Back Pain Factoids

Did you know?

A “Normal” spine is somewhat of a misnomer. There are so many variations on the “norm”, including 4, 5 or 6 lumbar or sacral vertebrae (average is five of each), vertebrae that are in two pieces, front and back (spondylolisthesis), and many others.

Discs lose fluid throughout the day. It is not unusual to lose ½ inch in height between arising in the morning and retiring in the evening.

Injuries to the cervical (neck) and lumbar (low back) areas of the spine are more common than injuries to the thoracic (mid-back) spine because the upper and lower areas are far more mobile. Ribs attaching to the thoracic spine make it more rigid, and less prone to injury.

Nerves exit between each vertebra and the one above and one below. Nerves in the neck group together and run down the arms. Those in the lower back run down the legs. The most “famous” one is the sciatic nerve, which runs down the back of the leg.

Newsletter - June 2007

Sensitization in Back Health

Many of us suffer from aches and pains in various regions of our bodies. Usually, those aches are temporary, and when resolved, our bodies return to the relatively pain-free, smooth function that we desire. However, at times some continue to suffer pain and other symptoms long after the injury has had time to resolve or the stressor is removed. This can lead to or be caused by a condition that medical doctors are now recognizing as sensitization.

Sensitization is defined variously as: the development, over time, of an allergic reaction to a chemical; exposure to an allergen that results in the development of hypersensitivity; the unspecified augmentation of a behavioral response to a stimulus after repeated exposure. For the purpose of this paper and the issue of sensitization being implicated in disease, we will describe it as a physiological response in the body in which the resting level of action (in muscles, nerves, or other soft tissue) is raised, resulting in a much lower stimulus being required for a reaction to be noted. For example, there is a certain level of sensitivity in the skin that allows for light touch to be ignored, but heavy pressure to be registered as causing pain. In sensitization situations, the resting level of sensitivity is so high that very little touch to the skin would cause a pain response. This can cause a debilitating level of pain and discomfort that at times is very difficult to treat.

Some of the factors that lead to sensitization and chronic pain include:

• Attitude and emotional dysfunction
• Chronic infections
• Depression and anxiety
• Fatigue
• Food Sensitivities
• Inflammation
• Hormone issues (thyroid, adrenal, sex and growth hormones)
• Mechanical Dysfunctions (especially in mid and lower back)
• Nutritional deficiencies
• Nutritional excesses
• Scar dysfunction
• Stress and adrenal dysfunction
• Social isolation

Sensitization manifests itself in various ways, with diagnoses such as fibromyalgia, chronic sleep disorder and irritable bowel syndrome. Sensitization can lead to and be caused by chronic inflammation, which in turn is a major factor in coronary artery disease and atherosclerosis. Many chronic pain conditions, in which pain persists for more than three months, have sensitization as a factor. So, what can be done to “turn down” the level of sensitivity of the body’s senses and decrease pain?

Treatment of sensitization involves treating the direct causes, as well as indirect “contributing” factors. If there are mechanical issues such as spinal misalignment or muscle weakness, those need to be addressed up front. Depression can be lifted (at least, in part), with proper medication. Sleep deprivation and fatigue can be improved with medication, but also with changes in sleep habits or sleep hygiene. Aerobic exercise is essential, both for the benefit in restful sleep, as well as in generating brain endorphins, the body’s natural pain-relievers. Hormone and nutritional deficiencies can be addressed with medication, weight lifting, and proper nutritional supplementation. Behavioral modification assists in decreasing social isolation and attitude dysfunction. Many times a multidisciplinary approach is needed, with assistance from a variety of practitioners who all recognize the tangled web of causes and symptoms of sensitization diseases.

At The Backworks Physical Therapy, we recognize the need for physical therapy intervention in chronic pain and other sensitization conditions, as well as the need for other medical, psychological, and nutritional assistance. We would be happy to assist with therapy and weight loss needs. Call us at 480-345-0379 today!