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Spinal Pain

Spinal Pain Generators

Disc Annulus

Posterior Longitudinal Ligament

Facet Joint Capsule

Fascia

Muscle

Dorsal Root Ganglion

Pain Reducing Techniques

Anti-inflammatory & Analgesic

Lysis of scar & Detethering

Decompression

Arthrodesis & Stabilization

Neural ablation

Neuromodulation

What is Spine Pain?

Spine pain refers to pain that comes from the structures associated with the spinal column and the contained nerves. The most common spine pain is felt as low back or buttock pain but pain can be felt in other areas of the spine such as the cervical (neck) or thoracic (middle section) areas. When the spinal nerves are the source of pain (neurogenic pain) then the pain can be experienced in the arms or legs and can have associated pins & needles, numbness or weakness of the muscles that are supplied by that nerve. Sometimes spine pain is felt in areas away from the pain source such as headaches or chest pains.

Types of Pain

Acute Spine Pain – this pain is the most common and has been present for less than 3 months. Most times acute spine pain is self limiting and does not reflect serious underlying disease even if the pain is severe. Most people in this category are suffering from an underlying mechanical problem in the spine. Most of the time the body can heal itself if it is given the right “instructions”.

Chronic Spine Pain – this pain has been present for months to years. It can be difficult to find a single

pain generator in this type of pain and even repairing the problem that started the pain can sometimes not

remove the pain. This makes this type of pain more difficult to treat but with appropriate interventions the

pain can be improved and controlled and function can be improved. A multi-disciplinary team approach

can improve care for patients with this type of difficult pain.

Intermittent Spine Pain – some people experience intermittent pain from various conditions of the spine and there may be an underlying structural problem in some of these people but often times there can be no clear pain generator and as long as the pain resolves or can be controlled there is no need to further investigate for an underlying cause. Your therapist or doctor will be the best to advise you the best treatment.

Specific Pathological Spinal Pain – due to underlying cancer or infection or fractures of the spine is

uncommon (doctor asking a few specific questions and performing a physical examination. A few of the things to loo

Why does my back hurt and when is the pain going to go away?

Patterns of mechanical spine pain

In order to best treat spinal pain it helps to work out if it fits a recognised pattern of pain even if an underlying cause cannot be clearly defined. Once the serious pathological specific causes of spinal pain are ruled out by your doctor or treating team then

working out a pattern that best fits your symptoms allows treatment to begin even without blood tests, X-rays, CT scan or MRI scans. Below are a series of patterns that are commonly seen with mechanical spinal pain. In order to work out which pattern you fit into you need to ask yourself a few questions.

1. Where is your pain worst?

For low back is it low back/buttock or leg pain?

For neck pain is it neck/shoulder or arm pain?

2. Is your pain constant or intermittent?

3. What makes the pain worse?

4. What makes the pain better?

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