Low Back Pain and the Role of Biological Plasticity. A clinical commentary published in the Journal of Orthopedic and Sports Physical Therapy decided to look at the role of biological plasticity in LBP (Low Back Pain) as well as its impact on the spine’s sensorimotor control. The commentary, broken into four sections, considered the implications for the clinical management of LBP. Understanding Pain Research has shown that pain is a complex phenomenon. It isn’t acceptable to consider pain in peripheral terms (with the involvement of nociceptive neuron activation) anymore. The underlying pain mechanisms have to be considered along with the increasing awareness of plasticity present in biological systems. Recent medical advancements have helped with understanding the critical role of neuroimmune interactions (in the peripheral and central nervous systems) as well as the interaction between the nervous system and body tissues with regards to development and even maintenance of pain; which included low back pain or LBP.
What's the Relationship Between MRI Findings & Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis? A recent study published in the last legs of 2019 set out to find the correlation between clinical symptoms and MRI findings in patients who are suspected to be suffering from lumbar spinal canal stenosis. What was the Context? Lumbar spinal stenosis (LSS) is the most common sign that a patient over the age of 65 will need a spinal surgery.
What is LSS? It is a condition that shows decrease in the available space for the vascular and neural components of the lumbar spinal cord. Within clinical practice, symptomatic LSS comes with different symptoms. This includes: buttock pain, bilateral or unilateral neurological disorder, and pain in the lower extremities. LSS manifests usually because of less space present for neural and vascular structures of the lumbar spine. Previous studies have shown that clinical symptoms showing mild to moderate lumbar LSS might exist in less than half of patients. Numerous clinical criteria and imaging are available for the diagnosis of LSS. What Does This Mean? Biomechanical Stress and Active Discopathy Theories in Low Back Pain. A study , in the European Spine Journal, set out to uncover some theories related to low back pain (LBP) and biomechanical stress. It concluded that using weight-bearing MRI scans offer a valuable complement to standard sequences due to them presenting the radiologist with additional (and beneficial) diagnostic information about low back pain.
The Context For many individuals out there, low back pain (LBP) caused by the degenerative disc disease of the spine is a leading reason for chronic disability and morbidity. Although there is a trend to avoid using this language with patients because of the mood it may create about their own spines. The preferred technique to evaluate a spine’s degenerative changes is an MRI because of its ability to detect water content in the discs. According to recent studies, the MRI signal changes in vertebral endplates, particularly the Modic changes (MC) type I, have been deemed a potential specific cause of LBP. What did this Study do? What was Used? Effect of Time of Day on Height Loss Response Variability. A study in the journal of Ergonomics investigated the likelihood of variability of height loss in the sitting position being impacted by the time of day. The day-to-day variability in asymptomatic participants was also analyzed.
The results shared data about height loss changes in the morning and the afternoon. LBP and Height Loss Millions of people (ranging from the young to the elderly) suffer from low back pain, or LBP, around the world. Spinal loading is considered as a cause for LBP as it causes spinal tissue shrinkage. Effects of Time of Day in Height Loss Certain studies display a significant difference between height loss following loading activity applied during the morning and in the afternoon. The Study The research utilized a test-retest design to assess the effects of time of day on the variability of height loss.
Take note, the participants were requested to sleep for eight hours (before every test) as well as to avoid vigorous activity for 24 hours before every test. Update Lumbar Spinal Stenosis — Educating/Including Patients in Care. Goal of the Study? Lumbar spinal stenosis affects approximately 11% of the population, primarily in the adult population. In this article, the authors worked to provide a clinical update giving practitioners a “what you need to know” perspective on the ins and outs of clinical practice. Why are they doing this study? Because of its prevalence and challenge to accurately diagnose, it is important to understand the clinical presentation of lumbar spinal stenosis from a symptomatology standpoint.
