Role of Latissimus Dorsi and Lower Trapezius in Chronic Mechanical Low Back Pain due to Thoraco-lumbar Dysfunction

Abstract

Study Design: Randomized controlled single blinded clinical trial. Objective: To identify prevalence of thoraco-lumbar dysfunction (TLD) and analyze the role of latissimus dorsi and Lower Trapezius in it. Summary of background data: 30% of chronic mechanical back pains are due to TLD. The thoracolumbar and Lower Trapezius muscles control the dynamic and postural stability of the lower spine. Though core stabilization exercises are widely recommended for low back pain, but no reports are available for exercises specific to thoraco-lumbar dysfunction. Methods: 30 subjects in age group of 25 to 40 years with non traumatic, chronic mechanical low back pain were identified for study and randomly divided into two groups. Group-A (n=15): core stabilization exercises with Latissimus dorsi and Group-B (n=15): latissimus dorsi strengthening, core stabilization and Lower trapezius exercises. Primary outcome measure was pain intensity (VAS score). Secondary outcome measures were general health (SF-36) and back pain disability (Aberdeen back pain disability score). Outcome measurement scores were compared using paired t-test. Results: Core muscles, latissimus dorsi along with lower trapezius strengthening alone is more effective in relieving pain and improving life than strengthening of core muscles and latissimus dorsi alone. Conclusion: Identification of TLD as a cause of low back pain is recommended in all non-traumatic, chronic, mechanical low back pains. Strengthening of Latissimus dorsi along with Lower Trapezius relieves thoraco-lumbar related back pain.