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Mechanical Low Back Pain

Three Mechanical Low Back Pain Syndromes

Postural Syndrome

The postural syndrome is a mechanical deformation of postural origin causing pain of a strictly intermittent nature, which appears when the soft tissues surrounding the lumbar segments are placed on prolonged stretch. A frequently-seen poor sitting posture includes a forward head, rounded shoulders, and a flexed low back.

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The posture may need to be sustained repeatedly for many hours before it becomes painful.

Dysfunction Syndrome

Developed as a result of poor postural habit, spondylosis, trauma or derangement, the dysfunction syndrome is the condition in which adaptive shortening and resultant loss of mobility causes pain before achievement of full normal end range movement. Essentially, the condition arises because movement is performed inadequately at a time when shortening of soft tissues is taking place. The dysfunction is named by the motion which is lost or restricted. For example, a flexion dysfunction would limit the ability of an individual to bend forward in that area of the spine.

Pain appears during test movements at end range and abolishes as soon as the patient's soft tissues are off stretch. The changes in the patient's symptoms are not sustained and his condition is neither better nor worse following test movements.

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End range pain and restricted motion available.

Derangement Syndrome

Derangement syndrome is the situation in which the normal resting position of the articular surfaces of two adjacent vertebrae is disturbed as a result of a change in the position of the fluid nucleus between these surfaces. The alteration in the position of the nucleus may also disturb annular material. This change within the joint will affect the ability of the joint surfaces to move in their normal relative pathways and departures from these pathways are frequently seen.

This condition becomes painful when the disk wall or nucleus deformation intrudes on adjacent pain sensitive soft tissues. This pattern of pain increases and peripheralizes as the tissues become more deformed or as nerve root irritation becomes a factor.

Symptoms tend to centralize and eventually diminish as the displaced disk material is relocated and the deformity of surrounding tissues is reduced. The effects of test movements on symptoms usually occur during the movement rather than at end range and tend to be sustained.

The nerve root is pictured above in light yellow.
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