Pain Mechanisms in Spine Disorders

This session explains the complex mechanisms underlying spinal pain, distinguishing between nociceptive pain caused by tissue injury and inflammatory processes, and neuropathic pain resulting from nerve compression or damage. It describes how mechanical stress, inflammation, and chemical mediators contribute to activation of pain receptors in spinal structures such as discs, ligaments, joints, and nerve roots. The session further explains radicular pain patterns, where pain radiates along the distribution of affected spinal nerves, and how this correlates with specific dermatomes. It also introduces the concept of central sensitization, where the nervous system becomes hypersensitive, leading to chronic pain even after the initial injury has healed. The session discusses clinical implications of chronic pain, including sleep disturbance, reduced mobility, psychological stress, and reduced quality of life. Management approaches include pharmacological therapy, interventional pain procedures such as nerve blocks and epidural injections, physiotherapy, and multidisciplinary pain rehabilitation programs.

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