Cause
One cause of pain in the spinous process can be a fracture caused by an accident or a fatigue of the bone. In addition, spinous processes that are coarser and larger tend to get in the way, especially if there is also a severe lordosis in the lumbar spine, i.e. a convex bend forward. An inflammatory reaction can also sometimes spread to the spinous processes and cause pain. In addition, malpositioning or misalignment of the vertebrae, for example in scoliosis or a hump, can also affect the spinous processes due to the pull that the resident ligaments and muscles exert on them.
Therapy
In order to make a diagnosis regarding the spinous processes, it is important not only to obtain information on the course of the symptoms and an examination of the spinal column, in which a good overview can already be obtained by prevention and palpation of each individual spinous process, but also to evaluate an X-ray or MRI image. Here one can identify a possible fracture, a malposition or the nature of the spinous process. The injuries and complaints of a spinous process can be described as relatively uncomplicated, since they usually do not affect other structures. The prognosis is therefore quite good, only pain can cause problems depending on the severity.
Prophylaxis
For prophylaxis, relatively little can be done, since injuries caused by an accident or the condition of the spinous process cannot be influenced. One can only ensure that existing malpositions of the spine are corrected by physiotherapy and that the spine as a whole is protected by strengthening the back muscles.
Fracture of a spinous process
A fracture of a spinous process usually occurs after an enormous force is applied to the spinal column. This force can be directed directly at the spinous processes or indirectly arrive at the spinous process through hyperextension or over-twisting of the spinal column. Since the spinous process is relatively securely embedded in the ligamentous apparatus of the spinal column and, in the case of a simple fracture, has no direct, dangerous contact with the spinal cord, no surgical intervention is usually necessary here.
Neither does a fatigue fracture, in which the spinous process of the lower cervical vertebrae has lost so much stability that, with repeated, unusually high levels of force, for example when shovelling, the pull of the muscle on the spinous process predominates that it may then have broken off. The spinous process may also have broken off as part of a more extensive injury to the vertebrae and may then require treatment.
