Acute Spasmotic Low Back Pain – Part 2

​Low back in spasm? What is causing it and how to help.

Chances are that when you present with these symptoms, you will have one of two problems occurring deep within your spine. You may have an annular tear or you may have a meniscal entrapment. In part 1 of this blog I discussed the first scenario (an annular tear). In this post, I will delve deeper into the second scenario – a meniscal entrapment.

​Meniscoid Entrapment (Meniscal Entrapment)
The bones of the spine are connected together by joints. At the front of the spine is an intervertebral disc which is a type of joint. At the back of the lumbar spine is a pair of facet joints (also known as zygapophysial joints). Each facet joint consists of two bones; one bone is part of the vertebra above and forms the top, back part of the joint and the other bone is the part of the vertebra below and forms the bottom, front part of the joint. In between these bones lies a meniscoid (may be referred to as a meniscus, menisci, intra-articular inclusion, intra-articular disc or a synovial fold). It is connected to the lining of the joint (capsule).

It is thought that this meniscoid provides some degree of a cushioning effect, but it also protects the joint surfaces when we bend forward. As the bones slide past each other (when you bend forward and /or twist) the meniscus slides over the ends of the bones and protects them. A meniscoid also has a very rich blood supply and a nerve supply. The nerve supply ensures proprioceptive input to the brain (lets the brain know where the spine is and how it is moving) but also nociceptive (pain) messages to the brain when the meniscoid is injured or pinched.

If you have experienced acute spasmotic low back pain after you have been stuck in an awkward position for a period of time (e.g. twisting around to have an extended conversation with somebody in the back seat of your car), you may have experienced a meniscoid entrapment – but how does this happen?

As mentioned earlier, the meniscoid slides over the joint surfaces when you move. When returning to your normal position the meniscoid should also glide back to its normal position. When you are twisted quite a long way for a period of time, the meniscoid may become caught or entrapped – away from this normal resting state. Because the meniscoid has a rich blood supply, it’s not long at all before an inflammatory reaction begins to occur and the nerve fibres start to tell the brain that something is wrong. We perceive pain and our body may move into spasm.

The good news is that if treated appropriately, a meniscoid entrapment should resolve fairly quickly. Pain can be decreased by reducing inflammation, but a more appropriate alternative is to move the joint enough to allow the meniscoid to sit back in its proper position, hence allowing the inflammation to dissipate in its own natural way. Chiropractic adjustments may be one way of achieving this.

In any case of acute spasmotic low back pain, it is important to receive a diagnosis and to know how your problem may be treated. At Catalyst Health and Wellness Group, we conduct a thorough initial consultation that enables you to receive a diagnosis and treatment plan. We inform you about your situation and involve you in devising a treatment plan that is suitable. We discuss your lifestyle and we provide referrals to appropriate health practitioners when this is necessary.

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by Catalyst Health and Wellness Group