Skip to main content
SpringerLink
Log in

Spinal Pain

  • Chapter
Pain Management and Palliative Care

  • 3139 Accesses

Abstract

The spine is the central switchboard that facilitates the complex interaction between the central and peripheral nervous system. It is arguably the most comprehensive and vital organ in respect to functional activities of daily living and quality of life, and even seemingly minor dysfunction within it can lead to devastating consequences. The perception of pain is generally the human body’s method of signaling attention towards an area of injury in need of repair. However, this signaling pathway itself often becomes a source of further dysfunction due to maladaptive physiological and psychological factors tied to the experience of pain. The importance of correctly identifying and treating the source of spinal pain cannot be emphasized enough.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

ALL:

Anterior longitudinal ligament

COG:

Center of gravity

CT:

Computed tomography

DDD:

Degenerative disc disease

DRG:

Dorsal root ganglia

HIZ:

High intensity zone

HNP:

Herniated nucleus pulposus

IDD:

Internal disc disruption

IDET:

Intradiscal electrothermal therapy

LE:

Lower extremity

MBB:

Medial branch blocks

MRI:

Magnetic resonance imaging

PLL:

Posterior longitudinal ligament

PSIS:

Posterior superior iliac spine

RFA:

Radiofrequency ablation

SI:

Sacroiliac

SLR:

Straight leg raise

UE:

Upper extremity

Z-joint:

Zygapophyseal joint

References

  1. Osti OL, Vernon-Roberts B, Moore R, Fraser RD. Annular tears and disc degeneration in the lumbar spine. A post-mortem study of 135 discs. J Bone Joint Surg Br. 1992; 74(5):678–82.

    Google Scholar 

  2. Freemont AJ, Peacock TE, Goupille P, Hoyland JA, O’Brien J, Jayson MI. Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet. 1997;350(9072):178–81.

    Article  CAS  PubMed  Google Scholar 

  3. Schmidt H, Kettler A, Heuer F, Simon U, Claes L, Wilke HJ. Intradiscal pressure, shear strain, and fiber strain in the intervertebral disc under combined loading. Spine. 2007;32(7):748–55.

    Article  PubMed  Google Scholar 

  4. DePalma MJ, Ketchum JM, Queler ED, et al. What is the etiology of LBP and does age affect prevalence. Best paper presentation. International Spinal Intervention Society Annual Meeting, Toronto. 2009.

    Google Scholar 

  5. Cooper G, Bailey B, Bogduk N. Cervical zygapophysial joint pain maps. Pain Med. 2007;8(4):344–53.

    Article  PubMed  Google Scholar 

  6. Lee MJ, Riew KD. The prevalence cervical facet arthrosis: an osseous study in a cadaveric population. Spine J. 2009;9(9):711–4.

    Article  PubMed  Google Scholar 

  7. Beaman DN, Graziano GP, Glover RA, Wojtys EM, Chang V. Substance P innervation of lumbar spine facet joints. Spine. 1993;18(8):1044–9.

    Article  CAS  PubMed  Google Scholar 

  8. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;15(6):453–7.

    Google Scholar 

  9. DePalma MJ, Ketchum JM, Kouchouk A, et al. What is the etiology of low back pain in patients having undergone lumbar fusion? An interim analysis of a cross-sectional analytic study. PMR J. 2009;1:S183.

    Google Scholar 

  10. Howe JF, Loeser JD, Calvin WH. Mechanosensitivity of dorsal root ganglia and chronically injured axons: a physiological bases for the radicular pain of nerve root compression. Pain. 1977;3:25–41.

    Article  CAS  PubMed  Google Scholar 

  11. Murphy RW. Nerve roots and spinal nerves in degenerative disk disease. Clin Orthop Relat Res. 1977;129:46–60.

    Article  PubMed  Google Scholar 

  12. Prushansky T, Gepstein R, Gordon C, Dvir Z. Cervical muscles weakness in chronic whiplash patients. Clin Biomech (Bristol, Avon). 2005;20(8):794–8.

    Article  Google Scholar 

  13. Elliott J, Jull G, Noteboom JT, Darnell R, Galloway G, Gibbon WW. Fatty infiltration in the cervical extensor muscles in persistent whiplash-associated disorders: a magnetic resonance imaging analysis. Spine. 2006;31(22):E847–55.

