90% of lower back pain can be treated at home, finds research by UBC

VANCOUVER, BC, Nov. 29, 2022 /PRNewswire/ -- University of British Columbia clinician Hélène Bertrand suffered decades of LBP before literally taking matters into her own hands. She has developed a new approach to diagnosing and treating a common cause of LBP through a simple, two-minute exercise. The sacroiliac forward flexion test (SIFFT) and associated exercise SIFFT-E could become a low-cost, drug-free addition to current LBP evaluation and treatment.

In recent papers published in 'Cureus', Hélène Bertrand describes how SIFFT-E brought relief to 90% of LBP sufferers in a pilot study. Critically, the exercises can easily be done at home, avoiding the time, expense, and potential side effects of chiropractic manipulation, injections, or surgery.

One of Dr Bertrand's patients had three ineffective back operations before eliminating his pain through the two-minute corrective procedure.

The offender in LBP is often a misalignment of the sacroiliac (SI) joints, which connect the sacrum, at the base of the spine, to the two (iliac) bones that form the pelvis. The pelvis holds the weight of the body, which tends to push the iliac bones away from the sacrum, straining the sacroiliac joint ligaments and the SI joints absorb the shock of every step we take as the hip joint is inside the iliac bone. Heavy landings, prolonged sitting, or heavy lifting can displace them. Unlike all the other joints, which are smooth, SI joints are rough and irregular, making misalignment hard to assess with x-rays, CT scans, or MRIs.

As a result, "While sacroiliac problems are a common generator of LBP, treatment is often generic or incorrectly focused on the lumbar spine and can be ineffective or even cause unpleasant side effects and complications", explains Bertrand.

For SIFFT, a quick physical exam, pen, and spirit level are all that's needed to detect misalignment. The practitioner locates the back of the pelvic bones – the posterior superior iliac spines (PSISs) – through the skin and marks each side with a pen to easily see any height difference. Misalignment of the iliac (pelvic) bones can then be corrected by adopting and holding specific positions. If patients cannot treat themselves, a practitioner can make the movements for them. In each case, the positions are held for just two minutes.

In a two-month evaluation of 60 patients who had LBP for at least three months and a height difference between left and right sides of at least 5mm, Bertrand found the condition of patients using SIFFT-E improved more than those receiving their usual care. Notably, 54 of 60 one-month SIFFT-E participants (90%) experienced immediate pain relief after the SIFFT-E exercise.

After two months, when all participants had used SIFFT-E instruction and a pelvic stabilisation belt as required, Bertrand found clinically significant improvements in condition and the average difference in height between the left and right PSISs had decreased by 8.6mm.  

Bertrand adds that painful sacroiliac joint displacement can be prevented using a pelvic belt like the one in her study – whenever these joints are likely to be strained.

NOTES FOR EDITORS

Hélène Bertrand gained her Doctor of Medicine at McGill University, Canada, in 1965. She has been a clinical instructor in the Department of Family Practice, University of British Columbia, Vancouver, since 2009.

Further information

The original research articles:

-  Bertrand, H, (2022) Chronic low back pain forced me to search for and find pain solutions: an autobiographical case report. Cureus, 14(1), e21529. doi.org/ 10.7759/cureus.21529

-  Bertrand, H, et al, (2021) Self-treatment of chronic low back pain based on a rapid and objective sacroiliac asymmetry test: a pilot study. Cureus, 13(11), e19483. doi.org/10.7759/cureus.19483

SOURCE Dr Hélène Bertrand