Most Patients in Study Believe LBP Flareups Have Biomedical Origins. An Australian study into what male and female lower back pain (LBP) patients believe about the cause of their LBP flair-ups found that the subjects were most likely to attribute the source of their recent pain to biomedical causes, including active movements and static postures, rather than psycho-social factors. Though current evidence points to a positive correlation between mental health issues, including stress, anxiety, and depression, and LBP, few of the patients in this study attributed the onset of LBP flair-ups to psycho-social causes. LBP is the most common global cause of disability, lost income, and productivity decreases in the marketplace. Post-acute LBP flair-ups contribute to chronic job absenteeism and economic disruption at the individual and collective societal levels.
While many studies have investigated the various causes of acute LBP episodes, few have focused on the fluctuations and triggers of LBP flair-ups. Professional LxH Dynamic Disc Model. Congenital Pain Insensitivity Need Better Understanding of Pain Perception. A topical review of the literature on congenital pain insensitivity highlights the complexity of pain perception as it relates to anatomical and physiological defects—congenital, or acquired—and concludes the deficits may preferentially affect carious components of the medial pain system, including the anterior cingulate cortex. Because the studies reviewed failed to locate the origin of the deficits observed, the authors of this review emphasize the need for careful assessment of all pain sensory components in patients to better understand the pathways involved in pain perception.
They also propose that gene mapping afflicted patients may help provide understanding about the molecular mechanisms at work in pain perception. This could lead to more effective and selective therapies in the future. There is overwhelming evidence about the necessity of pain perception to human survival. Medical literature about pain insensitivity has existed since the 1930’s.
Insensitivity to Pain. MRI Study Finds Lumbar Dural Sac Volume Expands at IVD on Standing. A position-dependent MRI study of 32 volunteer subjects found that the increased pressure from cerebrospinal fluid in the spines of the subjects who moved from supine to standing position while being imaged caused a significant expansion in their dural sac cross-sectional area. A positional magnetic resonance imaging (MRI) study was conducted to evaluate how postural changes affected the lumbar dural sac. Each of the 32 male subjects was examined while in the supine, standing, and sitting positions. The L3/L4, L4/L5, and L5/S1 discs cross-sectional dural sac area and anteroposterior (AP) dural sac diameters were measured. The AP dural sac diameter and upper-endplate L1 and S1 angles were measured on midsagittal images, as well. Lumbar Spinal Stenosis Model Forty-one percent of the subjects showed evidence of disc degeneration or protrusion, but no evident dural sac compression was found in any of the subjects.
Use Dynamic Spine Models to Demonstrate Disc Height Loss. In this Spine Education video, Dynamic Disc Designs’ Dr. Jerome Fryer demonstrates the benefits of helping lower back pain patients better understand their condition by using dynamic models and visual aids. “How often do you encounter a patient that explains that their symptoms are worse as the day progresses?” He asks. Though clinicians understand the key to a graduating pain syndrome involves a complex biomechanical and biochemical matrix in the spine, back pain patients don’t need extensive medical knowledge to appreciate the dynamics of what is happening in their bodies.
A simple visual aid can help clarify and simplify their predicament and potential solutions. Using a dynamic disc model, Fryer demonstrates the diurnal expression of fluid from the disc as the disc height changes over the course of the day. “As the day progresses, the disc height will slowly lose its height [causing the facets] to imbricate or shingle. “As the day progresses, the disc height is lost.” LxH Model Helps Practitioners Demonstrate Disc Bulge. In this video, Dr. Jerome Fryer, of Dynamic Disc Designs, shares the newest version of the LxH model, which contains a malleable disc bulge. He explains how using this model—inspired by the nomenclature and definitions of Fardon’s research paper in the Spine Journal— can help practitioners demonstrate to patients the biomechanics of what is happening in the spine when they are suffering from a disc bulge.
“[Fardon] defines the disc bulge [as extending] beyond the endplate, [past] its full circumference,” explains Fryer. “This model has a disc bulge extending beyond the… border [at] L4. Fryer says the new model also contains a protrusion with annular thinning on the left side which is helpful in explaining the nature and definition of protrusion. “It’s a contained nucleus with a thinned annular wall,” he says. He likens the condition to a low pressured car tire—something most adults will be able to relate to when shown a visual model. Chronic Stress-and-Pain-Induced Cortisol May Contribute to Degeneration. A July 2019 study examining the pathological effects of cortisol on the intervertebral disc (IVD) cells and human mesenchymal stem cells (hMSCs) of lower back pain (LBP) patients found evidence that stress-and-pain-induced cortisol—especially when chronic—may contribute to IVD degeneration and inhibit the regenerative process of IVD cells.
