Paravertebral Muscle Mechanical Properties and Spinal Range of Motion in Patients with Acute Neck or Low Back Pain: A Case-Control Study

Abstract

Our aims were to identify potential differences in muscle mechanical properties (MMPs) of cervical and lumbar tissues and in spinal range of motion (ROM) between patients with acute low back pain (LBP) or acute neck pain (NP) and healthy controls, and to identify if ROMs and MMPs are able to identify subjects among the three groups. Clinical variables (pain, disability, fear of movement, kinesiophobia, quality of life), MMPs and ROMs were obtained in 33 subjects with acute LBP, 33 with acute NP, and 33 healthy control subjects. Between-groups differences and explanatory models to discriminate groups depending on MMPs and ROMs were calculated. The results showed that cervical tone was higher in patients with acute NP than in controls, while cervical decrement was higher in both spinal pain groups. Patients with acute NP showed reduced cervical flexion when compared to acute LBP and control groups, and also cervical rotation, but just against controls. Furthermore, lumbar flexion was reduced in patients with acute LBP when compared to those with acute NP. Cervical decrement was able to discriminate spinal pain individuals from controls in a multinominal regression (R2: Cox–Snell estimation = 0.533; Nagelkerke estimation = 0.600). Lumbar flexion differentiated patients with acute LBP and controls, whereas cervical flexion differentiated patients with acute NP and controls. This study supports a tendency of the affectation of other spinal regions when only one is affected.

Mechanical Properties of Lumbar and Cervical Paravertebral Muscles in Patients with Axial Spondyloarthritis: A Case-Control Study

“…Our results are in line with previous studies that showed higher lumbar myofascial stiffness as a physical sign in AS patients [ 6 ] or in axSpA patients [ 15 , 32 ]. In fact, the current results showed higher tone, stiffness and decrement (linear elastic properties), and lower relaxation and creep (viscoelastic properties) for the axSpA patients than those reported for young asymptomatic subjects [ 14 ] and for acute spinal pain patients [ 15 ]. Therefore, axSpA increases lumbar and cervical muscle tone, which keeps increasing as the disease progresses [ 32 ].…”

“…For cervical muscles, it was identified that there is a consistent relationship between age, decrement and stiffness in healthy women [ 37 ], and also in mechanical cervical and lumbar pain [ 15 ] in our data of axSpA patients. This relationship was stronger than the relationship between decrement and stiffness with BMI and head posture.…”

“…This pattern found a pooled reflex in the linear regression analysis of our study that produced moderate to good fitted models (0.328 < R 2 < 0.697) for estimation of cervical and lumbar MMPs, mainly in the lumbar region. Again, the most significant variables introduced in the models were age, probably associated with the loss of skeletal muscle mass that occurs with advancing time [ 15 ], and conventional metrology. In addition to these, activity of the disease, as occurred in cervical decrement and lumbar frequency, and function, being the case of lumbar relaxation and creep, were included in the models.…”

“…Furthermore, the relationship between paraspinal muscle alterations with pain and a worse prognosis has also been described in chronic low back pain [ 41 ], probably due to the continuous activity of paraspinal muscles in the lumbopelvic biomechanics. These approaches increase the relevance of assessing the MMPs as a possible marker of the axSpA status and progression, as proposed in low back pain [ 15 ].…”

“…In this sense, MyotonPro© is a handheld device used to measure muscle mechanical properties in different research and clinical fields, including sports performance [ 10 ], stroke patients [ 11 ], polymeric gel-based tissue phantoms [ 12 ] and Parkinson’s disease [ 13 ]. The device has recently shown good results in characterizing the paravertebral mechanical features when applied to asymptomatic [ 14 ] patients with cervical and lumbar spinal pain [ 15 ]. Through the application of mechanical stimuli, this device allows one to measure: (a) tone or state of tension, as the natural oscillation frequency; (b) biomechanical properties, such as dynamic stiffness and logarithmic decrement of natural oscillation, which is inverse to the overall elasticity of the tissue; (c) viscoelastic properties, such as mechanical stress relaxation time and the ratio of deformation and relaxation time, characterizing creep (Deborah number).…”