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Iwahashi et al (2015) conducted the first study to report age and sex related changes in parameters of bony stenosis of the lumbar spine and their relationship to the occurrence of clinical symptoms of lumbar spinal stenosis in a population‐based cohort. The anterior posterior spinal diameter at the L4 level was significantly related to the occurrence of buttock and leg pains, whereas those at the other levels were not. Other factors (disc degeneration,etc.) are assumed to be related to the occurrence of clinical symptoms of LSS. This is interesting given the typical spinal canal is narrowest at L5 (Januja and Mohammed 1989).
References
Iwahashi, H., Yoshimura, N., Hashizume, H., Yamada, H., Oka, H., Shinto, K., Ishimoto, Y., Nagata, K., Teraguchi, M., Kagotani, R. and Muraki, S., 2015, January. relationship Between Bony Spinal Canal Stenosis And The Occurrence Of Clinical Symptoms Of Lumbar Spinal Stenosis—The Wakayama Spine Study: o14. In Spine Journal Meeting Abstracts (Vol. 2015, p. 50). LWW.
Janjua, M.Z. and Muhammad, F., 1989. Measurements of the normal adult lumbar spinal canal. JPMA. The Journal of the Pakistan Medical Association, 39(10), pp.264-268.
Conclusion of Amirdelfan et al (2014) on low back pain diagnosis. My synopsis, exclude specific LBP first, whilst assessing & managing the patient b-p-s.
LBP is an extremely common condition associated, as a symptom, with various disease processes, regardless of their relationship with the lumbar spine or its innervation. This article underscores the broad nature of LBP as a symptom of many diagnoses. The primary conclusion reached by the authors is the most important recommendation by all mentors in medicine, which is to obtain a comprehensive history and perform a complete physical examination on each patient. Despite the fact that there is an emerging school of thought questioning the validity of the physical examination, this tool continues to be the current standard of care and used by a majority of clinicians around the world. The physician must analyze the information obtained from his/her history, physical examination, and diagnostic tools with the recognition of the broad nature of the differential diagnoses of LBP in order to be able to best treat the patient.
onlinelibrary.wiley.com/doi/abs/10.1111/ner.12173
Anatomy! Everyone loves anatomy.
One of the most interesting ligament/ muscles in the abdominal cavity is the duodenal suspensory muscle/ ligament of trietz with attachments on the right crus of the diaphragm passes around the esophagus, the celiac artery and superior mesenteric artery, behind the pancreas, and inserts between the duodenum and jejunum. It always looks pretty big in text books and visceral therapists are highly interested in it however, it appears much smaller and likely less sexy when studied (Kim et al 2008).
www.researchgate.net/publication/6184396_The_ligament_of_Treitz_the_suspensory_ligament_of_the_Du...
researchgate.net
Sleep as a treatment for LBP
There is a paucity of research on sleep hygiene education in chronic low back patients with one randomised controlled trial showing the benefit of a medium firm mattress (Kovacs et al. 2003), and another showing the superiority of a specific bedding system (Jacobsen et al. 2002).
Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions
Excellent overview by the man Miguel Toribio-Mateas Many implications for managing patients with chronic pain, in particular small fiber neuropathy and systemic inflammation.
www.mdpi.com/2076-2607/6/2/35/htm#B113-microorganisms-06-00035
mdpi.com
An extensive body of evidence documents the importance of the gut microbiome both in health and in a variety of human diseases. Cell and animal studies describing this relationship abound, whilst clinical studies exploring the associations between changes in gut microbiota and the corresponding meta...