    Article  PubMed  Google Scholar 

  14. Falla D, Bilenkij G, Jull G. Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine. 2004;29(13):1436–40.

    Article  PubMed  Google Scholar 

  15. Cusick JF, Yoganandan N, Pintar F, Gardon M. Cervical spine injuries from high-velocity forces: a pathoanatomic and radiologic study. J Spinal Disord. 1996;9(1):1–7.

    Article  CAS  PubMed  Google Scholar 

  16. Nakama S, Nitanai K, Oohashi Y, Endo T, Hoshino Y. Cervical muscle strength after laminoplasty. J Orthop Sci. 2003;8(1):36–40.

    Article  PubMed  Google Scholar 

  17. Vasavada AN, Brault JR, Siegmund GP. Musculotendon and fascicle strains in anterior and posterior neck muscles during whiplash injury. Spine. 2007;32(7):756–65.

    Article  PubMed  Google Scholar 

  18. Fernández-de-las-Peñas C, Albert-Sanchís J, Buil M, Benitez JC, Alburquerque-Sendin F. Cross-sectional area of cervical multifidus muscle in females with chronic bilateral neck pain compared to controls. J Orthop Sports Phys Ther. 2008;38:175–80.

    Article  PubMed  Google Scholar 

  19. Tominaga Y, Ndu AB, Coe MP, et al. Neck ligament strength is decreased following whiplash trauma. BMC Musculoskelet Disord. 2006;7:103.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Solonen KA. The sacroiliac joint in the light of anatomical, roentgenological and clinical studies. Acta Orthop Scand Suppl. 1957;27:1–127.

    CAS  PubMed  Google Scholar 

  21. Szadek KM, Hoogland PV, Zuurmond WW, de Lange JJ, Perez RS. Nociceptive nerve fibers in the sacroiliac joint in humans. Reg Anesth Pain Med. 2008;33(1):36–43.

    Article  PubMed  Google Scholar 

  22. Sashin D. A critical analysis of the anatomy and the pathologic changes of the sacro-iliac joints. J Bone Joint Surg. 1930;12A:891–910.

    Google Scholar 

  23. Usta B, Gozdemir M, Sert H, Muslu B, Demircioglu RI. Fluoroscopically guided ganglion impar block by pulsed radiofrequency for relieving coccydynia. J Pain Symptom Manage. 2010;39:e1–2.

    Article  PubMed  Google Scholar 

  24. Silverman SL. The clinical consequences of vertebral compression fracture. Bone. 1992;13 Suppl 2:S27–31.

    Article  PubMed  Google Scholar 

  25. Gilsanz V, Boechat MI, Gilsanz R, Loro ML, Roe TF, Goodman WG. Gender differences in vertebral sizes in adults: biomechanical implications. Radiology. 1994;190(3):678–82.

    Article  CAS  PubMed  Google Scholar 

  26. Cooper C, Atkinson EJ, O’Fallon WM, Melton III LJ. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res. 1992;7(2):221–7.

    Article  CAS  PubMed  Google Scholar 

  27. Patel U, Skingle S, Campbell GA, Crisp AJ, Boyle IT. Clinical profile of acute vertebral compression fractures in osteoporosis. Br J Rheumatol. 1991;30(6):418–21.

    Article  CAS  PubMed  Google Scholar 

  28. Ross PD, Davis JW, Epstein RS, Wasnich RD. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med. 1991;114(11):919–23.

    Article  CAS  PubMed  Google Scholar 

  29. Kayanja MM, Togawa D, Lieberman IH. Biomechanical changes after the augmentation of experimental osteoporotic vertebral compression fractures in the cadaveric thoracic spine. Spine J. 2005;5(1):55–63.

    Article  PubMed  Google Scholar 

  30. Trout AT, Kallmes DF, Layton KF, Thielen KR, Hentz JG. Vertebral endplate fractures: an indicator of the abnormal forces generated in the spine after vertebroplasty. J Bone Miner Res. 2006;21(11):1797–802.

