Blog published on Tuesday, 21 May 2013
Neural cascade leading to disc injury:
- An injury occurs assaulting the neural integrity of the system.
- As a result, lower extremity motor reflex loops become down-regulated.
- The motor cortex responds by initiating a protective mechanism.
- This results in an altered movement pattern or neurological compensation.
- A net increase in cortical asymmetry becomes established (BAD).
- A reduction in postural integrity ensues because the down-regulated cortex loses capacity for inhibiting ipsilateral flexor musculature.
- Further neuromuscular asymmetry, delayed reflex, and inappropriate neuromuscular sequencing is promoted (winding up because of resulting poor motor afferentation).
- The system becomes vulnerable to injury due to a lack of force absorption capacity.
- The L5/S1 joint is a prime candidate for injury because of its anatomical location.
- Overwhelming force causes fraying of the peripheral disc, until bulge or sequestration occurs.
Cascade of events include:
- Discogenic pain
- Potential spinal nerve entrapment / compression
- Inflammatory products flood tissue
- Paraspinal musculature becomes pathologically short and tight to splint injury
- Further nociceptive stimuli and poor motor afferentation increases neural windup
The progression that develops in the neuromuscular system is usually overlooked and can lead to unnecessary delay in recovery time, unnecessary expense, and avoidable surgery in many cases. Addressing the neural factors in disc pathology are a vital component of recovery and increase success rates for non-surgical rehabilitation.