Low back pain

Knezevic, Nebojsa Nick; Candido, Kenneth D.; Vlaeyen, Johan W. S.; Zundert, Jan Van; Cohen, Steven P.

doi:10.1016/s0140-6736(21)00733-9

Cited by 676 publications

(562 citation statements)

References 145 publications

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“…Published guidelines have proposed non-pharmacological approaches such as exercise and physical therapy (massage, acupuncture, spinal manipulative therapy) as first-line treatments for lower back pain primarily due to concerns about the risk-benefit ratio of opioids and suboptimal opioid-related results in clinical trials [65][66][67]. A major gap in LBP research includes the contribution of musculoskeletal tissues (unspecialized muscles and connective tissues) in the lower back of the spine [68].…”

Section: Clinical Perspectives and Future Directionsmentioning

confidence: 99%

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Sinhorim

Amorim

Ortiz

et al. 2021

JCM

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Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over the past few decades; however, these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting lower back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane, and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies satisfied the following: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, after which data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met the inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in lower back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Additional knowledge of fascial neurological components could impact LBP treatment.

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Section: Clinical Perspectives and Future Directionsmentioning

confidence: 99%

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Sinhorim

Amorim

Ortiz

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Published guidelines have proposed non-pharmacological approaches such as exercise and physical therapy (massage, acupuncture, spinal manipulative therapy) as first-line treatments for low back pain due primarily to concerns about the risk-benefit ratio of opioids and suboptimal opioid-related results in clinical trials [61][62][63]. A major gap in LBP research includes the contribution of musculoskeletal tissues (unspecialized muscles and connective tissues) in the lower back of the spine [64].…”

Section: Clinical Perspectives and Future Directionsmentioning

confidence: 99%

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving in Vivo and Ex Vivo Studies

Sinhorim

Amorim

Ortiz

et al. 2021

Preprint

View full text Add to dashboard Cite

Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over decades, however these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting low back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies were: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in low back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Greater knowledge of fascial neurological components could impact LBP treatment.

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“…Low back pain (LBP) is the pathology that most contributes to the years lived with disability [21,22]. Its estimated prevalence in 2017 was about 577 million people [4,23], and more than 90% of the total LBP cases corresponds to unspecific mechanical LBP [24,25].…”

Section: Introductionmentioning

confidence: 99%

“…It has been described that muscle alterations may be an underestimated source of spinal pain [22] and that muscle physiology determines optimal spinal performance [30]. Indeed, excessive spinal muscle use or disuse is a well-known source of pain [35].…”

Section: Introductionmentioning

confidence: 99%

Paravertebral Muscle Mechanical Properties in Patients with Axial Spondyloarthritis or Low Back Pain: A Case-Control Study

et al. 2021

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Different musculoskeletal disorders are a source of pain in the spinal region; most of them can be divided into mechanical, such as low back pain (LBP), or inflammatory origins, as is the case of axial spondyloarthritis (axSpA). Nevertheless, insufficient information is available about the muscle negative consequences of these conditions. Thus, the objective of this study was to identify whether mechanical muscle properties (MMPs) of cervical and lumbar muscles are different between patients with axSpA, subacute LBP (sLBP), and healthy controls. Furthermore, we aimed identify whether MMPs were related to sociodemographic and clinical variables in various study groups. The MMPs, sociodemographic, and clinical variables were obtained in 43 patients with axSpA, 43 subjects with sLBP, and 43 healthy controls. One-way ANOVAs and ROC curves were applied to identify whether the MMPs could differentiate between the study groups. Intra-group Pearson r coefficients to test the associations between MMPs and the rest of the variables were calculated. The results showed that axSpA subjects have a higher tone and stiffness and a lower relaxation and creep than sLBP and healthy ones (p < 0.05). All lumbar and cervical MMPs, except for decrement, could correctly classify axSpA and healthy subjects and axSpA and sLBP patients (in both cases, Area Under the Curve > 0.8). However, no MMP could differentiate between sLBP and healthy subjects. Each group had a different pattern of bivariate correlations between MMPs and sociodemographic and clinical data, with a worse state and progression of the axSpA group associated with a higher tone and stiffness in both spinal regions. This study supports that MMPs are different and show different patterns of correlations depending on the type of spinal pain.

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Low back pain

Cited by 676 publications

References 145 publications

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving in Vivo and Ex Vivo Studies

Paravertebral Muscle Mechanical Properties in Patients with Axial Spondyloarthritis or Low Back Pain: A Case-Control Study

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