What is Maignes Syndrome? – Thoracolumbar Junction Syndrome

Did you also know that your low back ache might be caused by a problem further 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. It is a type of pain that is caused by stimulation of the nerves that sense pain in other parts of the body.

However, there are situations when a thoracolumbar junction in your spine may be the source of your back discomfort (TL junction). A trapped nerve in this location might cause all of your discomfort. Have you ever wondered which of your trapped nerves is causing your back pain? Today I’d like to tell you about Maigne Syndrome, also known as Thoracolumbar Junction Syndrome.

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

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 thoracolumbar junction is the area of the spine outlined with arrows pointing away from it.

Maignes Syndrome Posterior Rami

As you can see, nerves leave this location and deliver referred pain to your lower back’s crest (“some call hip”), groyne, or outer leg/hip area. This is where the posterior rami become entangled.

What is Maignes Syndrome

The syndrome consists first and foremost of low back pain, which, as a rule, is unilateral. It is to all intents and purposes like low back pain of lumbosacral origin, and is, in fact, frequently mistaken for that condition. Unilateral low back pain is the most frequently observed feature.

Thereafter, more features were added: The condition may be associated with abdominal or testicular pain that mimics intestinal or urological conditions; above all, the pain may be suggestive of gynaecological problems, which is very deceptive and may lead to repeated investigations; in a smaller number of cases, there may be pubic pain.

The patients never complain of discomfort at the thoracolumbar joint, which is crucial. Furthermore, radiographs of the junction seldom provide indications of anything wrong at that location. The symptoms are mainly clinical. However, the lumbosacral area frequently shows radiographic indications of significant degenerative illness or may have already undergone surgery. These findings lead to the incorrect conclusion that the lumbosacral area is the source of the disease. Mixed low back pain patterns, on the other hand, are not uncommon.

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.

Read also: A Simple Guide to Prevent Lower Back Pain

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.