On Cervical Zygapophysial Joint Pain After Whiplash

Bogduk, Nikolai

doi:10.1097/brs.0b013e3182387f1d

Cited by 66 publications

(37 citation statements)

References 46 publications

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“…The etiologies of neck pain are often multifactorial and difficult to identify, although trauma accounts for a significant proportion. 5,6 The heterogeneous nature of neck pain translates into inherent challenges in treatment, which has led to concerted efforts to better categorize and classify the symptom. There are numerous ways to classify neck pain, with categorization into neuropathic and nociceptive pain being perhaps the most relevant, as this has treatment implications at multiple levels (eg, medical and surgical therapy, referral patterns).…”

mentioning

confidence: 99%

Classification and Treatment of Chronic Neck Pain

Liu

Kurihara

Tsai

et al. 2017

Regional Anesthesia and Pain Medicine

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mentioning

confidence: 99%

Classification and Treatment of Chronic Neck Pain

Liu

Kurihara

Tsai

et al. 2017

Regional Anesthesia and Pain Medicine

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“…This study used analytical tools from the field of complex systems to investigate the stretch-induced collagen reorganization in the human FCL, as an example of a biological material whose loss of structural integrity may lead to changes in tissue mechanics and cellular responses [4,43]. Fibre alignment maps generated using QPLI were converted into weighted collagen rsif.royalsocietypublishing.org J. R. Soc.…”

Section: Discussionmentioning

confidence: 99%

Stretch-induced network reconfiguration of collagen fibres in the human facet capsular ligament

Zhang

Bassett

Winkelstein

2016

J. R. Soc. Interface.

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Biomaterials can display complex spatial patterns of cellular responses to external forces. Revealing and predicting the role of these patterns in material failure require an understanding of the statistical dependencies between spatially distributed changes in a cell's local biomechanical environment, including altered collagen fibre kinematics in the extracellular matrix. Here, we develop and apply a novel extension of network science methods to investigate how excessive tensile stretch of the human cervical facet capsular ligament (FCL), a common source of chronic neck pain, affects the local reorganization of collagen fibres. We define collagen alignment networks based on similarity in fibre alignment angles measured by quantitative polarized light imaging. We quantify the reorganization of these networks following macroscopic loading by describing the dynamic reconfiguration of network communities, regions of the material that display similar fibre alignment angles. Alterations in community structure occur smoothly over time, indicating coordinated adaptation of fibres to loading. Moreover, flexibility, a measure of network reconfiguration, tracks the loss of FCL's mechanical integrity at the onset of anomalous realignment (AR) and regions of AR display altered community structure. These findings use novel network-based techniques to explain abnormal collagen fibre reorganization, a dynamic and coordinated multivariate process underlying tissue failure.

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“…27,50,56,64 The facet capsular ligament enclosing the bilateral spinal facet joints that provide articulation between adjacent vertebrae in the spine is innervated by both mechanoreceptors and pain-detecting nociceptors. 27,34,47 In particular, biomechanical, animal and clinical studies have identified the cervical facet capsular ligament as a source of pain from neck trauma, 5,36,49,63 owing to its susceptibility to injury during its excessive stretch. 23,49 Although supraphysiologic deformation of the facet capsule induces pain, 6,16,37 the local cellular and molecular mechanisms that translate macroscopic tissue strains to nociceptive signals in afferents are still unknown, hampering the development of effective treatments for facet joint-mediated pain.…”

Section: Introductionmentioning

confidence: 99%

A Nociceptive Role for Integrin Signaling in Pain After Mechanical Injury to the Spinal Facet Capsular Ligament

2017

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Integrins modulate chemically-induced nociception in a variety of inflammatory and neuropathic pain models. Yet, the role of integrins in mechanically-induced pain remains undefined, despite its well-known involvement in cell adhesion and mechanotransduction. Excessive spinal facet capsular ligament stretch is a common injury that induces morphological and functional changes in its innervating afferent neurons and can lead to pain. However, the local mechanisms underlying the translation from tissue deformation to pain signaling are unclear, impeding effective treatment. Therefore, the involvement of the integrin subunit β1 in pain signaling from facet injury was investigated in complementary in vivo and in vitro studies. An anatomical study in the rat identified expression of the integrin subunit β1 in dorsal root ganglion (DRG) neurons innervating the facet, with greater expression in peptidergic than non-peptidergic DRG neurons. Painful facet capsule stretch in the rat upregulated the integrin subunit β1 in small- and medium-diameter DRG neurons at day 7. Inhibiting the α2β1 integrin in a DRG-collagen culture prior to its stretch injury prevented strain-induced increases in axonal substance P (SP) in a dose-dependent manner. Together, these findings suggest that integrin subunit 1-dependent pathways may contribute to SP-mediated pain from mechanical injury of the facet capsular ligament.

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On Cervical Zygapophysial Joint Pain After Whiplash

Abstract: The fact that multiple lines of evidence, using independent techniques, consistently implicate the cervical zygapophysial joints as a site of injury and source of pain, strongly implicates injury to these joints as a common basis for chronic neck pain after whiplash.

Cited by 66 publications

References 46 publications

Classification and Treatment of Chronic Neck Pain

Classification and Treatment of Chronic Neck Pain

Stretch-induced network reconfiguration of collagen fibres in the human facet capsular ligament

A Nociceptive Role for Integrin Signaling in Pain After Mechanical Injury to the Spinal Facet Capsular Ligament

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