Can IROM Help With Back Pain?

By Phillip Steele, MD RMSK CAQ Sports Medicine
Performance Injury Care & Sports Medicine

I am truly amazed that every day I learn something new! One aspect of my practice, Regenerative Medicine, is advancing at seemingly light speed. Thankfully, I have heard several fantastic lectures on Interventional Regenerative Orthopedic Medicine (IROM) for pain. In particular, one that significantly strikes me is focused on chronic back pain and what I call Posterior Column Disease.

Most research focuses on surgical techniques for the spine and degenerative disk disease, while little research has been done on Posterior Column Disease. The most recent conference I attended in Austin, TX had a lecture discussing this very subject. More specifically, why many patients with near normal imaging (MRI) of the spine have so much pain.

There are two major parts of the Spinal Column. First, the anterior column of the spine contains the vertebral bodies and disk material. Next, the posterior column is made up of ligaments, the spinous and transverse processes of the vertebrae and facet joints. The posterior column also contains a structure called the thoracolumbar fascia (TLF). The TLF is a thin, sheet-like material that connects the iliac hip crest, abdominal muscles, and arm muscles to the spine. This sheet-like material drapes over the spine like a tarp on a ridge pole. Likewise, the muscles act like the pegs in the ground stabilizing your tent against the wind and rain.

If a peg pulls out, the tent is no longer a rigid structure. Similarly, this is true for a TLF tear. The tear may be causing your pain. The TLF is heavily innervated with pain receptors. Therefore a tear may cause radiating pain down your legs. These symptoms can be very similar to sciatica or a disk herniation. In fact, the pop you heard in your back when lifting that heavy object may not be a disk herniation. You may have torn your TLF! So, your spinal MRI is near normal, with a bulge in your disk space. Well, this might simply be age related changes. It may have little to do with your pain.

By using Regenerative Medicine techniques, we may be able to help you heal a TLF tear. Our goal is to get you back on the road to life without pain. So, if you are tired of living with chronic back pain, call us for an appointment. We can do a thorough evaluation of your TLF and posterior column.