Degenerative Intervertebral Discs Are Innervated and Cause Pain When Injured
Many clients and patients present with pain after a traumatic event, whether in their vehicle or on-the-job. This is because there are pain generating structures in the spinal column and surrounding musculature. One of the most commonly injured structures after a traumatic event is the intervertebral disc.
In a recent study by Edgar (2007), “The anatomical studies, basic to our understanding of lumbar spine innervation through the sinu-vertebral nerves, are reviewed” (p. 1135). This paper addresses the innervation patterns of both the healthy and degenerative intervertebral discs.
Image Compliments of Medical Legal Art via The Doe Report (www.doereport.com). Copyright © 2010 Medical Legal Art, All rights reserved. The author goes on to say, “Sensory nerve endings in the degenerative lumbar disc penetrate deep into the disrupted nucleus pulposus, insensitive in the normal lumbar spine. Complex as well as free nerve endings would appear to contribute to pain transmission” (Edgar, 2007, p. 1135). This has profound implications on the understanding of how clients with degenerative discs can be injured with less trauma than those with healthy intervertebral discs.
The author also proposes an additional theory of disc pain that is gaining more and more evidence as the procedures associated with studying this phenomenon improve. He states “…there is growing evidence to support a ‘visceral pain’ hypothesis, unique in the musculoskeletal system. This mechanism is open to ‘peripheral sensitization’ and possibly ‘central sensitization’ as a potential cause of chronic back pain” (Edgar, 2007, p.1135). What this means is when a client gets injured as a result of a traumatic event, not only can the disc produce pain at the level of injury, but it can also effect the extremities or entire regions of the body. The nerve supply that accounts for this is outlined in the paper. If you have clients that have pain due to a traumatic event, it is important that you work with doctors that understand the most current and scientific explanations of disc anatomy and pain patterns.
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Reference:
Edgar, M. A. (2007). The nerve supply of the lumbar intervertebral disc. The Journal of Bone and Joint Surgery, British Volume, 89(9), 1135-1139.
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