It would, however, appear that patients with marked sequelae of Scheuermann’s disease, or Schmorl’s nodes, at the thoracolumbar junction, are much more prone to TLJ syndrome.
Not infrequently, however, there will be evidence of an old compression fracture of T12 or L1, which may have been missed in the past.
http://www.maitrise-orthop.com/viewPage_us.do?id=41
The following is an excerpt from ‘Sciatica Solutions Diagnosis, Treatment, and Cure of Spinal and Piriformis Problems’ the book by Loren Fishman, MD and Carol Ardman
Nerve Damage and Nerve Regrowth
There are three types of nerve damage that can be identified with an EMG or an SSEP, and the nerves have different possibilites for regrowth and recovery.
Sometimes the nerve is just compressed or stretched and temporarily put out of commission, and in time it repairs itself and conducts impulses normally again. It’s called neuropraxia. If neuropraxia is present, stimulating the nerve won’t get the muscle to react perfectly, or send a full volley of sensory signals toward the brain at normal speed. But the nerve fiber is still alive. A patient with neuropraxia can usually expect a complete recovery without treatment in one week to three months.
The second kind of damage occurs when the nerve itself is severed inside its protective, fatty sheath, but the sheath remains intact. The nerve fiber will eventually regenerate. Characteristic signals of axonotmesis–the severing of the little nerve fiber in the middle of the sheath–appear on the EMG. The normal regrowth is about an inch a month.
The third, more serious type of damage is where the sheath surrounding the fiber and the fiber itself have been severed and the fiber itself have been severed–cut in tow. When this happens, of course there is no conduction of impulses along the nerve. In this case regrowth is problematical.
Measuring regeneration of injured nerve fibers with an EMG helps predict future recovery.
hronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density
Our results imply that CBP is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes.
CBP patients were divided into neuropathic, exhibiting pain because of sciatic nerve damage, and non-neuropathic groups. Pain-related characteristics were correlated to morphometric measures.
Tarlov cysts are fluid-filled sacs that most often affect nerve roots in the sacrum, the group of bones at the base of the spine. These cysts can compress nerve roots, causing lower back pain, sciatica (shock-like or burning pain in the lower back, buttocks, and down one leg to below the knee), urinary incontinence, sexual dysfunction, and some loss of feeling or control of movement in the leg and/or foot. Pressure on the nerves next to the cysts can also cause pain. Tarlov cysts may become symptomatic following shock, trauma, or exertion that causes the buildup of cerebrospinal fluid. Women are at much higher risk of developing these cysts than are men.
Is there any treatment?
Tarlov cysts may be drained to relieve pressure and pain, but relief is often only temporary and fluid build-up in the cysts will recur. Corticosteroid injections may also temporarily relieve pain. Other drugs may be prescribed to treat chronic pain and depression. Filling the cysts with fat has not been shown to work. Injecting the cysts with fibrin glue (a combination of naturally occurring substances based on the clotting factor in blood) may provide temporary relief of pain. Some scientists believe the herpes simplex virus, which thrives in an alkaline environment, can cause Tarlov cysts to become symptomatic; making the body less alkaline, through diet or supplements, may lesson symptoms. Surgical resection may be needed when the cysts cause continued pain or progressive neurological damage.
What is the prognosis?
Most Tarlov cysts do not cause pain, weakness, or nerve root compression. The cysts do not appear to recur following complete resection by an experienced neurosurgeon. Acute and chronic pain may require changes in lifestyle. If left untreated, nerve root compression can cause permanent neurological damage.
What research is being done?
The NINDS, a component of the National Institutes of Health within the U.S. Department of Health and Human Services, vigorously pursues a research program seeking new treatments to reduce and prevent pain and nerve damage.
http://www.ninds.nih.gov/disorders/tarlov_cysts/tarlov_cysts.htm
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TARLOV CYST ASSOCIATION
Myofascial pain syndrome (MPS) is a fancy way to describe muscle pain. It refers to pain and inflammation in the bodys soft tissues.
Myofascial pain is a chronic condition that affects the fascia (connective tissue that covers the muscles). Myofascial pain syndrome may involve either a single muscle or a muscle group. In some cases, the area where a person experiences the pain may not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain.
http://www.medicinenet.com/muscle_pain/article.htm
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Myofascial pain is not a fatal condition, but it can cause significant reduction in quality of life (QOL) and is a major cause of time lost from work. Costs associated with MP sap millions, perhaps billions, of dollars from the economy.
Acupuncture may be helpful.
Osteopathic manipulation techniques may include integrated neuromusculoskeletal release, myofascial release, strain-counterstrain, muscle energy, and high-velocity/low-amplitude manipulation.
http://www.emedicine.com/PMR/topic84.htm
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The precise cause of MPS is not fully understood and is undergoing research in several medical fields.
A fairly new form of therapy called Myofascial Release, using gentle fascia manipulation and massage, is believed by some to be beneficial and pain-relieving.