    Article  PubMed  Google Scholar 

  31. Dean JR, Ison KT, Gishen P. The strengthening effect of percutaneous vertebroplasty. Clin Radiol. 2000;55(6):471–6.

    Article  CAS  PubMed  Google Scholar 

  32. Andrews DW, Lavyne MH. Retrospective analysis of microsurgical and standard lumbar discectomy. Spine (Phila Pa 1976). 1990;15:329–35.

    Article  CAS  Google Scholar 

  33. Caspar W, Campbell B, Barbier DD, Kretschmmer R, Gottfried Y. The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure. Neurosurgery. 1991;28:78–87.

    Article  CAS  PubMed  Google Scholar 

  34. Frymoyer JW, Hanley E, Howe J, Kuhlmann D, Matteri R. Disc excision and spine fusion in the management of lumbar disc disease. A minimum ten year follow-up. Spine (Phila Pa 1976). 1978;3:1–6.

    Article  CAS  Google Scholar 

  35. Rodríguez-García J, Sánchez-Gastaldo A, Ibáñez-Campos T, Vázquez-Sousa C, Cantador-Hornero M, Expósito-Tirado JA, Cayuela-Domínguez A, EchevarríaRuiz de Vargas C. Related factors with the failed surgery of herniated lumbar disc. Neurocirugia (Astur). 2005;16:507–17.

    Article  Google Scholar 

  36. Ross JS, Robertson JT, Frederickson RC, Petrie JL, Obuchowski N, Modic MT, de Tribolet N. Association between peridural scar and recurrent radicular pain after lumbar discectomy: magnetic resonance evaluation. ADCON-L European Study Group. Neurosurgery. 1996;38:855–61.

    Article  CAS  PubMed  Google Scholar 

  37. Fritsch EW, Heisel J, Rupp S. The failed back surgery syndrome: reasons, intraoperative findings, and long-term results—a report of 182 operative treatments. Spine (Phila Pa 1976). 1996;21:626–33.

    Article  CAS  Google Scholar 

  38. Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. Preliminary results of randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: part 3. Post surgery syndrome. Pain Physician. 2008;11:817–31.

    PubMed  Google Scholar 

  39. Bokov A, Isrelov A, Skorodumov A, Aleynik A, Simonov A, Mlyavykh S. An analysis of reasons for failed back surgery syndrome and partial results after different types of surgical lumbar nerve root decompression. Pain Physician. 2011;14(6):545–57. PubMed PMID: 22086096.

    PubMed  Google Scholar 

  40. Tyrrel PNM, Cassar-Pollucino VN, McCall IW. Spinal infection. Eur Radiol. 1999;9:1066–77.

    Article  Google Scholar 

  41. Stabler A, Reiser MF. Imaging of spinal infection. Radiol Clin North Am. 2001;39:115–35.

    Article  CAS  PubMed  Google Scholar 

  42. Danner RL, Hartmann BJ. Update of spinal epidural abscess: 35 cases and review of the literature. Rev Infect Dis. 1987;9:265–74.

    Article  CAS  PubMed  Google Scholar 

  43. Sapico FL, Montgomerie JZ. Vertebral osteomyelitis. Infect Dis Clin North Am. 1990;4(3):539–50.

    CAS  PubMed  Google Scholar 

  44. Jaramillo-de la Torre JJ, Bohinski RJ, Kuntz C. Vertebral osteomyelitis. Neurosurg Clin N Am. 2006;17:339–51.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physiatry, Hospital for Special Surgery, Assistant Professor of Clinical Rehabilitation Medicine, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA

    Jonathan S. Kirschner M.D.

  2. Interventional Spine and Sports Medicine, Spine Center and Orthopedic Rehabilitation of Englewood, Englewood, NJ, USA

    Kiran Vadada M.D.

Authors
  1. Jonathan S. Kirschner M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiran Vadada M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan S. Kirschner M.D. .

Editor information

Editors and Affiliations

  1. Department of Rehabilitation Medicine, Interventional Pain Management, New York University , Langone Medical Center, New York, New York, USA

    Kimberly A. Sackheim

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kirschner, J.S., Vadada, K. (2015). Spinal Pain. In: Sackheim, K. (eds) Pain Management and Palliative Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2462-2_21

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2462-2_21

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2461-5

  • Online ISBN: 978-1-4939-2462-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation