https://www.stpeteinjurychiro.com/blog daily 0.75 2026-03-25 https://www.stpeteinjurychiro.com/blog/the-unusual-suspects-in-spinal-pain monthly 0.5 2025-07-01 https://images.squarespace-cdn.com/content/v1/680a452cde6c2e16ad22ba4a/c271fe08-a5f7-477d-bd86-de9fa4c1adee/Hero-Probe-In-Bone-Call-Outs-Disc-Endplates-1.png Blog - The “Unusual Suspects” in Spinal Pain - Vertebral endplate The vertebral endplate is present on either side of each vertebra in the spine, and is thought to be one of the weakest links of the spine. The end plate has extensive nerve supply making it very sensitive to injury. These injuries typically happen with vertical loading mechanisms that cause disc injury, think falling straight down on you behind, dropped weight on your head or car accident injuries. Typical presentation is pain along the midline of the spine worsened by stationary positions and transitions from seated to standing. This can occur with or without apparent disc injury. We can confirm injury to the endplate when MR imaging demonstrates Modic changes (inflammation in the bone) or Schmorles nodes, although the presence of these findings is not essential for diagnosis. https://images.squarespace-cdn.com/content/v1/680a452cde6c2e16ad22ba4a/4011b5f0-3c1d-4fa2-8911-ec020c4a3f7e/pia+mater.jpg Blog - The “Unusual Suspects” in Spinal Pain - Thecal Sac Compression The thecal sac is a combination of tissues that covers and protects the spinal cord and nerves. The front side of the thecal sac (also the side facing the disc) is more densely innervated by nerves than the back of it. Pain from this region is often triggered by either physical compression by an injured disc or inflammatory irritation (discussed more below). We can pick this up on physical examination when a test called a straight leg raise test reproduces pain in the lower back but does not cause any leg pain. Recent studies suggest that this maneuver causes stretching of the thecal sac, known conveniently as the “thecal tension sign” and could indicate irritation near the structure. https://images.squarespace-cdn.com/content/v1/680a452cde6c2e16ad22ba4a/ccd3025b-582c-41e2-880b-c28935ea4e27/Untitled.png Blog - The “Unusual Suspects” in Spinal Pain - Granulation Tissue Ok, so we are talking about the disc again here, BUT…in this case we are not discussing acute injury to the disc itself but rather the changes in the disc tissue that follow an injury. The occurrence of disc injuries typically takes route from the inside out. This means the nucleus tears through the inner layers of tough fiber ring and makes its way outwards. Pain is not perceived until the tear reaches the outer one-third of the annulus which is innervated by nerve fibers. The healing process of this tear involves “plugging” it with what we call granulation tissue which does not exhibit the properties of full tensile collagen making it weaker and more susceptible to reinjury. More importantly, the deposition of granular tissue comes with deeper infiltration of the nerves into the disc, and increased expression of pain receptors, making the disc more sensitive and recording pain more frequently. https://www.stpeteinjurychiro.com/blog/blog-post-title-one-a43gm monthly 0.5 2026-03-25 https://images.squarespace-cdn.com/content/v1/680a452cde6c2e16ad22ba4a/1750880911775-AMNO9DKKNYFKBCJNSOAZ/unsplash-image-XcjVef6uvYA.jpg Blog - Choosing the best chiropractor for your condition It is just as critical to go to the right chiropractor if you have been involved in a traumatic event such as an auto accident or fall injury. Being put in this situation can be very overwhelming to navigate on your own as you deal with getting your car repaired, having your injuries examined, and making time for all of this while juggling your personal life and financial responsibilities. Your chiropractor should be equipped with the skills and knowledge to help address your medical/healthcare concerns and recovery. The following are some factors that you need to consider if you have been injured: https://images.squarespace-cdn.com/content/v1/680a452cde6c2e16ad22ba4a/1750881079383-R0BDZ62K37X5KGLS36BI/unsplash-image-rUfUd-7WW78.jpg Blog - Choosing the best chiropractor for your condition Your chiropractor should be experienced and comfortable in performing a thorough examination and ruling out some of the most common (and less common) injuries that you can sustain in the event that you have experienced. They should also be confident in ordering the right tests to diagnose your injuries. These are often imaging tests such as X-rays, MRIs or CT imaging to rule out certain conditions. More importantly, some complex injuries (concussions for instance) require waiting a certain amount of time to pass before ordering the test. If ordered too soon, this can result in a false negative test and the doctor missing the diagnosis. https://images.squarespace-cdn.com/content/v1/680a452cde6c2e16ad22ba4a/1750881180406-DRQYLU98IQHLLMHTTHFM/unsplash-image-OQMZwNd3ThU.jpg Blog - Choosing the best chiropractor for your condition Besides providing treatment, having an injury resulting from another person’s negligence will often result in a medicolegal case as the costs of treatment should not fall on the victim. It is therefore important to choose a chiropractor that is experienced with documentation of the events of the accident, your injuries sustained, as well as your anticipated future prognosis. This documentation is heavily relied upon by other parties involved such as attorneys and insurance adjusters to get a clear picture of your injuries. 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