Chronic LBP is experienced at some point by over 80 percent of the Western population. When caused by disc degeneration, it is often linked to chronic inflammation in the disc and endplates. The pain associated with disc degeneration induces a biochemical stress response that releases the hormone cortisol into the body. This study explored the in vitro effects of stress—and the subsequent release of cortisol—on IVD and stem cells.
Specifically, it examined how cortisol might be involved in the degenerative process and in inhibiting cell regeneration in LBP patients. IVDs receive important nutrients through endplate capillary diffusion. Relationship Low Back Pain and Sitting Behavior Sedentary Office Workers. A recent study (accepted July 2019) set out to analyze the relationship between Low Back Pain (LBP) and the sitting behavior among sedentary office workers. The results displayed a higher association between a person’s sitting behavior and chronic LBP compared to acute pain or disability. Such association was deemed plausible due to individuals with chronic pain being more aware of pain-free sitting positions.
Why Focus on LBP? Due to current lifestyles, sedentary working hours are everywhere. According to research, in general, rates of LBP has increased in office workers. Take note, LBP is the third leading cause of self-perceived disability and serves as an indicator for a significant economic burden to society. The Study A total of 70 office workers from a professional call-center were recruited for the current study. The measurement system involved a textile pressure mat “sensomative science” consisting of a 196 sensor matrix. Results What does it all mean? Overview of the Molecular Mechanisms of Intervertebral Disc Degeneration. A review article in Spine Surgery and Related Research presented an interesting overview of the molecular mechanisms involved in the degeneration of intervertebral discs.
The review also described certain molecular targets and therapies that may help with intervertebral regeneration and repair. Why do such a Review? Even though life expectancy has increased over the past century, it isn’t without a share of medical issues. According to research, neck pain and low back pain (LBP) tends to increase with age. They’re also the 1st and 4th leading causes of disability in humans, respectively. Furthermore, intervertebral disc degeneration (IDD) plays a significant role in generating back pain. That’s why it’s important to understand the degeneration of healthy joints (especially intervertebral discs or IVDs) with age to improve quality of life. One of the first tissues that experience degeneration in adults is the IVD. What Did the Review Cover? What was Concluded? A Review of the Sacroiliac Joint and Association with Low Back Pain.
According to research, at least 10 to 30% of LBP or low back pain is linked to the sacroiliac joints. A review in the journal of Best Practice & Research Clinical Rheumatology decided to give the said link a more in-depth look. The Context As mentioned, studies have shown an approximate 10-30% of all LBP being attributed to sacroiliac joints SIJ. While almost 44% of SIJ pain is associated with trauma onset, the etiology is still unclear. So, even today, there are numerous challenges when it comes to diagnosing as well as treating sacroiliac joints. One of the biggest challenges is determining whether or not pain or dysfunction in the human body is primarily due to the sacroiliac joint. SIJ being a causative factor, while theorized, doesn’t have a lot of evidence for support.
The Purpose of This Review The current content aimed to cover the available data regarding the anatomy of SIJ along with its examination, etiology, and treatment to assist clinical approaches. Analyzing the Sensorimotor Control of the Spine. A review was conducted to analyze the sensorimotor control of the spine. The overall conclusion of the review was that spinal structures were capable of monitoring sensory information and can control spinal muscles. They could likely offer kinesthetic perception to the sensory cortex. Why Conduct such a Review? One of the most common medical ailments affecting the middle-age population is low back pain or LBP. According to reports, LBP is an expensive musculoskeletal ailment.
It’s multi-faceted and needs to be covered under sociological and psychological parameters. Trying to find the origin of LBP still requires a lot of research. The mechanics behind numerous spinal disorders can act in combination or single variables. What did this Review Do? The current review went over the spinal viscoelastic structures. The review covered reflexes from different lumbosacral structures, the neuromuscular interaction between the spinal structures, and the reflexes from spinal ligaments. Defining The Term ‘Flare’ in Low Back Pain (LBP) It turns out, there isn’t much of a consensus when it comes to the definition of Low Back Pain Flare. A study from The Journal of Pain set out to change that to possibly help LBP patients, clinicians, and researchers around the globe. Why Focus on LBP Flare? Low back pain tends to vary over time. Numerous terms are used by medical professionals and researchers to describe the fluctuations.
With LBP being a common musculoskeletal condition around the globe, the current study deemed it necessary to bring consensus to the term “Flare” or “Flare up” with regards to LBP. The Study This was a mixed-method study. Deriving the definition of LBP flare from the perspectives of individuals with LBP. For the first step, five authors met on 3 different occasions for considering the perspective of individuals with LBP. For the second step, a workshop was held at the International Forum for Back and Neck Pain Research in Primary Care (Buxton UK, June 2016) with a group of 19 experts in LBP. Assessing the Relationship Between Biomechanical Instability and Degenerative Changes in the Lumbar Spine in CLBP Patients.
