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Related Experiment Videos

Pain and the nerve root. An interdisciplinary approach

M Hasue1

  • 1Department of Orthopaedic Surgery, Japan Red Cross Medical Center.

Spine
|October 15, 1993
PubMed
Summary

Radicular pain arises from nerve root involvement, leading to mechanical and chemical changes. These factors cause nerve damage and sensitization, resulting in pain.

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Area of Science:

  • Neurology
  • Pain Medicine
  • Spinal Cord Research

Background:

  • Radicular pain is a common clinical problem.
  • The exact pathomechanism of radicular pain is not fully understood.

Purpose of the Study:

  • To propose a working hypothesis for the pathomechanism of radicular pain.
  • To integrate experimental and clinical findings into a cohesive model.

Main Methods:

  • Literature review of experimental and clinical studies.
  • Synthesis of author's personal experience.

Main Results:

  • Nerve root involvement causes mechanical and circulatory changes.
  • Degenerative disc and facet material can cause chemical radiculitis.
  • Nerve fiber changes include axonal flow blockage and demyelination, leading to ectopic discharges and cross-talk.
  • Neuropeptide synthesis and transport can be altered.
  • Multifactorial changes lead to central and peripheral nervous system sensitization.

Conclusions:

  • A proposed hypothesis integrates mechanical, chemical, and cellular changes in radicular pain.
  • Nerve root compromise initiates a cascade of events leading to pain sensitization.

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