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Treatment of Chronic Lower Back Pain with Lumbar Extension and Whole-Body Vibration Exercise: A Randomized Controlled Trial

Rittweger, Jörn MD,*; Just, Karsten MD,†; Kautzsch, Katja MsPsych,‡; Reeg, Peter MD,§; Felsenberg, Dieter PhD∥

Randomized Trial

Study Design. A randomized controlled trial with a 6-month follow-up period was conducted.

Objective. To compare lumbar extension exercise and whole-body vibration exercise for chronic lower back pain.

Summary of Background Data. Chronic lower back pain involves muscular as well as connective and neural systems. Different types of physiotherapy are applied for its treatment. Industrial vibration is regarded as a risk factor. Recently, vibration exercise has been developed as a new type of physiotherapy. It is thought to activate muscles via reflexes.

Methods. In this study, 60 patients with chronic lower back pain devoid of “specific” spine diseases, who had a mean age of 51.7 years and a pain history of 13.1 years, practiced either isodynamic lumbar extension or vibration exercise for 3 months. Outcome measures were lumbar extension torque, pain sensation (visual analog scale), and pain-related disability (pain disability index).

Results. A significant and comparable reduction in pain sensation and pain-related disability was observed in both groups. Lumbar extension torque increased significantly in the vibration exercise group (30.1 Nm/kg), but significantly more in the lumbar extension group (+59.2 Nm/kg; SEM 10.2;P < 0.05). No correlation was found between gain in lumbar torque and pain relief or pain-related disability (P > 0.2).

Conclusions. The current data indicate that poor lumbar muscle force probably is not the exclusive cause of chronic lower back pain. Different types of exercise therapy tend to yield comparable results. Interestingly, well-controlled vibration may be the cure rather than the cause of lower back pain.

From the *Institut für Physiologie, Freie Universität Berlin,

the †Orthopädisches Rückentherapiezentrum, Berlin,

the ‡Klinik für Anästhesiologie und Operative Intensivmedizin, Pain Centre, Berlin,

the §Orthopädie-Praxis, Berlin,

and the ∥Center for Muscle and Bone Research, University Hospital Benjamin Franklin, Freie Universität Berlin, Germany.

Acknowledgment date: July 31, 2001.

First revision date: November 16, 2001.

Acceptance date: February 20, 2002.

Address reprint requests to

Jörn Rittweger, MD

Institut für Physiologie

Freie Universität Berlin

Arnimallee 22, 14195

Berlin, Germany


Device status category: The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

Conflict of interest category: No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2002 Lippincott Williams & Wilkins, Inc.