Stability = movement control

Pain-free movement is only possible with optimal function and coordination (cooperation) of the moving and holding muscles, control via the nervous system and intact passive structures. Many studies have shown that back pain patients with poor motor control (coordination of all factors involved) have a high relapse rate. Any severe acute pain of the back, regardless of the cause, an existing herniated disc or spondylolisthesis always leads to a weakening of the deep muscle system.

This system is also always disturbed after a pregnancy. For this reason, the training program for the local musculature is recommended for women after childbirth in any case, even independently of existing back pain. Symptoms of instability: These symptoms can, however, also occur for other reasons.

However, they can give the doctor or physiotherapist possible clues to guide further diagnostics in certain directions.

The patient describes sudden shooting pains in the lumbar or cervical spine when moving, e.g. when bending down or turning the head quickly
The feeling that the back breaks through or the head is not carried by the neck
Pain and stiffness after getting up from the prone position or after sitting in the car and desk work for a long time
Pain and stiffness in the morning after getting up
Pain after strenuous activities such as carrying weights for long periods (e.g. when shopping)
Frequently recurring (recurrent) pain attacks
When coming up from a bent position, the patient is not able to come up with stretched legs, but must bend the knees and support himself with his hands on the thighs
The therapist palpates the deep musculature directly at the spine in prone position or the deep abdominal muscle in supine position and tests the ability to tense
Reduced flexion ability in the lumbar spine and compensatory increased mobility in the lower thoracic spine
When testing the range of motion of individual vertebrae, the patient feels the pain typical for him and the therapist (possibly the patient) feels too much range of motion compared to other vertebrae;
If the patient tenses his back muscles during the test, the pain will subside
Other possible causes of back pain must be excluded, since mechanical dysfunctions or structural changes in the spine (e.g. herniated disc, slipped vertebrae) often occur in parallel
In the MRT (imaging procedure) a reduced muscle cross section of the local musculature is visible, this often remains even after the acute pain situation has subsided.
Electromyography can measure reduced activity of the deep muscles
During open spine surgery (e.g. disc surgery) in the lumbar or cervical spine, the surgeon can see the reduced muscle cross-section of the deep muscles