Anatomic substrate to pain originating in the disc and chronic low back pain posture damage resolution

Abstract

Chronic low back pain is a disease that most often affects people between 45 and 64 years. The incidence of low back pain goes from 60 to 90% and the annual incidence is 5%. Often low back pain is accompanied or replaced by an irradiated lower limb pain, configuring the symptomatology of lumboradiculalgia, whose most frequent cause is the disco-radicular conflict. The cause of the onset of pain, even excruciating, in cases of radicular compression of disc origin is not yet clear. Low back pain of disc origin is thought to be caused by direct mechanical compression factors; by indirect mechanical factors ischemia or venous stasis of vasa nervorum; and by type of immune-mediated inflammatory factors (reaction hernia) and/or biochemical evidence related to the disc type (the presence of substances which induce the inflammatory reaction). When a patient is suffering by chronic low back pain, apart from the algic problem, a series of changes in posture will occur, which contribute to worsen low back pain itself. The effects of a polluted posture and, therefore, the muscle retraction manifest in the joints in the form of compression, axial rotation and translation, resulting in modifications of the skeletal morphology (scoliotic attitudes, hyperkyphosis, valgus and varus of the knee, <em>etc</em>.) and possibly evolving into important postural disorders. Currently, the treatment of chronic low back pain and postural secondary disorders is still an open problem. The aim of this preliminary study is: i) to highlight the high incidence of low back pain by providing evidence that there is an anatomical substrate to low back pain originating in the disc; ii) and to assess the effects of the use of oxygen-ozone percutaneous paravertebral intramuscular therapy in synergy with a functional rehabilitation program in a group of patients suffering from chronic low back pain. From the data obtained, the combination of percutaneous paravertebral intramuscular oxygen-ozone therapy with functional rehabilitation is confirmed as an effective and safe method, whose favorable results are evident at the level of lumbar pain symptoms, postural secondary abnormalities, disability in activities of daily living, the mood and tone of the psychological state.