Moving beyond fine wine and creamy
cheese, France may have given the world a whole new way to make
life better: a specific form of physical therapy that promises
relief for millions of people now suffering the crippling effects
of severe back pain.
A new study out of Argentina
focuses new light on the potential benefits of the Souchard
global postural re-education method (GPR) -- a not-so-new regimen
of stretching and strengthening back muscles, developed over
a quarter-century ago by French doctor Philippe Souchard.
Study author Dr. Conrado Estol
said preliminary research suggests the GPR technique quickly
improves quality of life for a majority of patients disabled
by chronic lower back and neck pain.
"I am extremely enthusiastic,
said Estol, who presented his findings April 14 at the American
Academy of Neurology's annual meeting in Miami Beach.
"It's a very safe method, and I think we're proving it works."
The GPR method addresses posture
correction in problem areas by targeting entire muscle groups,
rather than individual muscles. These muscle chains are slowly
stretched and elongated over multiple therapy sessions to relieve
pressure on pinched spinal nerves. The technique is non-surgical
and does not involve prescription medications, Estol said.
As director of the Neurological
Center for Treatment and Rehabilitation in Buenos Aires, Estol
treated 102 Argentinian men and women, aged 25 to 91, between
2000 and 2004, for his study. All had been afflicted with severe
back pain for an average of seven months prior to the study
Patient diagnoses covered a range
of disc diseases, including spinal disc protrusions and spinal
canal stenosis -- a narrowing of the vertebrae channel, or spinal
canal, surrounding the spinal cord.
Prior to receiving GPR, all the
men and women had already been prescribed at least one traditional
remedy for a minimum of six months, including such non-surgical
treatments as regular physical therapy, anti-inflammatory drugs,
acupuncture, epidural injections, or simply rest.
Estol stressed that neither rest
nor any of the previous treatment options had helped diminish
symptoms among the 82 patients treated for lower back pain and
the 20 with neck pain. More than a quarter of these patients
said they had experienced major disruptions to their daily routine
as a result of their pain, such as ceasing to be able to work,
exercising, or walking more than five blocks without stopping.
The remaining 75 percent were forced to forego some work or
some exercise, and could not walk more than 10 blocks without
Following an initial week in
which they received two therapies, all the patients were placed
on a five-month regimen of once-weekly GPR administered in a
combination of standing, sitting, and lying positions. Therapy
sessions also included breathing instruction, and patients were
also instructed in a special home-exercise program.
According to Estol, 85 percent
of patients noticeably improved after the first three weeks
of GPR. By the end of the study period, 90 percent of the men
and women were able to resume their normal daily routines. Six
percent said they continued to experience some pain when engaging
in demanding sports activity, while four percent gained no apparent
benefit from GPR.
The researcher reports that after
almost two years of in-person or telephone follow-up, none of
the patients who appeared to benefit from GPR reported any back
"This technique would probably
be good for almost anyone," suggested Estol, who has been exploring
the promise of GPR for more than 14 years. "It corrects posture,
and can help with all kinds of back pain."
But he also emphasized that his
study only focused on people experiencing the most severe and
enduring kind of back disease.
"Most cases of lower back pain
and neck pain go away spontaneously while the patient is being
worked up or just starting physical therapy," said Estol. "Intractable
back pain is very rare nowadays, but these people were not going
to improve on their own in four or five days. Some of these
patients couldn't walk."
Estol described GPR as a softer,
less brisk alternative to traditional physical therapies, as
well as an effective non-surgical answer to back pain intervention.
In his opinion, surgery involves a substantially higher amount
of risk, as well as costing more.
"GPR appears to be effective,
but, of course, people should always get evaluated first by
a physician with expertise before they choose a treatment,"
Dr. Arya Nick Shamie, chief of
spine surgery at Veterans Administration Wadsworth in Brentwood,
Calif., agrees that informed medical advice is in order whenever
back pain persists beyond two weeks or is the result of an accident.
But once in the doctor's office, he's not so sure GPR is a patient's
"Back pain is such a mixed soup
of various problems, and this study lumps all sorts of diagnoses
into one group," cautioned Shamie, who is also medical director
at UCLA Spine Center. "A patient with sciatic pain, and another
with degenerative disc disease, and another with a cyst in his
spine -- if you group all of these patients together and suggest
this one form of physical therapy is going to treat them all,
it's not so compelling."
Shamie also expressed concern
that no other form of therapy was studied alongside GPR as a
point of comparison as a "control" group. And he stressed that
back pain is an extremely complex, often misdiagnosed phenomenon
that defies easy solutions.
"But I don't want to totally
dismiss this study," he said. "Ninety percent of patients get
back pain sometime in their life. It's a very common problem.
And you depend on your back anytime you move or do anything.
That's why it makes patients
so desperate, because they can't function," he said. "So this
is interesting, and it might tell us that physical therapy,
overall, does help patients, and we shouldn't disregard it as
Reference Source 101