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- Scope of the Problem
-
1. Current thinking in back pain management - introduction
- Ms. Anna Hlavsova MSc, MCSP, HPC
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2. Genetic epidemiology of low back pain and intervertebral disc degeneration
- Dr. Frances Williams
- Biomechanics, Spinal Surgery and Research Methods
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3. The biomechanics of back pain: what we know so far
- Prof. Michael Adams
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4. Low back pain: a composite of interacting systems?
- Prof. Alison McGregor
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5. What does physiotherapy teach us about back pain?
- Ms. Josephine O'Callaghan
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6. How we currently measure back pain
- Prof. Rob Froud
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7. Back pain: are we measuring the right things?
- Prof. Rob Froud
- Chronic Pain and Current Challenges
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8. The psychosocial flags framework: overcoming obstacles to work
- Prof. Kim Burton
- Current Therapies and Treatments
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9. Psychological treatment for people with musculoskeletal pain 1
- Prof. Tamar Pincus
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10. Psychological treatment for people with musculoskeletal pain 2
- Prof. Tamar Pincus
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11. Current thinking in pain medicine and some thoughts on back pain
- Dr. Nick Hacking
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12. Combined physical and psychological programmes plus alternative therapies for back pain
- Ms. Anna Hlavsova MSc, MCSP, HPC
Printable Handouts
Navigable Slide Index
- Introduction
- Talk outline
- Normal function/dysfunction
- Skeletal system
- The spine
- So how does the spine function?
- The spine from an engineering perspective
- Mathematical models to understand function
- Problems with the models
- Potential causes why the models are wrong
- New thoughts on posture
- Implications of curved vs. straight spine (MRI)
- Implications of curved vs. straight spine (lifting)
- Implications to disc
- Rethink ideas
- Spine as an arch
- Structure, functionality and failure
- Integration of the spine in the skeleton
- Is the spine only one pendulum?
- Inverted pendulums & the spine
- Stiffness feedback
- Three systems that work together
- People as pendulums on platforms (movies)
- Platform results: motion
- Ternplot: ankle, knee & hip on platform
- Ternplot: spinal regions on platform
- Platform results: muscle activation
- Segmental model
- Muscle synergy
- Indeterminacy/patient heterogeneity
- Muscular system
- Key component of stability: muscles
- Bergmark’s theory on stability 1989
- “Local” muscles
- The local system
- Ultrasound
- Degenerate muscles
- Cohort study
- Myelopathic changes in back pain patients
- “Global” muscles
- Strength, fatigue and endurance
- Symmetry contraction
- Spinal muscles
- Motor control (CNS)
- Control system: corticospinal pathways
- Symmetry contraction
- Thresholds to stimulation in back muscles
- Thank you
Topics Covered
- Skeletal system: segmental joint motion of the spine
- Muscular system: creating motion in body segments
- Control system (CNS): co-ordination of muscles and body segments to produce function
- Management and surgical care: surveys of practice, clinical studies and optimal post-operative management
Talk Citation
McGregor, A. (2015, July 30). Low back pain: a composite of interacting systems? [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 7, 2024, from https://doi.org/10.69645/FBNT4918.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Alison McGregor has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Neurology
Transcript
Please wait while the transcript is being prepared...
0:00
Hello.
My name's Alison McGregor.
I'm a professor of Musculoskeletal
Biodynamics at Imperial College,
London, and I've been asked to
talk to you today about lower
back pain and the composite
of its interacting systems
and how they work.
0:14
Just to give an overview of what
I'm going to tell you about, first
of all, I want to allude to
different aspects of structure and
function, and how they interlink.
And I then want to explain
how some of these links
are made through different
modelling, and theories, and ideas.
And hopefully by the
end of this, you'll
see that it's not quite
as straightforward
as we may have thought.
0:35
Normal function has actually
been described as a composite
of three different systems.
We have a skeletal system,
which, to you and I,
are the bones of skeleton, a
muscular system, which is, not
surprisingly, the muscles
that make your joints work,
but also a higher center, a
control system, which is the brain.
And hopefully by the
end of this talk,
you'll see how these three systems
have to work together to allow us
to have normal function,
and when they don't work,
it's been postulated
that you get some level
of dysfunctional, structural
compensation in the body.
1:07
First of all though, I'd like to
talk through the skeletal system.
1:12
If we think with
the spine initially,
we know it's the central
core of the body,
and from which our upper limb,
our head, and our lower limbs
are attached to.
We know it's got a
very complex structure
of muscles surrounding
it, and it has very
many discrete roles in the body.
But what you may not know is if
you actually dissect the spine,
and take away all those muscles,
it actually buckles which just 2
kilograms of load going through it.
1:37
So that then begs the question,
how does the spine function?