PubMed · 4237899
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B Graber-Duvernay. [Functional back pain].. https://pubmed.ncbi.nlm.nih.gov/4237899/
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Pain in the pelvis and lower back appears to be becoming an increasing problem in Norway. The relation between pelvic pain and low back pain is unclear. In the literature a variety of designations, such as pelvic girdle relaxation, pelvic joint instability, posterior pelvic pain, peripartum pelvic pain etc. have been used as identifying labels. The condition(s?) seems to be culturally specific for the Nordic countries in particular. However, pelvic pain is also recognized in England, Holland and Australia, but seemingly unknown in France, Germany, Italy and Spain. The article describes the current knowledge--focusing criteria, etiology, prevalence and nomenclature--and points to the need for systematic epidemiological and clinical investigations.
STUDY DESIGN: Human tissue specimens were examined for the presence of neural end-organs under light and electron microscopy. OBJECTIVES: To define the innervation of the thoracolumbar fascia in problem back pain patients who have articular abnormality defined through pain-provocation discography or facet blocks. SUMMARY OF BACKGROUND DATA: Previous investigators have defined the presence of innervation in control (no back pain) tissue specimens. METHODS: Tissue specimens were harvested during surgery from 24 back pain patients who had not undergone previous lumbar surgery. Specimens were fixed immediately in the operating room and later processed and studied under light and electron microscopy. RESULTS: Structural and ultrastructural studies failed to identify specific neural end-organs in any of the specimens. Serendipidously, microscopic changes suggestive of ischemia or inflammation in this tissue were found. CONCLUSIONS: These findings suggest that the thoracolumbar fascia may be deficiently innervated in problem back pain patients.