The origin of chronic non-specific low back pain is difficult to determine, at least some seem to think so. So much so, the current trending understandings have almost given up on the mechanistic injury model and believe the source to be coming from the brain with the fear avoidance model leading the charge.
However, what we do know regarding the spine’s bending movements is that when the individual vertebrae do not motion share in a smooth way, this can indicate instability. These abnormal movements (when one vertebra moves out of its sharing path) are used by spinal surgeons to identify spinal levels of pain so they can be more precise on the surgical level. The imaging techniques that have historically been an asset to ‘pull-out’ these abnormal motion areas have included end-range load-bearing x-ray. Even though this modality has been useful, researchers are now turning to dynamic real-time fluoroscopy to help assess the quality of motion.
In a recent paper published by Breen
- Alan Breen; Alexander Breen. Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy. Eur Spine J 24 May 2017 DOI 10.1007/s00586-017-5155-y ↩
- Mellor FE, Thomas P, Thompson P, Breen AC (2014) Proportional lumbar spine inter-vertebral motion patterns: a comparison of patients with chronic non-specific low back pain and healthy controls. Eur Spine J 23:2059–2067. doi:10.1007/s00586-014-3273-3 ↩
- Jerome C.J. Fryer, Jeffrey A. Quon, DC, Francis W. Smith, MD. Magnetic resonance imaging and stadiometric assessment of the lumbar discs after sitting and chair-care decompression exercise: a pilot study. The Spine Journal 10 (2010) 297–305 ↩