Physiology of chronic spinal pain syndromes: from animal models to biomechanics.
METHODS
The literature and current research related to spinal pain mechanisms were reviewed, as well as animal models related to its study.


OBJECTIVE
To provide a pragmatic discussion of spinal pain that both reviews relevant research and coherently synthesizes the existing body of literature related to pain, nociception, animal modeling, and injury biomechanics.


BACKGROUND
A detailed body of literature suggests that spinal pain mechanisms are quite complicated and involve a host of different processes (e.g., genetics, gender, neurophysiology, and biomechanics) that may contribute to clinical manifestations and symptoms.


METHODS
Both a review of the literature and a presentation of current and ongoing laboratory research are presented. Specific findings from the authors' laboratory using a rodent model of lumbar radiculopathy are presented to elucidate the role of local nerve root biomechanics in initiating and maintaining behavioral symptoms of nociception and pain.


RESULTS
For an understanding of chronic pain, a bidirectional-translational approach that incorporates cross-disciplinary methods such as in vivo biomechanical techniques is required. A conceptual model of chronic spine pain is proposed that details the dynamic and integrated roles of injury, biomechanics, and nociceptive physiology.


CONCLUSIONS
Areas of continued research are highlighted that may help guide the management of painful spine symptoms and syndromes.
DeLeo
Joyce A
JA
Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire 03756, USA. joyce.a.deleo@hitchcock.org
Winkelstein
Beth A
BA
D000818:Animals; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D004195:Disease Models, Animal; D005727:Ganglia, Spinal / Q000503:physiopathology; D006801:Humans; D010146:Pain / Q000209:etiology* / Q000503:physiopathology*; D011843:Radiculopathy / Q000276:immunology / Q000503:physiopathology; D012106:Research / Q000639:trends; D013118:Spinal Cord Diseases / Q000150:complications* / Q000503:physiopathology*