Back pain pathophysiology: Difference between revisions
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Pathophysiology
Muscle strains (pulled muscles) are commonly identified as the cause of back pain, as are muscle imbalances. Pain from such an injury often remains as long as the muscle imbalances persist. The muscle imbalances cause a mechanical problem with the skeleton, building up pressure at points along the spine, which causes the pain. Ligament strain is a very common cause of back pain as well.[1] Another cause of acute low back pain is a meniscoid occlusion. The more mobile regions of the spine have invaginations of the synovial membrane that act as a cushion to help the bones move over each other smoothly. The synovial membrane is well supplied with blood and nerves. When it becomes pinched or trapped it can cause sudden severe pain. The pinching causes the membrane to become inflamed, causing greater pressure and ongoing pain.
Radiographic abnormalities of the low back may occur in patients without pain.[2][3] SPECT/CT can identify lesions in some patients and these patients may be more likely to have responses to treatment.[4]
Back Pain During Pregnancy
About 50% of women experience low back pain during pregnancy.[5]Back pain in pregnancy may be severe enough to cause significant pain and disability and pre-dispose patients to back pain in a following pregnancy. No significant increased risk of back pain with pregnancy has been found with respect to maternal weight gain, exercise, work satisfaction, or pregnancy outcome factors such as birth weight, birth length, and Apgar scores.
Biomechanical factors of pregnancy that are shown to be associated with low back pain of pregnancy include abdominal sagittal and transverse diameter and the depth of lumbar lordosis. Typical factors aggravating the back pain of pregnancy include standing, sitting, forward bending, lifting, and walking. Back pain in pregnancy may also be characterized by pain radiating into the thigh and buttocks, night-time pain severe enough to wake the patient, pain that is increased during the night-time, or pain that is increased during the day-time.
References
- ↑ "Ligament Pain, Stretched, Torn Or Strained, Prolotherapy". Retrieved 2013-03-05.
- ↑ Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994). "Magnetic resonance imaging of the lumbar spine in people without back pain". N Engl J Med. 331 (2): 69–73. doi:10.1056/NEJM199407143310201. PMID 8208267.
- ↑ Cheung KM, Karppinen J, Chan D, Ho DW, Song YQ, Sham P; et al. (2009). "Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals". Spine (Phila Pa 1976). 34 (9): 934–40. doi:10.1097/BRS.0b013e3181a01b3f. PMID 19532001.
- ↑ Lee I, Budiawan H, Moon JY, Cheon GJ, Kim YC, Paeng JC; et al. (2014). "The value of SPECT/CT in localizing pain site and prediction of treatment response in patients with chronic low back pain". J Korean Med Sci. 29 (12): 1711–6. doi:10.3346/jkms.2014.29.12.1711. PMC 4248596. PMID 25469075.
- ↑ Ostgaard HC, Andersson GBJ, Karlsson K. Prevalence of back pain in pregnancy. Spine 1991;16:549-52.