In this discussion, we hope to advance a clinical approach to low back pain that is more in line with our modern understanding of neuropathic pain. We review the current understanding of normal and pathologic neuroanatomy of the lumbar spine and then outline how pathology in the different structures can lead to neuropathic pain and cause common pain patterns seen in clinical practice. We also detail the available treatments for neuropathic low back pain.
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http://dx.doi.org/10.1007/s11916-005-0058-8 | DOI Listing |
JBJS Rev
January 2025
Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Background: Iliopsoas injuries are a common cause of anterior hip and groin pain and can be successfully managed with conservative treatment. Corticosteroid and local anesthetic injections can also be offered in conjunction with nonoperative management. Given the variability in reported injection guidelines, composition, and techniques, the purpose of this study was to systematically review the literature to assess progression to surgery and patient outcomes following iliopsoas injections.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States of America.
Epidural steroid injections (ESIs) are often used to treat low back pain (LBP) due to lumbosacral radiculopathy as well as LBP without a clear component of radiculopathy, in some cases. While it is increasingly recognized that psychosocial factors are associated with pain outcomes, few studies have assessed the contribution of these factors to common pain interventions like ESIs. This study aimed to summarize the scope and nature of how psychosocial factors are accounted for in research on ESIs for the treatment of LBP with or without lumbosacral radiculopathy and to identify gaps and recommendations for future research.
View Article and Find Full Text PDFAm J Ther
January 2025
Department of Neurosurgery, Sana Klinikum Lichtenberg, Academic Teaching Hospital of Charité-Medical University Berlin, Germany.
Pain Ther
January 2025
Robert Wood Johnson University Hospital/Rutgers Medical School, New Brunswick, NJ, USA.
Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.
View Article and Find Full Text PDFInsights Imaging
January 2025
Department of Radiology, Radio-Oncology and Nuclear Medicine, Université de Montréal, Montreal, QC, Canada.
Objectives: To compare thoracolumbar fascia (TLF) shear strain between individuals with and without nonspecific low back pain (NSLBP), investigate its correlation with symptoms, and assess a standardized massage technique's impact on TLF shear strain.
Methods: Participants were prospectively enrolled between February 2021 and June 2022. Pre- and post-intervention TLF ultrasound and pain/disability questionnaires were conducted.
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