There still seems to be some controversy when it comes to addressing the relationship between biomechanical instability and the degenerative changes in the lumbar spine in CLBP (chronic lower back pain) patients. A study decided to gather more data about it. Why such a focus? Chronic low back pain or CLBP may be caused by the biomechanical instability following degenerative changes in the lumbar spine. Low back pain is experienced by millions of people around the globe. The course of clinical treatment for such an issue can be guided through radiographical assessment. Such an assessment would be of the bending motions of the lumbar spine as it might aid with the identification of the absence or presence of biomechanical instability in patients with CLBP. Due to the said controversy, this study decided to look into the relationship between biomechanical instability and degree of degenerative changes in the lumbar spine in CLBP patients.
The Study What were the Results? The Conclusion. Low Back-related Leg Pain - Axial Loading with MRI. Goal of the Study? Low back-related leg pain is thought to be neuropathic in origin due to compromise of a nerve root(s) and is also commonly known as sciatica. In a study published in the Journal of Clinical Medicine a group of authors looked to see if loading the spine during MRI imaging (axial loaded MRI) would help discern more specificity to the anatomical cause of the low back-related leg pain. These leg pain sufferers will often undergo recumbent MRI while their symptoms are in the vertical or axially loading posture.
Why are they doing this study? Many cases of sciatica can be challenging to diagnose because of the complexity of the disc mechanics and physiology. There are many nuances of sciatica, and each case can bring its own set of complexities. Learning to determine the source(s) of sciatica more accurately can be helpful in its therapeutic management. What was done? Ninety patients were recruited for this retrospective observational study. What did they find? Novel rat disc degeneration model induced by static bending compression. Goal of the Study? In this primary research article , the authors aim to establish an animal model that can be extrapolated to the complex mechanical load of a human intervertebral disc during bending and compression loading. They hypothesized that a disc herniation could be gradually induced by static complex loading. Why are they doing this study?
Disc bulges or protrusions often pre-exist in patients with acute back pain, suggesting that repeated compressive loads may gradually result in a herniated intervertebral disc. To the author’s knowledge, this assumption has never been verified using animal models. What was done? Twenty research rats were randomly divided into four equal groups. What did they find? No statistical difference was found between the control group and the sham surgery group, so bending alone seemed to have little or no effect on disc degeneration. Why do these findings matter? Education of pain only helpful in the short course for low back pain. Goal of the review? In this review the authors evaluate the effectiveness of advice/education of pain and disability in people with non-specific spinal pain. They also examine to what extent the characteristics of patients and interventions change the treatment effects.
Why are they doing this study? Spinal pain is a leading cause of disability across the world. In Australia, the costs associated with chronic pain are predicted to increase from $139 billion to $215 billion by 2050. Despite the significant impact of chronic pain (spinal pain is the largest contributor), most systematic reviews are outdated and have missed critical studies and new research. Moreover, existing reviews have only looked at advice to stay active without analyzing advice on ergonomic changes or pain neuroscience education. What did they do? The researchers did a systematic review with meta-analyses of randomized controlled trials. What did they find? In total, they included 27 trials with 7,006 participants. How Much Does Pelvic Incidence Impact Sitting and Standing Positions? Occupational Low Back Pain Between 2000-2020. Does the Human Body Hold Potential for Improved Regeneration? Why is Subchondral Bone Density Higher in People with Low Back Pain?
Does Spinal Posture Act as a Trigger for an Episodic Headache? Muscular Flexion–relaxation Response Change Due to Static Flexion. Shorter Lumbar Paraspinal Fascia and Higher Intensity LBP and Disability. Effect of Time of Day on Height Loss Response Variability. Can Spinal Shrinkage Be Reversed Through Press-Ups & Spinal Loading? Head posture found by meta-analysis to contribute to neck pain. Low Back Pain and the Role of Biological Plasticity. What's the Relationship Between MRI Findings & Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis? Biomechanical Stress and Active Discopathy Theories in Low Back Pain. Effect of Time of Day on Height Loss Response Variability. Update Lumbar Spinal Stenosis — Educating/Including Patients in Care. Facet joint degeneration's link to intervertebral disc degeneration.
Knuckle cracking habit and relationship to hand impairments. Understanding Placebo and Nocebo effects in Healthy Vs. Chronic Patients. Mechanotherapy and how exercise promotes tissue repair. Disc nutrient supply and its role in disc degeneration. Cartilage damage and osteoarthritis-related nociceptive behaviour. Core stability exercise in the treatment of low back pain. Why Perching is Beneficial for People with Desk Jobs and LBP. Lumbopelvic alignment is important to be adjustable for each person. How Low Back Pain is Linked to Mechanoreceptors in the Lumbar Spine’s Intervertebral Discs.
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.