DISTRIBUTION OF a-Δ AND C-Fiber RECEPTORS IN THE CERVICAL FACET JOINT CAPSULE AND THEIR RESPONSE TO STRETCH

CHEN, CHAOYANG; Lü, Ying; Kallakuri, Srinivasu; Patwardhan, Ajit; Cavanaugh, John M.

doi:10.2106/00004623-200608000-00018

Cited by 24 publications

(18 citation statements)

References 37 publications

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“…14,57 Interestingly, these strain magnitudes are consistent with those associated with pain 27,53 and are also comparable to those generated during whiplash-like neck loading and those inducing microscopic injury of the capsular ligament in biomechanical testing. 66,76,84 Together, these findings suggest that the local mechanical environment of the afferent fibers in the facet capsule likely plays an important role in modulating their responses to excessive joint stretch.…”

Section: Neuronal Responses To Excessive Stretchsupporting

confidence: 62%

“…14,57 Excessive strains that induce behavioral hypersensitivity also induce electrophysiological changes in neurons during and after capsular stretch.…”

Section: Neuronal Responses To Excessive Stretchmentioning

confidence: 99%

“…Although basic science studies collectively have defined thresholds for neuronal activation and the induction of pain, those studies are based on work in vivo in the rat and/or goat, or even in artificial constructs simulating the ligament. 14,19,26,27,57,115 Nonetheless, because a common, nondimensional biomechanical metric (strain) has been used across all of those studies, the findings are agnostic of species and/or scale, and it may therefore be possible to extend such findings to the human. The bigger challenges of understanding injury risk and predicting injury in humans are complicated by very complex and integrated systems at play in pain.…”

Section: The Challenges Of Translating Basic Science To the Clinical mentioning

confidence: 99%

“…1,66,67,108 The pathology associated with those tissue injuries includes microstructural damage to the collagen fibrous matrix of the capsular ligament, synovial fold pinching, and/or degenerative changes to the articular cartilage, which can lead to osteoarthritis. 67,80,85 Because the facet joints are innervated by mechanoreceptive and nociceptive afferent fibers, 5,14,42 any abnormal loading of the facet joint can also generate forces that mechanically load those afferents and initiate a host of pathophysiological responses that can lead to pain. 43,53,54,57 In particular, injury of the innervated ligament tissue that encapsulates the synovial joint has the potential to generate pain (FIGURE 1).…”

mentioning

confidence: 99%

“…The afferent nerve fibers that innervate the facet capsular ligament have their cell bodies in the dorsal root ganglion (DRG) and axons with both peripheral and central terminals. Those afferent fibers synapse with dorsal horn neurons in the spinal cord and transmit sensory information from the periphery to the central nervous system (CNS) 4,8,14,41,42 (FIGURE 1). As such, the nociceptive signaling underlying facet-mediated pain, under some conditions, can initiate peripheral sensitization and/or central sensitization.…”

mentioning

confidence: 99%

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The Physiological Basis of Cervical Facet-Mediated Persistent Pain: Basic Science and Clinical Challenges

Ita¹,

Zhang²,

Holsgrove³

et al. 2017

Journal of Orthopaedic & Sports Physical Therapy

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FIGURE 1. Schematic illustrating the anatomy in the periphery of the facet joint and the relevant neuronal connections to the central nervous system. Afferents that innervate the facet joint and its capsular ligament have cell bodies in the DRG and synapse with neurons in the spinal dorsal horn. Nociceptive information is encoded by many types of afferents, including IB4-positive nonpeptidergic neurons and peptidergic fibers that produce neuropeptides, such as CGRP and substance P. Noxious stimuli are translated into electrical (eg, action potentials) and biochemical (eg, neurotransmitter) signals. In persistent pain, central sensitization occurs, with neuronal hyperexcitability and altered neurotransmitter production and release in the spinal dorsal horn. Abbreviations: CGRP, calcitonin gene-related peptide; DRG, dorsal root ganglion; IB4, isolectin B4.

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Section: Neuronal Responses To Excessive Stretchsupporting

confidence: 62%

“…14,57 Excessive strains that induce behavioral hypersensitivity also induce electrophysiological changes in neurons during and after capsular stretch.…”

Section: Neuronal Responses To Excessive Stretchmentioning

confidence: 99%

Section: The Challenges Of Translating Basic Science To the Clinical mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

The Physiological Basis of Cervical Facet-Mediated Persistent Pain: Basic Science and Clinical Challenges

Ita¹,

Zhang²,

Holsgrove³

et al. 2017

Journal of Orthopaedic & Sports Physical Therapy

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Pain Biomechanics

Crosby¹,

Smith²,

Winkelstein³

2014

Accidental Injury

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Painful injury is a tremendous problem affecting a large proportion of the population during their lifetime. Pain most commonly results from trauma and/or injury, with the spine as the most common injury site for producing chronic pain. This chapter reviews relevant anatomy, mechanics and techniques used to study cervical spine pain in particular, since it is the region most prone to injury and because the largest body of research has been in this region. In vivo, many behavioral assessments exist to functionally measure painful outcomes, with hyperalgesia and allodynia as the two primary classes of behavioral responses. Both provide quantitative measures of pain that relate to the clinical presentation of symptoms. This chapter begins with a brief review of the anatomical tissues that are most at risk for injury and pain generation. This is followed by a review highlighting the cellular and molecular mechanisms of nociception and pain, addressing modifi cations in the periphery and in the central nervous system (CNS). The relationship between injury biomechanics and the local and spinal cellular responses are presented in the context of nociception and pain, with specifi c focus on injury to the facet capsule and nerve root because of their common involvement in cervical spine injury. Lastly, a brief review of experimental methodologies used to study pain biomechanics, ranging from the macroscopic to the cellular and molecular scales, is provided along with contextualization of the relative advantages and limitations of each. A brief summary integrates all of the sections to identify future areas of research that will defi ne a more detailed understanding of pain biomechanics.

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