When Stretched Ligaments Cause Back Pain

August 22, 2017 in Our News & Bulletins by Primary Spine & Rehab

The missing piece to some back pain puzzles: ligaments


When low back pain is not responding to exercise therapy and manual therapy, doctors and therapists should evaluate for lax ligaments. Ligaments are tough, fibrous bands of connective tissue that connect bones, connect cartilage, and/or hold together joints. While proper functioning of the spine relies heavily on normal movement of spinal segments and muscle balance, ligaments additionally serve as important passive support structures for the spine. “Passive” means a person cannot flex them for additional support.

Injury, overuse, and just normal aging can cause ligaments to become lax, especially the ligaments of the low back. Weakened ligaments allow the low back to be too mobile. In response, the body automatically tenses and over-recruits muscles to supplement the back’s stability. This scenario causes pain and ongoing injury.

Ligaments prove difficult to heal. They can not be exercised like muscles. They also have poor blood supply, so they do not receive healing factors in the blood as much as other tissues. As a result, ligaments often experience incomplete healing.

The solution is prolotherapy. Prolotherapy involves the injection of a mild irritant such as dextrose (a simple sugar) into the ligament. Ultrasound guidance is needed for proper accuracy. The irritant causes a mild, targeted inflammatory response. The inflammatory response causes the body to rush healing factors to specific areas that had been ignored. With repeated injections over time, we can influence the body to strengthen the ligament beyond what the unaided healing response would have accomplished. Research demonstrates that this technique is effective in many pain syndromes including chronic low back pain that has resisted other treatment methods.

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