The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review

Wilke, Jan; Schleip, Robert; Klingler, Werner; Stecco, Carla

doi:10.1155/2017/5349620

Cited by 95 publications

(77 citation statements)

References 37 publications

(31 reference statements)

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“… 58 The fascial tissue that loses part of its ability to slide could create adhesions to the tissues it comes into contact with, further stimulating the nociceptive fascial afferences. 49 We have no data on the adaptation of the endothoracic fascia in patients with COPD, but we can suppose, considering scientific elements coming from other body areas, that this deep structure could be one of the sources of the chronic pain perceived by patients.…”

Section: Thoracic Pain: Possible Fascial Somatic Causesmentioning

confidence: 99%

Chest pain in patients with COPD: the fascia’s subtle silence

Bordoni

Marelli²,

Bruno

et al. 2018

COPD

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COPD is a progressive condition that leads to a pathological degeneration of the respiratory system. It represents one of the most important causes of mortality and morbidity in the world, and it is characterized by the presence of many associated comorbidities. Recent studies emphasize the thoracic area as one of the areas of the body concerned by the presence of pain with percentages between 22% and 54% in patients with COPD. This article analyzes the possible causes of mediastinal pain, including those less frequently taken into consideration, which concern the role of the fascial system of the mediastinum. The latter can be a source of pain especially when a chronic pathology is altering the structure of the connective tissue. We conclude that to consider the fascia in daily clinical activity may improve the therapeutic approach toward the patient.

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Section: Thoracic Pain: Possible Fascial Somatic Causesmentioning

confidence: 99%

Chest pain in patients with COPD: the fascia’s subtle silence

Bordoni

Marelli²,

Bruno

et al. 2018

COPD

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“…The presence of nociceptive fibers in fascial tissue has recently been demonstrated: Mense and Hoheisel showed evidence of nociceptors in rat thoracolumbar fascia 17 and Taguchi and coauthors demonstrated that peptidergic and non‐peptidergic axons of unmyelinated C‐fibers with nerve terminals are distributed in the rat crural fascia 18 . These findings help to explain the non‐specific low back pain from a pathologically altered thoracolumbar fascia 19,20 . However it is still not clear whether other fasciae also play a role as pain generators and to what extent they are decisive when compared with other tissues 21 .…”

Section: Introductionmentioning

confidence: 98%

Fascia and soft tissues innervation in the human hip and their possible role in post‐surgical pain

Fede

Porzionato

Petrelli

et al. 2020

Journal Orthopaedic Research

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Persistent symptoms, most commonly pain, may remain after otherwise successful hip replacement surgery. Innervation of fascia and soft tissues has become increasingly important in etiopathogenesis of pain, but the relative importance of the various anatomical structures in the hip region is still not known. Innervation of skin, superficial adipose tissue, superficial fascia, deep adipose tissue, deep fascia, muscles, capsule, capsule ligament, ligamentum teres, and tendon in the human hip from 11 patients and 2 cadavers were quantified by staining with anti‐S100 antibody for myelin‐forming Schwann cells, to obtain the percentage of antibody positivity, density and mean diameter of the nerve fibers. The skin was the most highly innervated (0.73% ± 0.37% of positive area in patients; 0.80% ± 0.28% in cadavers); the tendon was the least innervated (0.07% ± 0.01% in patients, 0.07% ± 0.007% in cadavers). The muscles (vasto‐lateral and gluteus medius) were the second most innervated structure according the percentage (0.31% ± 0.13% in living humans, 0.30% ± 0.07% in cadavers), but with only a few nerves, with large diameters (mean diameter 36.4 ± 13.4 µm). Instead, the superficial fasciae showed 0.22% ± 0.06% and 0.26% ± 0.05% of positive areas in living humans and cadavers, respectively. Fasciae were invaded by networks of small nerve fibers, revealing a possible role in pain. The superficial fascia was the second most highly innervated tissue after the skin, with a density of 33.0 ± 2.5/cm2, and a mean nerve sizes of 19.1 ± 7.2 µm. Lastly, the capsule turned out to be poorly innervated (0.09%), showing that its removal does not necessarily lead to painful consequences. Statement of clinical significance: Deeper knowledge about the innervation of the soft tissue in the human hip joint will enhance study and understanding of the best surgical procedures to follow during hip arthroplasty to reduce post‐operative pain.

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“…They play an important role in maintaining spinal stability and transmitting 1 – 3 . Studies have demonstrated that the increase of thoracolumbar fascia (TLF) hardness is associated with low back pain (LBP) 4 , 5 . However, the elastic properties of TLF lack specific vivo numerical data.…”

Section: Introductionmentioning

confidence: 99%

Reliability of shear-wave elastography in assessing thoracolumbar fascia elasticity in healthy male

Chen

Zhao

Liao

et al. 2020

Sci Rep

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The objectives of this study were to examine the intra and inter-operator reliability of shear wave elastography (SWE) device in quantifying the shear modulus of thoracolumbar fascia (TLF) and the device’s abilities to examine the shear modulus of the TLF during upper body forward. Twenty healthy male subjects participated in this study (mean age: 18.4 ± 0.7 years). Two independent operators performed the shear modulus of TLF during upper body forward using SWE, and interclass correlation coefficient (ICC) and minimum detectable change (MDC) were calculated. The shear modulus of the TLF was quantified by operator A using SWE at upper body forward 60°. The intra-operator (ICC = 0.860–0.938) and inter-operator (ICC = 0.904–0.944) reliabilities for measuring the shear modulus of the TLF with the upper body forward 0° were rated as both excellent, and the MDC was 4.71 kPa. The TLF shear modulus of upper body forward 60°was increased 45.5% (L3) and 55.0% (L4) than that of upper body forward 0°. The results indicate that the SWE is a dependable tool to quantify the shear modulus of TLF and monitor its dynamic changes. Therefore, this device can be used for biomechanical study and intervention experiments of TLF.

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The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review

Cited by 95 publications

References 37 publications

Chest pain in patients with COPD: the fascia’s subtle silence

Chest pain in patients with COPD: the fascia’s subtle silence

Fascia and soft tissues innervation in the human hip and their possible role in post‐surgical pain

Reliability of shear-wave elastography in assessing thoracolumbar fascia elasticity in healthy male

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The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review

Cited by 95 publications

References 37 publications

Chest pain in patients with COPD: the fascia&rsquo;s subtle silence

Chest pain in patients with COPD: the fascia&rsquo;s subtle silence

Fascia and soft tissues innervation in the human hip and their possible role in post‐surgical pain

Reliability of shear-wave elastography in assessing thoracolumbar fascia elasticity in healthy male

Contact Info

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Chest pain in patients with COPD: the fascia’s subtle silence

Chest pain in patients with COPD: the fascia’s subtle silence