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The anatomical basis for spinal pain syndromes
1Faculty of Medicine and Health Sciences, University of Newcastle, Australia.
Journal of Manipulative and Physiological Therapeutics
|November 1, 1995
Summary
Spinal muscles are unlikely to cause chronic pain, unlike discs and zygapophyseal joints. Controlled studies confirm discogenic pain and zygapophyseal joint pain are common causes of chronic spinal pain.
Area of Science:
- Orthopedics
- Pain Medicine
- Spinal Anatomy
Background:
- Spinal pain has multiple potential anatomical sources, including discs, zygapophyseal joints, and muscles.
- The role of spinal muscles as a source of chronic pain lacks scientific validation.
- Existing research highlights the prevalence of discogenic and zygapophyseal joint pain.
Purpose of the Study:
- To evaluate the scientific evidence supporting different anatomical structures as sources of chronic spinal pain.
- To differentiate the etiological contributions of spinal discs, zygapophyseal joints, and muscles to chronic pain conditions.
Main Methods:
- Review of controlled studies and scientific data on spinal pain origins.
- Analysis of etiological factors contributing to chronic neck and low back pain.
Main Results:
- No scientific data support spinal muscles as a source of chronic pain.
- Cervical zygapophyseal joint pain is a significant cause (>50%) of chronic neck pain post-whiplash.
- Lumbar zygapophyseal joint pain, internal disc disruption, and sacroiliac joint pain collectively account for ~70% of chronic low back pain.
Conclusions:
- Zygapophyseal joints and intervertebral discs are established sources of chronic spinal pain.
- Spinal muscles are not scientifically supported as a primary source of chronic pain.
- Understanding these pain generators is crucial for effective diagnosis and treatment of spinal pain.