Abstract

Few validated tests allow a precise aetiological diagnosis of Low Back Pain (LBP), and the difficulty of clinical evaluations could be one of the reasons to explain the lack of effectiveness in the therapeutic management of chronic LBP. However, an implication of a sensory impairment in the control of sensorimotor circuits could be suggested. Interactive and specific responses between nociceptive nerve fibres and the paraspinal musculature motor control could have clinical implications, in particular through kinematic evaluation. Following an introduction to the link between the sensory innervation of the spine and pain, we then summarise the maladaptive movement in LBP at the kinematic and neuropathological level. A clinical objectification of these kinematic adaptations at the lumbar spine level, would clarify the aetiological diagnosis causes of chronic LBP, and so help optimising therapeutic strategies by proposing a relevant and precise clinical model of this painful condition.

摘要

很少有经过验证的测试可以对腰痛 (LBP) 进行精确的病因诊断，临床评估的困难可能是解释慢性 LBP 治疗管理缺乏有效性的原因之一。然而，可以提出感觉运动电路控制中感觉障碍的含义。伤害性神经纤维和椎旁肌肉组织运动控制之间的相互作用和特异性反应可能具有临床意义，特别是通过运动学评估。在介绍了脊柱感觉神经支配与疼痛之间的联系之后，我们然后总结了 LBP 在运动学和神经病理学水平上的适应不良运动。这些运动学适应在腰椎水平的临床客观化，