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Related Experiment Videos

Paraspinal muscles and intervertebral dysfunction: part two.

Gary Fryer1, Tony Morris, Peter Gibbons

  • 1School of Health Science, Victoria University, Melbourne, Australia. gary.fryer@vu.edu.au

Journal of Manipulative and Physiological Therapeutics
|June 15, 2004
PubMed
Summary

Altered paraspinal tissue texture in spinal lesions lacks direct evidence, with complex muscle activity changes, not simple spasms, potentially explaining palpable abnormalities. Further research is recommended.

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Area of Science:

  • Musculoskeletal research
  • Spinal biomechanics
  • Pain science

Background:

  • The concept of altered paraspinal tissue texture is a key diagnostic feature of manipulable spinal lesions, though direct evidence is scarce.
  • While protective muscle spasm is a proposed explanation, studies on low back pain suggest complex motor control changes rather than simple reflexes.

Purpose of the Study:

  • To systematically review existing literature for evidence supporting or refuting explanations for clinically observed paraspinal tissue texture changes.
  • To identify research gaps and provide recommendations for future investigations into spinal manipulation and paraspinal tissues.

Main Methods:

  • Comprehensive literature search of MEDLINE and CINAHL databases using keywords related to paraspinal muscles, palpation, EMG, spine, low back pain, and manipulation.

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  • Inclusion of relevant data from bibliographies of selected articles and textbooks.

    • Main Results:

    • Established evidence shows decreased paraspinal muscle activity and strength in low back pain patients, with multifidus atrophy and altered muscle fiber composition.
    • Research on the impact of spinal manipulation on paraspinal electromyography (EMG) activity is inconclusive but shows promising trends.
    • Disturbances in microcirculation are linked to muscle pain in nonparaspinal regions.

    Conclusions:

    • Limited direct evidence supports the existence or nature of paraspinal tissue texture changes detected via palpation.
    • The hypothesis of segmental reflex paraspinal muscle contraction is not supported, particularly in the context of low back pain.
    • A complex interplay of deep paraspinal muscle inhibition and nonvoluntary guarding behavior likely contributes to palpable tissue changes, warranting further investigation.