Discogenic lower back pain Flashcards
what is DLBP?
pain from the stimulation of pain-sensitive afferents within the annulus fibrosis of intervertebral disc
what would a patient present with? 5
- low back pain without radicular lower limb symptoms
- sitting intolerances
- pain on spinous process palpation
- pain bending forward
- pain coughing/sneezing
MOI 3
- due to trauma or deterioration due to ageing
- bent over flexed and twisted lifting something heavy
- nucleus pulposus migration resulting in a directional preference
population 5
weightlifters
gymnasts
golf
cycling
ageing population
Imaging to confirm diagnosis 2.
MRI or discography (dye inserted into disc to make visible under fluoroscopy
non invasive approach 7
Medication
- anti-inflammatory drugs, anti-depressants, opioids
Physiotherapy
- ultrasound, TENS, massage, strengthening lower back and abdomen
exercises 5
- Pelvic tilt
- Knee to chest
- Lower trunk rotations
- Extensions Mckenzie
- birddogs
advice
back friendly bodyweight
advice
back friendly bodyweight
reference info
The causes of discogenic pain and late IVD degenerative changes are also multifactorial and can vary from mechanical overloading, oxidative stress, metabolic disorders, and genetics.
reference person
Vergroesen et al 2015
Internal Disc Disruption (IDD) 4.
- disc tears or cracks (fissure)
- allowing the nucleus pulposus to meet the annulus fibrosus.
- a chemical called a protecogylcan may be released from the nucleus pulposus.
- Protecoglycans may irritate the annular nerves causing an inflammatory response and pain