The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Biomechanics of Back Pain
Abstract
This paper offers a mechanistic account of back pain which attempts to incorporate all of the most important recent advances in spinal research. Anatomical and pain-provocation studies show that severe and chronic back pain most often originates in the lumbar intervertebral discs, the apophyseal joints, and the sacroiliac joints. Psychosocial factors influence many aspects of back pain behaviour but they are not important determinants of who will experience back pain in the first place. Back pain is closely (but not invariably) associated with structural pathology such as intervertebral disc prolapse and endplate fractures, although age-related biochemical changes such as those revealed by a ‘dark disc’ on MRI have little clinical relevance. All features of structural pathology (including disc prolapse) can be re-created in cadaveric specimens by severe or repetitive mechanical loading, with a combination of bending and compression being particularly harmful to the spine. Structural disruption alters the mechanical environment of disc cells in a manner that leads to cell-mediated degenerative changes, and animal experiments confirm that surgical disruption of a disc is followed by widespread disc degeneration. Some people are more vulnerable to spinal degeneration than others, largely because of their genetic inheritance. Age-related biochemical changes and loading history can also affect tissue vulnerability. Finally the concept of ‘functional pathology’ is introduced, according to which, back pain can arise because postural habits generate painful stress concentrations within innervated tissues, even though the stresses are not high enough to cause physical disruption.
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Cites
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Nerve ingrowth into diseased intervertebral disc in chronic back pain
Freemont, A., Peacock, T., Goupille, P., Hoyland, J., O'Brien, J., & Jayson, M. (1997) · The Lancet · doi:10.1016/s0140-6736(97)02135-1 · Cited by 989
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‘STRESS’ DISTRIBUTIONS INSIDE INTERVERTEBRAL DISCS: THE EFFECTS OF AGE AND DEGENERATION
Adams, M. A., McNally, D. S., & Dolan, P. (1996) · The Journal of Bone and Joint Surgery. British volume · doi:10.1302/0301-620x.78b6.0780965 · Cited by 702
Self-citationThe Tissue Origin of Low Back Pain and Sciatica:
Kuslich, S. D., Ulstrom, C. L., & Michael, C. J. (1991) · Orthopedic Clinics of North America · doi:10.1016/s0030-5898(20)31644-8 · Cited by 562
Sambrook, P. N., MacGregor, A. J., & Spector, T. D. (1999) · Arthritis & Rheumatism · doi:10.1002/1529-0131(199902)42:2<366::aid-anr20>3.0.co;2-6 · Cited by 524
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Prolapsed Intervertebral Disc: A Hyperflexion Injury
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Self-citation
Cited by
European guidelines for the diagnosis and treatment of pelvic girdle pain
Vleeming, A., Albert, H. B., Östgaard, H. C., Sturesson, B., & Stuge, B. (2008) · European Spine Journal · doi:10.1007/s00586-008-0602-4 · Cited by 887
Laird, R. A., Gilbert, J., Kent, P., & Keating, J. L. (2014) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-15-229 · Cited by 443
Laslett, M., Young, S. B., Aprill, C. N., & McDonald, B. (2003) · Australian Journal of Physiotherapy · doi:10.1016/s0004-9514(14)60125-2 · Cited by 294
Geere, J.-A. L., Hunter, P. R., & Jagals, P. (2010) · Environmental Health · doi:10.1186/1476-069x-9-52 · Cited by 182
Swain, C. T. V., Pan, F., Owen, P. J., Schmidt, H., & Belavy, D. L. (2020) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2019.08.006 · Cited by 136
Metadata
- Authors
- Adams, M. A.
- Venue
- Acupuncture in Medicine
- Publisher
- SAGE Publications
- Published
- 2004-12
- Volume
- 22
- Issue
- 4
- Pages
- 178-188
- ISSN
- 0964-5284 (ISSN-L)
- 1759-9873
- OpenAlex
- W2024277950
- Cited by
- 578
- References
- 29
- FWCI
- 12.26
- Type
- journal article
- Language
- en
- Open access
- closed
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
