Sensory findings after stimulation of the thoracolumbar fascia with hypertonic saline suggest its contribution to low back pain, 2013
Topics: fascia, low back pain, thoracolumbar fascia, erector spinae muscle, hypertonic saline, peripheral sensitization
Authors: Andreas Schilder, Ulrich Hoheisel, Walter Magerl, Justus Benrath, Thomas Klein and Rolf-Detlef Treede
Injection of hypertonic saline into deep tissues of the back (subcutis, muscle, or the surrounding fascia) can induce acute low back pain (LBP). So far, no study has analyzed differences in temporal, qualitative, and spatial pain characteristics originating from these tissues. The current study aimed to investigate the role of the thoracolumbar fascia as a potential source of LBP. In separate sessions, 12 healthy subjects received ultrasound-guided bolus injections of isotonic saline (0.9%) or hypertonic saline (5.8%) into the erector spinae muscle, the thoracolumbar fascia (posterior layer), and the overlying subcutis. Subjects were asked to rate pain intensity, duration, quality, and spatial extent. Pressure pain thresholds were determined pre and post injection. Injections of hypertonic saline into the fascia resulted in significantly larger area under the curve of pain intensity over time than injections into subcutis (P
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