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Pathophysiology of upper extremity muscle disorders
Bart Visser1, Jaap H van Dieën
1Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, The Netherlands.
Summary
Upper extremity muscle disorders (UEMDs) may stem from sustained muscle activity and impaired circulation. While several mechanisms are proposed, none fully explain UEMD development, suggesting additional factors like sensitization are involved.
Area of Science:
- Orthopedics
- Neurology
- Sports Medicine
Background:
- Upper extremity muscle disorders (UEMDs) are common but their pathophysiology remains incompletely understood.
- Existing literature suggests muscle cell dysfunction and impaired local circulation contribute to UEMDs.
Purpose of the Study:
- To review and synthesize current literature on the pathophysiology and pathogenesis of UEMDs.
- To identify and evaluate proposed mechanisms underlying UEMD development.
Main Methods:
- A comprehensive literature review was conducted.
- Clinical findings and etiological hypotheses for UEMDs were analyzed.
Main Results:
- Multiple potential mechanisms for UEMDs were identified, including motor unit recruitment, intracellular calcium accumulation, impaired blood flow, myofascial force transmission, and trigger points.
- No single hypothesis adequately explains the full spectrum of UEMDs, indicating a multifactorial etiology.
- Sustained muscle activity, particularly of type I motor units, is implicated as a primary cause.
Conclusions:
- UEMDs likely result from a combination of factors, including muscle cell changes, altered blood flow, and potentially central sensitization.
- Further research with robust empirical data is needed to elucidate the precise mechanisms driving UEMD pathogenesis.