Pain Research and Management

Chronic Spinal Pain: Pathophysiology, Diagnosis, and Treatment


Publishing date
01 Mar 2019
Status
Published
Submission deadline
19 Oct 2018

Lead Editor

1General Hospital of Armed Police Force, Beijing, China

2University of Newcastle, Newcastle, Australia

3Virginia Spine Research Institute, Virginia, USA

4Shanghai Jiao Tong University, Shanghai, China


Chronic Spinal Pain: Pathophysiology, Diagnosis, and Treatment

Description

Chronic spinal pain is a common global problem, one of the most leading causes of disability among adults worldwide. It covers chronic neck, thoracic, and low back pain. Chronic spinal pain in the absence of radiculopathy, myelopathy, or clear serious underlying disease is also called mechanical pain. Despite the frequency of this presenting complaint, a clear understanding of its etiologies is often elusive. Any innervated neck structures, such as muscles, synovial joints, intervertebral discs, dura mater, and ligaments, may cause pain theoretically. Among all the causes of chronic spinal pain, discogenic and facetogenic pain related to degeneration of intervertebral discs and facet joints have been thought as the top two common causes. Despite its enduring presence, pain ostensibly emanating from a disc or a facet joint itself has hitherto remained poorly defined, and its diagnosis and treatment have been exceedingly controversial.

For patients with chronic spinal pain alone, in the absence of obvious lesions, the specific anatomic cause of pain and illness can rarely be known with certainty unless precision and fluoroscopically guided diagnostic procedures are performed. Imaging studies, in particular magnetic resonance imaging, may reveal no abnormality or show common degenerative changes that are most frequently observed among people without spinal pain. Under such circumstances, some invasive diagnostic techniques, such as discography and facet joint injection or nerve block, may have to be used. Acceptable low false positive rates can only be maintained using these diagnostic procedures by adhering to stringent operational criteria.

The conservative therapy includes the use of nonsteroidal anti-inflammatory drugs, muscle relaxants, or even a short course of opioid pain medication in conjunction with nonpharmacological strategies such as physical therapy, all of which lead to improvement in a majority of patients. However, if conservative therapy fails in symptomatic relief, some invasive treatments such as epidural steroid injections, facet injections, and radiofrequency ablations are generally considered. Unfortunately, these invasive procedures may not decrease the need for subsequent surgeries in patients with chronic neck or back pain secondary to degenerative cervical or lumbar intervertebral discs if the exact diagnosis is not confirmed. Surgical intervention in the absence of disc herniation, stenosis, or clear obvious underlying disease is controversial. Because the reported results vary considerably in different studies, the debate continues as to whether surgical treatment should be attempted.

This special issue seeks to cover chronic spinal pain related basic and clinical studies. Authors are cordially invited to submit high-quality review or research articles that may improve our understanding on pathophysiology, diagnosis, and treatment of chronic spinal pain. We will give priority to new pathophysiological insights, new diagnostic and differential methods, and treatment of chronic spinal pain. Of course, long term randomized double-blind clinical control studies are especially welcome in the treatment of chronic spinal pain.

Potential topics include but are not limited to the following:

  • Novel insights into pathophysiology of chronic spinal pain
  • Epidemiology of chronic spinal pain
  • Natural history of chronic spinal pain
  • Diagnostic and differential methods
  • Discography and facet joint block related basic and clinical study
  • Treatment of chronic spinal pain including conservative, invasive, surgical, or biologic methods

Articles

  • Special Issue
  • - Volume 2019
  • - Article ID 8957847
  • - Review Article

The Chinese Association for the Study of Pain (CASP): Consensus on the Assessment and Management of Chronic Nonspecific Low Back Pain

Ke Ma | Zhi-Gang Zhuang | ... | Yan-Qing Liu
  • Special Issue
  • - Volume 2019
  • - Article ID 1729059
  • - Editorial

Chronic Spinal Pain: Pathophysiology, Diagnosis, and Treatment

Baogan Peng | Nikolai Bogduk | ... | Ke Ma
  • Special Issue
  • - Volume 2019
  • - Article ID 6528528
  • - Research Article

Skin/Muscle Incision and Retraction Induces Evoked and Spontaneous Pain in Mice

Juan Yang | Fei Yuan | ... | Zhiying Feng
  • Special Issue
  • - Volume 2019
  • - Article ID 8184592
  • - Review Article

Optimizing the Management and Outcomes of Failed Back Surgery Syndrome: A Proposal of a Standardized Multidisciplinary Team Care Pathway

Kliment Gatzinsky | Sam Eldabe | ... | Philippe Rigoard
  • Special Issue
  • - Volume 2019
  • - Article ID 5948686
  • - Research Article

Microglial BDNF, PI3K, and p-ERK in the Spinal Cord Are Suppressed by Pulsed Radiofrequency on Dorsal Root Ganglion to Ease SNI-Induced Neuropathic Pain in Rats

Xueru Xu | Shaoxiong Fu | ... | Rongguo Liu
  • Special Issue
  • - Volume 2019
  • - Article ID 9617280
  • - Review Article

The Chinese Association for the Study of Pain (CASP): Expert Consensus on the Cervicogenic Headache

Hong Xiao | Baogan Peng | ... | Yanqing Liu
  • Special Issue
  • - Volume 2019
  • - Article ID 8185316
  • - Research Article

Analyzing the Influence of Modic Changes on Patients with Lower Back Pain Undergoing Conservative Treatment

Yufeng Chen | Huilin Yang | ... | Jun Zou
  • Special Issue
  • - Volume 2019
  • - Article ID 9394715
  • - Research Article

Locating the Site of Neuropathic Pain In Vivo Using MMP-12-Targeted Magnetic Nanoparticles

Syeda Fabeha Husain | Raymond W. M. Lam | ... | Hee-Kit Wong
  • Special Issue
  • - Volume 2019
  • - Article ID 9758273
  • - Research Article

Differences in Nonspecific Low Back Pain between Young Adult Females with and without Lumbar Scoliosis

Wangshu Yuan | Jianxiong Shen | ... | Youxi Lin
  • Special Issue
  • - Volume 2019
  • - Article ID 3126464
  • - Review Article

Optimizing the Management and Outcomes of Failed Back Surgery Syndrome: A Consensus Statement on Definition and Outlines for Patient Assessment

Philippe Rigoard | Kliment Gatzinsky | ... | Sam Eldabe
Pain Research and Management
 Journal metrics
Acceptance rate34%
Submission to final decision74 days
Acceptance to publication31 days
CiteScore2.800
Impact Factor2.153
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