13/07/2022
There are lots of different reasons for back pain… here are just some of them!
Potential neuropathic and nociceptive components of chronic low-back pain
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👉 The lower back (L1-L5) is a complex structure comprising vertebrae, intervertebral discs that cushion and support vertebrae, facet joints lined with cartilage and lubricated with synovial fluid that connect vertebrae and allow for movement, large muscles that support the spine and power movement, and ligaments and cartilage which provide structural support. https://pubmed.ncbi.nlm.nih.gov/27408698/
👉 Spinal nerve roots exit the spine through the intervertebral foramen, whereas bone, muscle, and facet joints are innervated with nociceptors that respond to injury, inflammation, or mechanical stress. This complexity makes it difficult to identify the specific underlying cause(s) of CLBP in an individual patient, particularly since patients often phenotypically show aspects of both neuropathic and nociceptive pain states (Fig.). https://pubmed.ncbi.nlm.nih.gov/26935254/
👉 A nociceptive component can arise from persistent nociceptor activation and/or sensitization in response to inflammatory processes in a variety of structures including intervertebral discs, facet joints, bones, ligaments, muscles, and organs within the abdominal cavity. https://pubmed.ncbi.nlm.nih.gov/31145219/
👉 Such persistent nociceptive signaling can lead to central sensitization in the dorsal horn. Sensitization is believed to play a role in some forms of CLBP, although the precise contribution of sensitization to the overall pain state is not clearly delineated. https://pubmed.ncbi.nlm.nih.gov/27062464/
