic value of musculoskeletal ultrasound in patients with low back pain – a review of the literature

Patients with low back pain (LBP) frequently undergo various imaging studies in the pursuit of a more precise diagnosis. Ultrasound (US) has the advantage of being a widely available, multiplanar, fast and radiation-free diagnostic tool. Moreover, compared to most of the other imaging modalities, it is particularly efficient in the visualization and assessment of soft tissues. Consequently, the question about the possible diagnostic application of US in such a common pathology as LBP is very relevant to the clinical practice. For this reason, we performed a review of the literature on the diagnostic value of US in differentconditions that could cause LBP. We hereby discuss available studies on the diagnostic application of US in spinal canal stenosis and disc herniation (probably of historical significance only), as well as in the pathology of soft tissue structures like the lumbar and pelvic ligaments, muscles and entheses, the thoracolumbar fascia and the sacroiliac joints (maybe of greater importance nowadays). The evidence for the diagnostic value of US is not equivocal, though promising for some of the causative conditions, and clearly this area remains open to further research.

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How is recovery from low back pain measured? A systematic review of the literature

European Spine Journal ◽

10.1007/s00586-010-1477-8 ◽

2010 ◽

Vol 20 (1) ◽

pp. 9-18 ◽

Cited By ~ 41

Author(s):

Steven J. Kamper ◽

Tasha R. Stanton ◽

Christopher M. Williams ◽

Christopher G. Maher ◽

Julia M. Hush

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Review Of The Literature

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Effect of Physiotherapy Treatment in the Autonomic Activation and Pain Perception in Male Patients with Non-Specific Subacute Low Back Pain

Journal of Clinical Medicine ◽

10.3390/jcm10081793 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1793

Author(s):

Vanesa Abuín-Porras ◽

Vicente Javier Clemente-Suárez ◽

Gonzalo Jaén-Crespo ◽

Emmanuel Navarro-Flores ◽

Helios Pareja-Galeano ◽

...

Keyword(s):

Nervous System ◽

Low Back Pain ◽

Back Pain ◽

Pain Perception ◽

Soft Tissues ◽

Low Back ◽

Physiotherapy Treatment ◽

Subacute Low Back Pain ◽

Subjective Pain ◽

System Activation

Introduction: Physiotherapy treatment is a common intervention for low back pain (LBP) patients. These interventions have been related to physiological effects in the central nervous system. Thus, the aim of this study was to analyze the effect of physiotherapy treatment in patients with LBP in the autonomic nervous system activation and subjective pain perception of patients. Methods: A total of 30 male subjects diagnosed with non-specific subacute LBP received a 50 min session consisting of (a) a manual therapy based on joint mobilization and soft tissues techniques in the lumbo-pelvic area, (b) a stretching program, and (c) motor control exercises of the core muscles. The autonomic modification of participants was assessed prior to and after the physiotherapy treatment. Results: Heart rate variability (HRV) analysis reported a significant increase in average RR (p = 0.001), RMSSD (p = 0.008), LRMSSD (p = 0.001), SDNN (p = 0.005), and PNN50 (p = 0.024) after the session. Frequency-domain measures showed a significant increase in LF (p = 0.030) and HF (p = 0.014), and a decrease in LF/HF ratio (p = 0.046). A significant decrease was found in minimum HR values (p = 0.001) and average HR (p = 0.001). Moreover, maximal HR decreased its value from 116.7 ± 26.1 to 113.7 ± 40.8 after intervention. In addition, subjective pain perception (VAS scores) was significantly lower (p = 0.001) in the post-session assessment. Conclusions: Physiotherapy treatment produced an increase in parasympathetic nervous system activation and a decrease in subjective pain perception in non-specific subacute LBP patients.

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