What was done? A review of the anatomy is important when understanding the clinical symptoms of lumbar spinal stenosis. Lumbar spinal stenosis model What did they find? As the discs lose height, the associated anatomical changes can lead to narrowing. The classic presentation is the patient reporting of not being able to distance walk as they have previously. How is Lumbar Spinal Stenosis Diagnosed? A careful history and examination are at the roots of a proper diagnosis. Facet joint degeneration's link to intervertebral disc degeneration. A very recent study from 2019, in the Journal of Biomechanics offered some interesting results. It set out to analyze the relationship between IVD intervertebral disc (IVD) and facet joint (FJ) degeneration with regards to chronic low back pain. The results suggested that FJ loading is significantly impacted by the early mechanical changes linked to IVD degeneration. However, the said impact decreased as the degeneration progressed.
What Was the Context? LBP or low back pain has been researched to be the most common condition (musculoskeletal), negatively affecting humans around the world. The Study The current research effort developed a parametric finite element (FE) model using ANSYS APDL of an L4-L5 human motion segment. The analysis was conducted using a custom Python code. What Were the Results? Of the total of 1000 models, 14 of them were excluded from further evaluation. In Grade 0, 141 showed non-degenerated FJ. What was Concluded? Knuckle cracking habit and relationship to hand impairments. An interesting study published in the journal of Orthopedics and Related Research, back in 2016, decided to see if knuckle cracking was related to hand impairments. The results showed a small increase in a range of motion among ‘cracked’ joints. The Context Behind the Study According to numerous records, the voluntary cracking of knuckles happens to be a common habit among humans.
It has been reported to have a prevalence range of 25%-45%. Apparently, many people have a habit of cracking their knuckles when they’re typing on keyboards because their joints feel tight. Numerous physicians have continued to be intrigued by such a habit. A previous large study did suggest their being an association between cracking knuckles and functional hand impairment. The current study decided to use imaging to find certain answers. The Methods Used This study had 40 subjects with no history of joint problems in their hands. What Were the Results? What Was Concluded? Understanding Placebo and Nocebo effects in Healthy Vs. Chronic Patients. A very recent systematic review , in the Journal of Pain, went over the neurotransmitter systems associated with the placebo and nocebo effects in healthy humans as well as those with chronic pain.
It did offer a fascinating insight. What Was the Context? Researchers have been interested in pain for a long time. That’s why numerous studies have been conducted involving neurotransmitters. However, most of the said studies feature healthy participants who are exposed to experimental pain or are experiencing acute postoperative pain. With a continued focus on finding a way to optimize placebo effects while minimizing nocebo effects during clinical practice, it has been deemed crucial for the neurotransmitter systems (that are involved in nocebo and placebo effects) to be directly investigated in subjects with chronic pain.
According to studies, the endogenous opioid system has been observed to be involved in the placebo effects demonstrated by healthy participants. Why Conduct Such a Review? Mechanotherapy and how exercise promotes tissue repair. Goal of the Study? In this study , the goal is to answer how physical exercise promotes tissue healing in bone, muscle, tendon, and cartilage. Why are they doing this study? Physical therapists and other clinicians prescribe exercise to address muscle tears, non-inflammatory arthropathies and controlled loading after injuries. This practice is in line with systematic reviews and controlled trials that demonstrate how exercise and movement can benefit patients with a range of musculoskeletal problems. However, in this short article, the authors focus on what happens at the tissue level to promote the repair and remodelling of tendon, muscle, articular cartilage, and bone.
They argue that mechanotransduction, which is the physiological process where cells sense and respond to mechanical loads, is the term that best describes this process. What was done? The authors began with a literature search for the earliest reference to mechanotransduction, finding 2441 citations in Medline. Disc nutrient supply and its role in disc degeneration. A well-received study , in the journal ‘Spine,’ decided to observe the relationship between cellular nutrition and disc degeneration. The results shared that a fall in disc nutrient supply can lead to disc degeneration. Why Was such Research Conducted? According to previous studies, the disc tends to degenerate earlier when compared to other tissues. The consequences of such degeneration include sciatica, back pain, and other spinal disorders. The treatment of such ailments can be quite expensive. They also harm a person’s psychological wellbeing.
