Painful disorders of muscle

Ja, Morgan-Hughes

doi:10.1016/b978-0-407-00308-8.50032-x

Contemporary Neurology 1984

DOI: 10.1016/b978-0-407-00308-8.50032-x

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Painful disorders of muscle

Morgan-Hughes Ja

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Cited by 9 publications

(1 citation statement)

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“…Muscle pain is perceived following stimulation of muscle pain receptors (nociceptors), and can be a consequence of muscle cell destruction, involvement of intramuscular blood vessels, or defective energy metabolism, as found in painful myopathies (Mills and Edwards, 1983; Morgan-Hughes, 1987). Owing to their carcinogenic nature, other PKC activators such as the phorbol esters have not been investigated in humans.…”

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confidence: 99%

Bryostatin 1, a novel antineoplastic agent and protein kinase C activator, induces human myalgia and muscle metabolic defects: a 31P magnetic resonance spectroscopic study

Hickman

Kemp²,

Thompson³

et al. 1995

Br J Cancer

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Summary Bryostatin 1, a novel antineoplastic agent and protein kinase C (PKC) activator, has been found to induce myalgia (muscle pain) 48 h after administration in clinical trials. This is the dose-limiting toxicity and has restricted the duration of therapy in phase I trials. To investigate the mechanisms and try to increase toleration of the drug, we studied calf muscle metabolism of 14 patients at rest and during exercise and subsequent recovery using 31P magnetic resonance spectroscopy (MRS) before and 4 h, 48 -72 h and 1-2 weeks following bryostatin therapy. In resting muscle there was a significant (P<0.001) increase in the phosphodiester/adenosine 5'-triphosphate (PDE/ATP) ratio 48 h post bryostatin and in patients with myalgia compared with pre-bryostatin control studies. Following exercise, patients with myalgia showed significantly slower phosphocreatine (PCr) and ADP recovery half-time (P <0.05) suggesting impaired mitochondrial (oxidative) energy production, possibly due to a direct effect on the mitochondria or secondary to reduced blood flow. The apparent proton efflux rate following exercise was significantly reduced 4 h after bryostatin (P <0.05), suggesting reduced blood flow. The rate of post-exercise reoxygenation was studied in four patients by near-infrared spectroscopy 4 h post bryostatin. In three of these the rate was reduced, consistent with reduced muscle blood flow. Bryostatin 1 appeared to cause a long-lasting impairment of oxidative metabolism and proton washout from muscle, consistent with a vasoconstrictive action. Thus these studies provide evidence for two mechanisms of the dose-limiting toxicity for bryostatin. Prospective studies on the use of vasodilators to improve the tolerance of the drug should be carried out.

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mentioning

confidence: 99%

Bryostatin 1, a novel antineoplastic agent and protein kinase C activator, induces human myalgia and muscle metabolic defects: a 31P magnetic resonance spectroscopic study

Hickman

Kemp²,

Thompson³

et al. 1995

Br J Cancer

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Occupational musculoskeletal stress and disorders of the neck and shoulder: a review of possible pathophysiology

Hagberg

1984

Int. Arch Occup Environ Heath

156

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Disorders and complaints in the neck and shoulder regions are common among industrial workers and are often attributed to occupational musculoskeletal stress. The possible pathophysiological mechanism of occupational stress on the neck and shoulders is reviewed. A mechanical origin for cervical disc degeneration and osteoarthrosis is reported for a few occupational groups. However, a mechanical origin for osteoarthrosis is debatable. A work posture involving elevated arms may accelerate degeneration of shoulder tendons through impairment of circulation due to static tension and humeral compression against the coracoacromial arch. Furthermore, work tasks with repetitive arm movements may evoke shoulder tendinitis or tendo-vaginitis, probably due to friction. Three possible routes to neck-shoulder muscular pain are discussed; mechanical failure, local ischemia and energy metabolism disturbance.

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Pathological mechanisms implicated in localized female trapezius myalgia

Kadi

Waling

Ahlgren

et al. 1998

Pain

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Myalgia localized to the neck and shoulder in women is a growing problem both in the general population and in the industrial world. The aim of this study was to investigate the mechanisms involved in work-related myalgia. In 21 women (age, 38.7+/-5.5 years), muscle biopsies were obtained from the upper part of the trapezius and the morphologic and metabolic characteristics of muscle fibres were analyzed. The patients indicated the number of painful areas on a pain drawing and the intensity of pain was assessed using a visual analogue scale (VAS). Two groups were formed on the basis of the median values: lower pain level and higher pain level. Trapezius muscles were characterized by the large size of type I fibres and the low capillary to fibre area ratio for both type I and type IIA fibres. Patients with the highest pain scores had the lowest capillary to fibre area ratio for type I fibres (coefficient correlation r = -0.45 and P < 0.05). Moreover, the proportion of cytochrome c oxidase (COX)-negative fibres seen in the cross-sections was significantly higher in the group of patients which had the higher pain and more painful areas than in the group of patients with lower pain level and painful areas (P < 0.05). The significant increase (P < 0.05) of the size of the type I fibres in trapezius myalgia point to the special strain imposed upon type I muscle fibres during work tasks. Cytochrome oxidase c deficiency which is indicative of an energy crisis within muscle cells and the low capillary to fibre area ratio which might impair oxygen delivery and removal of metabolites in the working muscles are both associated with pain in the trapezius muscle.

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Painful disorders of muscle

Cited by 9 publications

References 48 publications

Bryostatin 1, a novel antineoplastic agent and protein kinase C activator, induces human myalgia and muscle metabolic defects: a 31P magnetic resonance spectroscopic study

Bryostatin 1, a novel antineoplastic agent and protein kinase C activator, induces human myalgia and muscle metabolic defects: a 31P magnetic resonance spectroscopic study

Occupational musculoskeletal stress and disorders of the neck and shoulder: a review of possible pathophysiology

Pathological mechanisms implicated in localized female trapezius myalgia

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