Interspinous Ligament Sprains and Pain

Interspinous Ligament Sprains and Pain

Dr. Warren Hammer frequently writes on musculoskeletal conditions and pain. He is one of the leaders in soft tissue therapies to address myofascial pain. He recently wrote an article on how interspinous ligaments may relate to chronic low back pain. The interspinous ligaments are small ligaments in between the spinal vertebrae. They connect the spinous process of each bone to the bone adjacent to it. These ligaments can be stretched and damaged with trauma or chronic repetitive motions.


As you may know, muscles have an excellent blood supply, but tendons are somewhat limited. Ligaments have the worst blood supply, which is one of the reasons ligaments tend to take weeks or months to heal. Their poor blood supply and limited nutrients make repair and healing a time-consuming process. In addition, they are structural tissues that prevent excessive motion. If we continue performing the same activities, we keep tugging at the injured ligament, further damaging it.


The interspinous ligaments can produce tenderness on palpation, but they can also produce pain radiating down an arm or leg. The pain referral patterns can be confused with other types of joint, ligament, or nerve damage. They’re often confused with trigger point referral patterns.


Damage to the interspinous ligaments can produce shut off responses in adjacent muscle. The injured mechanoreceptors of the ligaments send bad information to the brain, which results in this dysfunctional muscular control. These ligaments, and their corrupted mechanoreceptors, is often cited in fascial manipulation pain syndromes.


We have pain receptors throughout the entire body. Muscles, tendons, joints, and ligaments all have several types of pain and pressure receptors. When these receptors are sending signals to the brain, we can interpret this as pain. Treatment needs to address these dysfunctions in the tissue for healing and long-term improvement.
Cold laser, Graston Technique, and active release technique are excellent tools and treatments for addressing ligament mechanical receptor dysfunction. These treatments help address the fascial restrictions between adjacent tissue, especially near the interspinous ligaments. These treatments can then be combined with massage therapy, exercises, stretches, and neuromuscular re-education to enhance functional movements in the injured area.