GET ACTIVE COLUMN: Advice on spinal pain

One of the most important issues surrounding sports people and the general population alike is the ubiquitous issue of spinal pain.

As a practitioner I specialise generally in all chronic and acute soft tissue and joint pains, however I do spend a good proportion of my time dealing with spinal pain.

Spinal pain is in itself a vast topic but over the next few months I will attempt to cover the most frequent presentations that I see on a day to day basis.

One the most common of these issues is facet joint pain.

Ignoring soft tissue structures, briefly the spine is comprised of three basic repeating elements that include the actual building blocks of the spine, the vertebral bodies, and small joints that join these together, known as facet joints, and shock absorbers that provide a cushion between each vertebral body (intervertebral discs).

As a collective unit the spine not only provides protection to the spinal cord but it also permits rhythmic movements that are necessary walking, running, swimming.

Facet joints are integral to this inherent movement and flexibility, particularly in the neck (cervical spine) for rotational movements and in the lower back (lumbar spine) mainly for forward and backward bending; the facet joints in the mid-back anatomy, or thoracic spine, meanwhile have comparable much less movement overall.

The movement that the facet joints can provide in each of the three regions of the spine is dictated by their shape and orientation.

In accordance with the above much of the facet joint pain I see will be in the cervical or lumbar regions.

In general these presentations will have point tenderness overlying the affected inflamed joint combined with local acute muscle guarding.

In the cervical spine pain may radiate locally into the shoulders and upper back, if the pain pattern radiates into the upper arm and forearm and hand, and is constant and unremitting in nature, this may indicate an intervertebral disc issue which will be discussed in another piece.

In the case of the lower back pain can radiate into the buttock and down the back of the leg (but is usually described as an intermittent sharp shooting pain specifically on certain movements).

A persistent dull throbbing toothache, as above, may be more indicative of a disc issue.

In general these issues are resolved well through osteopathic or chiropractic manipulation and treatment with the aid of rehabilitation exercises, advice on maintaining good posture and modifying daily routine.