2023-09-12T08:08:15
Physiotherapy clinic in Tambaram Are you Looking for Physiotherapy Treatment in Tambaram, Sunshine Super Speciality Physiotherapy Clinic, We Provide Electrotherapy, Exercise and Manual Therapy, Orthopedic, Neuro, Cardio, Pediatric, Sports and Geriatric Rehabilitation, Post Operative Physiotherapy Treatment, Fracture Rehabilitation, pain free movement. 5⃣ Reasons Why Some Herniated Intervertebral Discs are Painless 👉 Despite clear findings of an herniated intervertebral disc (HIVD) on MRI or CT, many HIVDs do not cause pain. Jensen et al reported that only 36% of 98 asymptomatic patients had normal discs at all levels on MRI, with 52% showing a bulging disc at least at one level and 27% with a disc herniation. https://pubmed.ncbi.nlm.nih.gov/8208267/ 💡 Shin & Chang propose five reasons why some HIVDs do not induce pain. https://www.dovepress.com/five-reasons-why-some-herniated-intervertebral-discs-are-painless-peer-reviewed-fulltext-article-JPR 1⃣ Chemical inflammation around the sinuvertebral nerve and nerve root is the main mechanism of pain in an HIVD, together with direct mechanical compression of these nociceptive nerves. https://pubmed.ncbi.nlm.nih.gov/12616153/. An HIVD can be painless if compression and inflammation are insufficient to cause pain. 2⃣ Although rare, motor weakness or sensory deficits without pain may develop following HIVDs. Painless weakness or sensory deficits following HIVDs suggest less of a transient, inflammatory component and more of an established mechanical component. Compression of nerve tissue in the absence of inflammation results in painless loss of motor or sensory function. https://www.sciencedirect.com/science/article/pii/S1040738315001008 3⃣ Secondary change in gene expression within the dorsal root ganglia (DRG) after HIVDs might be attributed to painless HIVDs. Gene expression within the DRG dynamically changes after an HIVD has developed, which alters the level of protein production of certain factors related to the inflammation process and nociception (ie pro-inflammatory, pro-apoptotic, and pro-nociceptive factors). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404509/ If gene expression within the DRG changes in a way that prevents persistent inflammation through natural adaptation processes or treatments, there may be no pain even in the presence of an HIVD. 4⃣ Reorganisation of neural circuits within laminae I–III of the spinal dorsal horn could be the cause of a painless HIVD. Inhibitory and excitatory interneurons in these laminae play an important role in the nociceptive signalling pathway through modulating the activity of wide dynamic range neurons and nociceptive-specific neurons in the spinal dorsal horn. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703564/ During reorganisation because of neuroinflammation, when inhibitory synapses are greatly increased compared with excitatory synapses, the secretion of neurotransmitters involved in the transfer of nociceptive signals is significantly reduced. In such situations, patients may not experience pain, even in the presence of an HIVD. 5⃣ An HIVD can be painless in patients with an effective pain coping strategy. Pain is a complex sensory and emotional experience that involves both physiological and psychological factors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680716/ Coping strategies can influence pain perception and the level of pain experienced by patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957813/ Additionally, people with effective coping strategies may have a higher tolerance for pain, and their bodies may release pain-relieving chemicals that mask any discomfort from pain. SUNSHINE ® SUPER SPECIALITY PHYSIOTHERAPY CLINIC - #DrParthiban #Sunshinephysioclinic.in #Physiotherapyclinicintambaram DR.M.P. PARTHIBAN.M.P.T (Ortho), Chief Orthopedic Physiotherapist, Call for Appointments: - 9345122177 East Tambaram, CHENNAI