What Are Types of Low Back Pain?

Back pain back pain is a symptom and the cause of the pain may occur within spine or a lesion outside spine.

Generally speaking a pain in the back could be classified into following types.

Spondylogenic Back Pain

Spondylogenic back pain is the back pain which originates in the spinal column and its associated structures. This type of back pain worsened by general and specific activities and is relieved by rest.

The lesions leading to this pain could be in bony components of spine, sacroiliac joints or changes in soft tissues like discs, ligaments, and muscles. [Read more...]

Degenerative Spondylosis – Presentation, Diagnosis and Treatment

Degenrative spondylolistheis was first described by Rosenberg in 1975. The most commonly affected level is L4-L5 followed bby L3-L4. It may occur at two levels or even three levels simultaneously.

It has also been reported in cervical spine.

Occurrence

Degenerative spondylolisthesis is more common in people over age 50. It is more common in women and blacks.

Cause

Facet joints of the vertebral column restrain the motion of the spine [Allow flexion and extension but restrict rotational movements] while the disc itself acts as shock absorber. With age, as the degeneration sets, the facet joint may not remain competent and allow vertebral body to slip forward on the other. [Read more...]

Developmental Spondylolisthesis – Cause, Diagnosis and Treament

Spondylolisthesis is present in 5% of the population and there is no gender difference in occurrence.

Most spondylolistheses in children and adolescents are developmental.

This type of spondylolisthesis  generally is not noticed until later in childhood or even in adult life.

Etiology and Natural History

Developmntal stenosis needs to be differentiated from acquired traumatic spondylolisthesis caused by stress fracture. Trauamtic sopndylolisthesis following a stress fracture occurs in individuals with no posterior element dysplasia and with normal spino pelvic morphology.

Following conditions are thought to represent a continuum of disease [Read more...]

Artificial Collagen/Hydrogel Discs Successfully Tested In Mouse

Artificial collagen/hydrogel disc resembles the natural discs more closely as compared to artificial discs available now. Modern artificial spinal discs are commonly made of rigid materials such as metal and plastic, but  natural discs are more like a stiff gel, and softer and bouncy.

Cornell researchers have successfully tested artificial discs in a mouse model that are made of collagen and a hydrogel called alginate. The discs were populated with mice’s own cells and the implants actually improved over time as new cells grew within the implant’s matrix. After six months of living with the new discs, the mice retained 80-90% of their implants’ initial height. [Read more...]

GDF5 SNP rs143383 Associated With Lumbar Disc Disease In Northern European Women

A new study published in Arthrits and Rheumatism reports that gene GDF5 SNP rs143383 has been found to be associated with  lumbar disc disease in northern European women.

GDF5 is a gene whose variants have been shown to play a role in skeletal height as well as predisposing to peripheral joint osteoarthritis.

The study authors investigated  whether the 5′ upstream SNP variant rs143383 was associated with lumbar disc disease in five [Read more...]

Opioids Help Stabilize Depression, Anxiety in Patients With Chronic Low Back Pain

According to a research presented in the American Academy of Pain Management, 21st Annual Clinical Meeting, opoids help stabilize depression, anxiety in patients with chronic low back pain.

The study was done with 1302 patients with chronic low back pain and 407 with osteoarthritis completed the Depression, Anxiety, and Positive Outlook Scale (DAPOS) questionnaire to gauge depression, anxiety, and positive outlook at baseline and 6 months and 12 months after opioid therapy.

The results showed stabilized or slightly improved levels of the mental health factors during the observation.

Patients experiencing chronic pain often have depression, anxiety, or both related to their physical discomfort.

Diffuse Idiopathic Skeletal Hyperostosis

Diffuse idiopathic skeletal hyperostosis, also called Forestier’s disease is characterized by unique, flowing (wave like in shape) calcification along the sides of the vertebrae of the spine. It is also commonly associated with inflammation and calcification of tendons at their attachments points to bone, a condition called enthesitis. Enthesitis can frequently lead to bone spurs such as heel spurs.

Usually the disease occurs after fifth decade of life. [Read more...]

Failed Back Surgery Syndrome

Failed back surgery syndrome [FBSS, or failed back syndrome] is a vague term used to describe the condition of patients who did not get a successful result with back surgery and have experience continued pain.

A spine surgery in lumber region  is mainly done for two causes

  • To decompress a nerve root
  • To stabilize a painful joint.

Failed back surgery syndrome is a group of disorders with persistent or recurrent symptoms following spinal surgery with hallmarks of back pain, sciatica and functional impairment. The severity of failed back surgery is often sufficiently great to cause a change in the job. [Read more...]

Posterior Ramus Syndrome – Thoracolumbar Junction Syndrome

This also called Maigne Syndrome or Dorsal Ramus Syndrome. It is caused by the unexplained activation of the primary division of a posterior ramus of a spinal nerve.

In absence of any radiological signs, the  diagnosis is made clinically.

The thoracolumbar junction (TLJ) is comprised of the T10-11, T11-12 and T12-L1 motion segments. This transitional area, interposed between the thoracic and lumbar spine, is often the source of a characteristic pain syndrome characterized by a referral of the pain in the related dermatomes (T10 to L1). [Read more...]

List of Causes Of Back Pain

There are more than 400 conditions that can cause back pain. Instead of  providing comprehensive list, I have divided the conditions into different groups creating an overview.

Contrary to general belief, the bcak pain does not always originate from spine and vertebrae. Backpain may originate in visceral problems too.

Here are the major condtions that can cause backpain.

Mechanical Causes

Inflammatory Causes

Infection

Epidural abscess or vertebral osteomyelitis

Neoplastic Causes

  • Bone tumors (primary or metastatic)
  • Intradural spinal tumors

Metabolic Causes:

Referred pain:

  • Pelvic/abdominal disease