While genetics is involved in such an occurrence, there have been suggestions about disc nutrition playing a role, too. The current research was conducted to further understand this existing relationship. Use a dynamic disc model to help in the patient education of nutrition and discs. What Methods Were Used? The research team cultured isolated bovine nucleus cells in agarose gels. What was Concluded? Cartilage damage and osteoarthritis-related nociceptive behaviour.
A very recent study in the journal ‘Osteoarthritis and Cartilage’ has offered some helpful results. It focused on OA-induced pain in relation to mechanical joint loading and cartilage damage. Why Conduct Such a Study? Osteoarthritis or OA is defined as a degenerate joint disease that involves cartilage damage and the loss of cartilage.
It tends to physically, emotionally, and economically impact numerous people around the world. Due to multiple joint tissues having identified pathologies as well as their relationship with OA, many have questioned the role pathologies play with regards to the clinical presentation of pain associated with OA. When it comes to patients, the clinical presentation of their pain happens to be the most problematic oesteoarthritis symptom. The current study’s primary objective was to better understand the complexities of the pain-structure relationship. What Was the Methodology? The study used the MLJ model for inducing OA in the right knees of male mice.
Core stability exercise in the treatment of low back pain. An interesting meta-analysis , published in PLoS One, decided to review the effects of core stability exercise and general exercise when dealing with people with chronic LBP or low back pain. The results showed that core stability exercise was beneficial for decreasing chronic LBP in the short term. What Was the Context? Along with mental illness, LBP happens to be one of the most common disabilities affecting people in Western countries.
Chronic LBP is known to psychologically, physically, and financially affect global populations in an adverse manner. Exercise therapy has been deemed to help with relieving pain as well as improve the overall functionality of people with chronic LBP. Sports medicine and rehabilitation centers have begun to use core stability training. However, it’s been a bit unclear about whether or not core stability exercise is more beneficial compared to general exercise for patients managing chronic LBP.
What Was the Objective? What Was the Methodology? Why Perching is Beneficial for People with Desk Jobs and LBP. A study published last year in the ‘Ergonomics’ Journal decided to see if perching was a good compromise between standing and sitting. The team concluded that certain custom-made seats could help with keeping low back pain and discomfort at bay. What was the Context? Experiencing low back pain (LBP) and discomfort is linked to prolonged static standing and sitting postures. Studies have shown that taking breaks from standing or sitting can help relieve some discomfort.
For example, changing postures from standing to sitting (and vice versa), standing on a sloped surface, walking around for a bit, and using a footrest for one leg are credited for temporarily reducing low back discomfort. With LBP impacting millions of people around the globe, and professional life demanding people to sit at desks, it’s vital to address certain postures for a person’s wellbeing. When compared, sitting is said to give rise to the most significant restriction on a person’s postural movements.
Lumbopelvic alignment is important to be adjustable for each person. Lower back pain is a global problem. Its rate has increased steadily over the last several decades, with now more than 637 million individuals suffering around the world. What has also been steadily increasing is the act of sitting. People are working from home more than ever, especially with the recent coronavirus outbreak, forcing people to self-isolate to reduce the spread of the disease. Even before COVID-19, businesses and individuals have increasingly adopted computer-based platforms that increase screen time. Engaging with screens are a large part of life for many and presents a new reality of work life.
What do we know about the origins of lower back pain? Lower back pain is considered multifaceted with intervertebral disc degeneration (IDD) being the most probable leading cause. Disc height loss is normal through the day/night cycle. So we need a balance—a balance of compression and decompression to our spines. So what is it about sitting that is so different? Adjustable Tilt. How Low Back Pain is Linked to Mechanoreceptors in the Lumbar Spine’s Intervertebral Discs. A study published in the ‘Journal of Clinical Neuroscience’ decided to analyze mechanoreceptors present in the lumbar spine’s intervertebral discs.
