Question:
Why I have regular episodes of mechanical low back pain or lumbago?
The pathophysiology
of mechanical LBP or mechanical low back pain (lumbago) remains complex
and multifaceted.
Leroy
Answer:
Dear
Leroy,
The pathophysiology
of mechanical LBP or mechanical low back pain (lumbago) remains complex
and multifaceted.
Multiple
anatomic structures and elements of the lumbar spine (e.g., bones,
ligaments, tendons, disks, and muscle) are all suspected to have a
role.
Many
of these components of the lumbar spine have sensory innervations
that can generate nociceptive signals representing responses to tissue-damaging
stimuli. Other causes could be neuropathic (e.g., sciatica).
Most
chronic LBP or mechanical low back pain cases most likely involve
mixed nociceptive and neuropathic etiologies.
The lumbar
spine position most at risk for producing LBP is forward flexion (bent
forward), rotation (trunk twisted), and attempting to lift a heavy
object with out-stretched hands.
Research
since the late 20th century suggests that chemical causes may play
a role in the production of mechanical LBP (mechanical low back pain
or lumbago).
Components
of the nucleus pulposus, most notably the enzyme phospholipase A2
(PLA2), have been identified in surgically removed herniated disk
material.
This
PLA2 may act directly on neural tissue, or it may orchestrate a complex
inflammatory response that manifests as LBP or mechanical low back
pain.
