Maignes Syndrome: Thoracolumbar Junction Syndrome
Did you know your low back pain could be coming from higher up in your spine. In our bodies we experience something called referred pain. Referred pain means the area that is sore could actually be referred pain from somewhere else. This happens all the time in organs referring pain, like a heart attack pain going down your left arm.
However, there are times the answer to your back pain could be from an area in your spine known as the thoracolumbar junction (TL junction). You can get a trapped nerve in this area causing all your pain. Ever wondered which trapped nerve is causing all your back pain? Today I want to let you know about something called Maigne Syndrome or Thoracolumbar Junction Syndrome.
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ThoracoLumbar Spine Pain
Dr Robert Maigne is a Rheumatologist who had an interest in using his hands to also fix back pain problems other than just medication.
Dr Maigne first identified a one-sided low back pain which could also be associated with other symptoms like:
- Testicular pain
- Abdominal pain
- Gynaecological pain
- Pubic bone pain
You can read an interview with Dr Robert Maigne and his history here.
So Where is the Pain Referred From?
In our spines we have lots of nerves leaving and going to different places. The part causing all the trouble here is called the posterior rami.
The part of the spine circled with arrows pointing away from it is the thoracolumbar junction.
As you can see nerves leaving this area and send referred pain to the crest (“some call hip”) of your lower back, your groin or outside leg/hip area. This is where the posterior rami get trapped.
How to Test For Maignes Syndrome
Ideally your chiropractor should be looking for tenderness of the spine between T11-L2.
They could also do a skin roll test over the sore areas feeling for tension in the skin and overly sensitive skin. See the video below to skin rolling technique in action over a spine.
The crazy thing with the skin rolling is if you give a little tug with the skin between your fingers over the thoracolumbar junction you probably will get a little click sound.
What I have seen and experienced is by pushing into the bone along your “hip”, which is actually called the iliac crest, it can be excruciatingly painful to light touch even. This is where the doctor is pointing to in this picture.
When doing skin rolling starting very light and continuous helps a lot. You can be very sensitive over the skin rolled for a day or so after.
How to Treat Maigne Syndrome
The way Dr Maigne treated his patients was with spinal manipulation and/or a facet joint infiltration injection.
Most of the time you wont be needing the injection, but this is another reason you might hear those stories of someone walked into the chiropractor got their back “clicked” and came out walking so much better.
In the long-term you also got to look at the stress you are placing on that section of your spine.
Poor posture, weak core muscles, poor body movements all add up over time to stress our spines muscle, joints and nerves till one day back pain begins.
So if you are having a hard time getting some back pain relief. Ask your chiropractor, physiotherapist or osteopath if they can do the skin roll test to see if yours is overly sensitive and treat that to see if your pain goes away. If they looked confused tell them to read this post.