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Making Sense of Joint Sense in the Low Back

Posted on: 11/30/1999
Joints in the body can tell what position they are in. Joint position sense is called proprioception. When a joint is injured, proprioception can be damaged. Scientists are studying this special joint function. If we can understand how joint sense works, there's a chance to help repair it after injury.

There are joints in the spine, too. Back pain can alter joint sense in the back. Researchers are in the early stages of studying how this works. One area of interest is the accuracy of joint positioning. This looks at how well a person can return to a position after moving out of it.

Some studies have only used one test position (standing). Physical therapists and other movement experts at McGill University in Canada are studying spine position sense in other positions, too.

Recently, they tested a group of 70 men between the ages of 20 and 51. No one had back pain and all were manual laborers. The three positions used were standing, sitting, and on hands and knees called four-point kneeling (FPK). The men were tested with their eyes open and also blind folded.

The men assumed each position, then moved out of the position, and returned to the same position as closely as possible. Measurements were taken of how well they returned to the original positions. As reported in other studies, the men were best able to return to the same standing position. The most difficult position to resume was FPK.

Lumbar (low back) spine position seems to go from best to worst when comparing positions of standing and FPK. Researchers reported this was true with and without vision. The authors think this has something to do with the affects of gravity, the position of the hips and knees, and the way muscles contract in different positions.

Position sense in the spine must be taken into consideration during rehabilitation for back pain. The results of this study show that exercises to train proprioception should include more than one position.

References:
Richard Preuss, PT, MSc, et al. The Effect of Test Position on Lumbar Spine Position Sense. In Journal of Orthopaedic & Sports Physical Therapy. February 2003. Vol. 33. No. 2. Pp. 73-78.

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