ReActiv8 Scientific Background

The strongest stabilizer of the lower back is the multifidus muscle which attaches to the spine at multiple levels. Its segmental activation is orchestrated by the central nervous system in response to a variety of sensory and proprioceptive stimuli.

Joint pain which originates from a strain or sprain injury of one of the ligaments, tendons, joint capsules or discs can lead to disruption of motor control and compromised spine stability. Inhibition of the multifidus allows spine joints to move beyond their pain free zone, and leads to increased pain intensity and possible re-injury. The result is an ongoing cycle of chronic pain, inhibition and eventually muscle atrophy.

Several studies have demonstrated that ultrasound image guided exercise programs targeting multifidus motor control can improve low back pain1. Treatment guidelines2 recommend completion of individualized exercise programs before other options are considered.

The use of electrical stimulation to reactivate the motor control system is well established for other skeletal joints and stabilizing muscles (e.g.: quadriceps inhibition after knee surgery3).

Results of a recently presented feasibility study4 suggest that electrical stimulation of the medial branch of the dorsal ramus to activate the multifidus may indeed lead to improvements in chronic low back pain.

  • 1 Ghamkhar, L., Emami, M., Mohseni-Bandpei, M. A., & Behtash, H. (2011). Application of rehabilitative ultrasound in the assessment of low back pain: a literature review. Journal of bodywork and movement therapies, 15(4), 465–77. doi:10.1016/j.jbmt.2010.07.003
  • 2 Airaksinen, O. et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur. Spine J. 15 Suppl 2, S192–300 (2006).
  • 3 Gondin, J., Guette, M., Ballay, Y. & Martin, A. Electromyostimulation training effects on neural drive and muscle architecture. Med. Sci. Sports Exerc. 37, 1291–9 (2005).
  • 4 Van Buyten, JP. et al. A New Therapy for Patients with Chronic Low Back Pain (CLBP): Results of a European Multicenter Feasibility Study. in Int. Neuromodulation Soc. Congr. 10, (2013). Neuromodulation 2013; 16: e176,e177.