Chronic low back pain: Why does it happen?

Low back pain is a very frequent and disabling condition. It is estimated that 632 045 people worldwide have low back pain (corresponding to 9.17% of the world population). This is a condition that has reached epidemic proportions, since about 80% of the world's population has already experienced or will experience this pain at least once in their lifetime.

There are people who recover in a month but the majority will have recurrence pain episodes over 12 months, becoming a chronic situation.

In individuals with low back pain there is a decrease in the activation of the deep abs and spinal muscles and an increase of superficial trunk muscles. These are the changes that our body makes to adapt to the pain! The problem is that these changes in postural control of the trunk muscles persist after the lumbar pain episode, contributing to relapses.

Studies have shown that inhibition of the motor cortex can reduce the postural activity of the trunk muscles. What happens in patients with chronic low back pain is that there is a delay in the activation of the transverse abdomen (TRA) during voluntary movements of the upper limbs.

These deficits in postural activation occur because there has been a reorganization of the motor cortex, caused by the pain and functional limitation that these people acquire.

In patients with recurrent LBP, these deficits in postural activity can be trained by qualified motor training. Pilates is a method that involves voluntary contractions of the TrA and multifidus muscles and is associated with improvements in postural activity. This type of exercise induces a greater change of plastic in the motor cortex than strength training, therefore, after training is predicted a reorganization of the motor cortex.