What is Pain? Different Medical Conditions
Medical Conditions
Back and Neck pain is extremely complex. And dome of the medical term that are used by health professionals. It can often be confusing.
Amongst some of the more common conditions are:
Osteoarthritis of the Spine or Spondylosis
Osteoarthritis or "spondylosis" is degenerative joint disease. When the low back area is affected, it is known as osteoarthritis of the spine, or "lumbar spondylosis". When affecting the neck area, it is known as "cervical spondylosis".
Spondylosis is thought to be mainly a problem of "wear and tear"
and ageing. When it occurs in the younger
age groups, it is usually associated with injury or previous damage to the
joint. Certain occupations may also make a person more prone to
osteoarthritis in certain joints. Do bear in mind that while you may have
a degree of spondylosis, it may not necessarily be the cause of pain.
Spondylosis affects the following parts of the spine:
- Intervertebral Discs
As you age, changes affecting tissue occur throughout the body. In the spine, the structure of the discs between your vertebras may be compromised.
The outer cover of the disc or anulus fibrosus is composed of 60 or more concentric bands of collagen fiber termed lamellae. The center of the disc or the nucleus pulposus is a gel-like substance inside the intervertebral disc encased by the anulus fibrosus.
The degenerative effects from aging may weaken the structure of the anulus fibrosus causing wear or tear. The water content of the nucleus decreases with age affecting its shock absorbing quality. The structural alterations from degeneration may decrease disc height and increase the risk for disc herniation. - Facet Joints
Each vertebral body has four facet joints that work like hinges. These are the moving joints of the spine enabling extension (arching back), flexion (bending forward), and rotation.
Like other joints, the bony joint surfaces are coated with cartilage. Cartilage provides a self-lubricating low-friction gliding surface. Facet joint degeneration causes loss of cartilage and formation of osteophytes (e.g. bone spurs). These changes may cause hypertrophy or osteoarthritis, also known as degenerative joint disease.
- Bones and Ligaments
Osteophytes (e.g. bone spurs) may form adjacent to the end plates, which may block or reduce blood supply to the vertebra. The end plates may also stiffen due to sclerosis; a thickening/hardening of the bone under the end plates.
Ligaments are bands of fibrous tissue connecting spinal structures (e.g. vertebrae) and protect against the extremes of motion (e.g. excessive arching of the back). However, degenerative changes may cause ligaments to lose some of their strength. The ligamentum flavum (a primary spinal ligament) may thicken and/or buckle toward the dura mater (a spinal cord membrane). - Cervical Spine
The complexity of the cervical anatomy and its wide range of motion make this spinal segment susceptible to disorders associated with degenerative change. Neck pain from spondylosis is common. The pain may spread (radiate) into the shoulder or down the arm. When a bone spur causes nerve root compression, weakness in the extremities (e.g. arms) may occur.
- Thoracic Spine
Pain associated with degenerative disease is often triggered by forward flexion and hyperextension. In the thoracic spine disc pain may be caused by flexion - facet pain by hyperextension.
- Lumbar Spine
Pain and morning stiffness are common complaints. Usually multiple levels are involved (e.g. more than one vertebrae).
The lumbar spine carries most of the body's weight. Therefore, when degenerative forces compromise its structural integrity, symptoms including pain may accompany activity. Movement stimulates pain fibers in the discs and facet joints. Sitting for prolonged periods of time may cause pain and other symptoms due to pressure on the lumbar vertebrae. Repetitive movements such as lifting and bending (e.g. manual labor) may increase pain.
>>What treatment options are available?
References
Back2Sports, a division of Core Concepts,
is the Official Physiotherapist for
Bookmark this page