(A3)

Deconditioning Syndrome
Prepared by Gina Lund
The word decondition is defined as either causing extinction of a conditioned response
or causing and then losing physical fitness. It is important to understand that most of
the patients seen at PNBC have deconditioned spinal muscles due to the chronic nature
of their pain resulting in disuse atrophy. Therefore, almost all PNBC patients carry the
diagnosis of deconditioning syndrome.
Causes of Deconditioning Syndrome:
The common causes of chronic spinal pain include genetic, degenerative conditions or
traumatic experiences. Deconditioning syndrome is caused by a prolonged decrease in
physical activity due to chronic low back or neck pain. It is associated with a gradual
reduction and change in muscular strength, mobility of joints, and even cardiovascular
fitness. This unfortunate result
sometimes occurs due to the myths
people often believe or have been
told by a physician or friend that bed
rest, physical restriction, and/or pain
medications are best for relieving
chronic spinal pain. Over an
extended period of time, an
individual may guard his or her body
from work and activity due to fear of
aggravating spinal pain again. This
leads to the cycle of pain, stiffness, disuse, and muscle atrophy - a self-sustaining cycle
helping perpetuate chronic spinal pain that may control a persons life.
Symptoms of Deconditioning Syndrome:
Symptoms associated with this diagnosis include constant,
and/or recurrent pain. Initially, individuals may complain of
pain that is provoked by activities that use the deconditioned
muscle group. However, over time, the person can be so
susceptible and weak that any activity or stressor can
precipitate pain, leading to constant pain no matter what the
activity may be.
How is this syndrome diagnosed at PNBC?
On evaluation, the physician examines and interrogates the
patient - discussing which activities may lead to an increase
in pain. Physicians will often test patients on specific

Compiled by Physicians Neck and Back Clinics. 2009

equipment to determine how weak a patient may truly be in the lumbar/cervical extensor
muscle groups. Patient deconditioning may be rated as mild (0-15%), moderate (16-49%)
or severe (>50%) by comparing test outcomes to normalized values. It is from the actual
test values that rehab staff calculates the start weight for the patients first maximum
workout. The patient history of the chronic pain and exam may sometimes point to
deconditioning syndrome so clearly that the physician can assume it exists even without
the benefit of testing on specialized equipment.
Treatment:
If an individuals pain has reached a chronic level and he or she has not been able to
maintain normal function, some type of resistance strengthening is usually required for
functional recovery. Weak muscle groups must be specifically trained to get stronger.
The movement involved will increase blood flow and disc health as well. PNBC helps by
engaging the person in a prescribed, specific strengthening protocol. By strengthening
lumbar and cervical extension and rotation muscles, as well as muscles associated with
the affected area, patients experience improved strength, range of motion, function and
overall health.

Acknowledgements:
http://emedicine.medscape.com/article/1144130-overview, http://www.merriamwebster.com/dictionary/deconditioning

Compiled by Physicians Neck and Back Clinics. 2009