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Paraspinal muscles and intervertebral dysfunction: part one.

Gary Fryer¹, Tony Morris, Peter Gibbons

¹School of Health Science, Victoria University, City Campus, PO Box 14428 MCMC, Melbourne 8001, Australia. gary.fryer@vu.edu.au

Journal of Manipulative and Physiological Therapeutics

|May 19, 2004

Summary

Altered spinal tissue texture is a diagnostic sign, but its exact nature is unclear. While reactive muscle contraction is plausible, increased muscle activity in low back pain is complex, not a simple reflex.

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Area of Science:

Musculoskeletal research
Spinal biomechanics
Manual therapy

Background:

Altered paraspinal tissue texture is a characteristic of spinal lesions.
Hypotheses suggest this may involve deep segmental muscle overactivity.

Purpose of the Study:

Review literature on detecting and understanding paraspinal tissue texture changes.
Examine explanations for these changes and evidence for muscle spasm/dysfunction in low back pain (LBP).

Main Methods:

Searched MEDLINE and CINAHL databases for relevant studies.
Used keywords related to paraspinal muscles, palpation, EMG, spine, LBP, and manipulation.
Included literature reviews and textbook references.

Main Results:

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Limited direct evidence exists on the nature of abnormal paraspinal tissue texture.
Palpation for tenderness is more reliable than for texture changes.
Increased paraspinal EMG in LBP results from complex motor control changes, not just a protective reflex.

Conclusions:

The concept of reactive muscle contraction is plausible, despite limited direct evidence.
Increased paraspinal EMG activity in LBP is not explained by a simple protective reflex.