Despite going to yoga, Pilates, and meuromuscular integrative action (NIA) classes, I still have chronic low back pain. What else can I do to get over this?

Chronic pain is a problem many people face every day. Back pain sufferers are among the most common chronic pain patients in the world. People with chronic back pain often experience an associated movement disorder. It is often overlooked and may account for the fact that the pain doesn't go away no matter what you do.

Studies of low back pain have made some interesting new discoveries. For example, with low back pain, there's more that's affected than just the muscles. In addition to physical factors, there are psychologic, social, and emotional factors that must be considered.

From a strictly physiologic point of view, pain and fatigue can occur as a result of inefficient and/or dysfunctional movement. Muscles start to contract together at the same time in a pattern called cocontraction. The result is that the muscles experience a decrease in motion, force, and endurance.

Movement dysfunction and altered motor control can occur resulting in a pain-spasm cycle that just won't quit. We don't have a perfect answer yet, but we do know that addressing the motor control component of low back pain is helpful. Physiotherapists are especially equipped to test for this problem. They can set up a program to help you overcome inefficient habitual movement patterns.

Maureen J. Simmonds, PhD, PT, et al. Pain, Mind, and Movement. In The Clinical Journal of Pain. May 2008. Vol. 24. No. 4. Pp. 279-280.