The Anatomy of Back Pain
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By Dr. John Raymond Baker in General Published: Sunday, 01 July 07 - 03:06 PM (GMT) |
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There is a reason many days are lost from back pain every year.
One is that there are many potential sources of back pain. One very common one is the intervertebral disc. It used to be thought that the disc itself had no nerve supply, but since then, we have discovered that there is a sinuvertebral nerve supplying the outsiode of the disk than can cause considerable pain.
A herniated disc or protruding disc, can, depending on its size and position, press on the nerve root, spinal cord, or both. It can decrease the space for the nerve between the bones (the foraminal size, a decrease is stenosis of the foraminal opening or foraminal stenosis). This can serious problems that can even end up being permanent if one does not get prompt attention and/or surgical intervention.
Another source of pain is the zygapophyseal joints. These joints are also called "facet joints". Inflammed and damaged cervical zygapophyseal joints have, in the past few years, been found to be a great source of pain in folks injured in so-called "whiplash injuries" (a longer term is hyperextension / hyperflexion injuries resulting from hyperacceleration/hyperdeceleration forces).
An interesting article about these joints as a nocigenerative or pain causing element, is found at:
BMC Musculoskeletal Disorders 2004, 5:15 doi:10.1186/1471-2474-5-15
Of course , torn muscles can be sources of pain as well, even without these more serious sources.
Swelling in the tissues around the nerves in or near the foraminal openings, can cause a relative increase in partial pressures exrerted on the nerve root, and can cause altered function, the results of which can include pain. This swelling can happen as a result of inflammation, but also, as a result of the paraspinal and deep muscles going into spasm after trauma, and locking the low back down, preventing the normal flexion, extension, and torsion, which helps to move fluids in and out of the area.
These are just a few of the pain causing factors in the low back, and in most of these, the answer is not a narcotic pain reliever, but using ice to reduce pain and spasms, stretching lumbar muscles, using digital pressure over the belly of the muscle to induce stretching, electrical muscle stimulation to fatigue muscles in spasm, intervertebral traction / intersegmental traction to stretch paraspinal muscles and to introduce added segmental motion in the axial plane. And, if it is not contraindicated by other factors, Chiropractic manipulation to increase movement and proper positioning of the osseous elements of the spinal joints.
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