17 January 1997

Breakthrough research linking the brain to lower back pain will revolutionise the treatment of back pain and understanding how the brain works, according to University of Queensland researchers.

Dr Paul Hodges' research has discovered that the brain failed to send messages to certain back muscles in people who suffered lower back pain.

And when Dr Hodges, 27, put his back into his work it paid off this year with five awards to his credit.

His PhD supervisor Dr Carolyn Richardson of the Physiotherapy Department said Dr Hodges was the first researcher in the world to link the brain to back pain.

'His research is absolutely revolutionary,' she said. 'It will change the way the world looks at back pain.
'This work has contributed remarkably to the knowledge base of the profession.'

Dr Hodges' PhD examined the way the brain controlled the muscles of the trunk and the way that related to lower back pain and back injury.

'Before the body moves, the brain tells certain muscles of the trunk to contract to prepare it for movement and to protect itself against injury,' he said.

'We don't know if the brain's failure to send messages is the result of back pain or the cause of back pain, but we know that every person with lower back pain that we have tested has this problem
'There's a high chance that similar problems may occur in joints in every part of the body.'
Dr Hodges said the brains of people with Parkinson's disease and those with trauma to their frontal lobe also failed to enact protective mechanisms for other muscles.

'This is the first evidence that people with a muscloskeletal condition and muscloskeletal pain experience a similar problem - it's the first evidence that something goes wrong with the brain and not just with the periphery.'

Dr Hodges has become the first physiotherapist in Australia to win a prestigious National Health and Medical Research Council Australian Postdoctoral Fellowship, which will support his research for a further four years.

The grants have been awarded mainly to medical or dental researchers and selection is based on the applicant's publication and academic record and intended area of research.

Before Dr Hodges takes up the fellowship at the Prince of Wales Medical Research Institute in Sydney, he will spend the next year working with neurophysiologists at the Karolinska Institute in Stockholm, leaving Australia on January 8, 1997.

The Swedish institute, which awards the Nobel Prize, applied for and won a Wenner-gren Centre for Scientific Research Postdoctoral Fellowship to enable Dr Hodges to work there.

'It's quite exciting because it's a chance to get physiotherapy to meld with neurophysiology and provide some scientific basis for our profession,' Dr Hodges.

This year he also won the Queensland Biomedical Research Award and the AMRAD Australian Society for Medical Research Young Investigator Award.
The QCL Science and Technology winner of the Queensland Young Australian of the Year awards, Dr Hodges is a finalist in that category for the national awards in Canberra in January.

Back pain affects between 60 and 80 percent of the population at some point during their lives.

For his PhD, Dr Hodges conducted 10 separate studies of 45 people - a control group of 30 and 15 people who endured recurring lower back pain for at least 18 months.

He found that one muscle, the transversus abdominus, was likely to be one of the main causes of recurrent back pain.

'This muscle is the most important and deepest muscle of the abdomen. It looks and works like a corset to stabilise the back,' he said.

'These ?corsets' should prepare you for every time you move but that doesn't happen when there's lower back pain.
'Treating back pain can be a very difficult process. It's not just a matter of doing sit-up exercises - this doesn't actually target the muscle that protects the back.'

Dr Hodges' work is the culmination of Physiotherapy Department research efforts in the past eight years.
He, Dr Richardson, Associate Professor Gwen Jull, and PhD student Julie Hides have developed a new assessment for back pain and an exercise program treat back muscles.

Dr Richardson and Miss Jull had already developed a device used by physiotherapists in a clinical setting to measure the function of the ?corset' muscle.

They had identified the ?corset' muscle as the main problem for back pain sufferers but Dr Hodges was the first in the world to measure the function of the muscle in a scientific setting, according to Dr Richardson.

This year the team visited South Africa, the UK, Germany, Switzerland and Canada teaching physiotherapists about the research and treatment program.

Dr Hodges completed a bachelor of physiotherapy with first class honours at the University in 1991, winning all four available academic prizes for his year and a University medal.

He worked at the Royal Brisbane Hospital before undertaking his PhD and winning an Australian Postgraduate Award to support his research. In 1995, he won the coveted Menzies Research Scholarship in Allied Health Sciences worth $24,000 a year.

For more information, contact Dr Hodges (telephone 07 3371 6574 until January 8; then in Sweden, c/- Andy Cresswell 0011 46 8 402 2243) or the Physiotherapy Department (telephone 07 3365 2019).