With such receptors linked to Low Back Pain, the study presented certain conclusive results. What Was the Context? Low back pain or LBP has been observed to impact people around the globe. Such ailment effects a person’s social, financial, physical, and psychological wellbeing. Research continues to create therapies to address LBP. When talking about such a condition, the nerve structures present in the intervertebral discs can’t be ignored. Intense muscle spasm of the vertebral musculature is an important component of LBP, elicited through reflex arches mediated by specialized nerve endings. Type 1 is encapsulated mechanoreceptors with similarity to Ruffini endings. While mechanoreceptors present in the human intervertebral disc have been studied, there is limited data available. What Was the Methodology? What Were the Results?
Understanding Soft Tissue Connection Between Neck Muscles and Dura Mater Can Help Address Craniocervical Pain. What’s the Relationship between Subchondral bone features, pathology & pain in Peripheral Joint OA. Podcast with Jerome Fryer, founder of Dynamic Disc Designs. Lumbar Lordosis and Disc Herniation in Young Participants. Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study. Intervertebral disc and Physical Exercise: An Evidence-Based Remark. Biomechanical contribution of spinal stability structures of the lumbar spine.
Does facet joint morphology affect the development of spondylolysis? Is Acceleration a Proxy Injury Risk in Minimal Damage Traffic Crashes? Intervention in the management of lumbar prolapse intervertebral disc. Parkinson disease pain classification system | Pain Syndromes. The Role of Patient Education - Does Reassurance Make a Difference? Spinal mobility in radiographic axial spondyloarthritis.
Spontaneous regression of herniated cervical disc | Review of Literature. Facet Angle and the Relationship to Disc Herniation. The degenerative disc: not a disease but a changing spinal landscape. Lower Extremity Arterial Occlusive Disease vs. Lumbar Disc Herniation. Plastic Models and Sciatica - A Qualitative Interview Study. The sensory nervous system in intervertebral disc-related low back pain. Learning the mechanical affects to the spinal cord - herniated disc model. Pure Facet Pain | Prevalence of “Pure” Lumbar Zygapophysial Joint Pain. Spinal mobility in radiographic axial spondyloarthritis. Spontaneous regression of herniated cervical disc | Review of Literature. Low back pain in children and adolescents - Real life research. Lower Extremity Arterial Occlusive Disease vs. Lumbar Disc Herniation. Lower Extremity Arterial Occlusive Disease vs. Lumbar Disc Herniation. DYNAMIC CERVICAL SPINE UPRIGHT IMAGING. In vivo sagittal motion of the lumbar spine in low back pain patients.
Entropy Intervertebral Disk Degeneration - Fibrotic Remodelling Study. Can vacuum sign provide clues on a joint's stiffness? Vertebral Osteophyte. Is it related to mechanics? Research on Specimens. Podcast with Jerome Fryer, founder of Dynamic Disc Designs. How Low Back Pain is Linked to Mechanoreceptors in the Lumbar Spine’s Intervertebral Discs.
Differentiating the Cause of Shoulder and Cervical Spine Pain – An Evidence-Based Approach. Impact of Lumbar Disc Herniation (LDH) Treatment in Children & Adolescents - A Review. Why Perching is Beneficial for People with Desk Jobs and LBP. Why You Should Use Armrests and Back Support During Cellphone Use. Does Oxygen Concentration and Culture Time Effect Metabolism of Porcine Nucleus Pulposus Cells? Does Spinal Posture Act as a Trigger for an Episodic Headache? – Dynamic Disc Designs. Why is Subchondral Bone Density Higher in People with Low Back Pain? – Dynamic Disc Designs. Assessing the Relationship Between Biomechanical Instability and Degenerative Changes in the Lumbar Spine in CLBP Patients.