Top

Published in:

01-10-2007 | Letter to the Editor

Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi)

Authors: Robert Schleip, Andry Vleeming, Frank Lehmann-Horn, Werner Klingler

Published in: European Spine Journal | Issue 10/2007

Excerpt

In his article Panjabi gives a concise overview on the current knowledge and understanding of low back and neck pain [12]. He introduces the hypothesis that chronic back pain originates from subfailure injuries of three types of spinal ligamentous structures and their embedded mechanoreceptors: namely the spinal ligaments, the disc annulus and the facet capsules. These injured tissues then send out corrupted transducer signals to the neuromuscular control unit, and as a result corrupted muscle response patterns are generated leading to adverse consequences such as higher stresses, muscle fatigue, further injuries, and inflammation. …

Barker PJ, Briggs CA (1999) Attachments of the posterior layer of lumbar fascia. Spine 24:1757–1764PubMedCrossRef

Barker PJ, Briggs CA, Bogeski G (2004) Tensile transmission across the lumbar fasciae in unembalmed cadavers. Effects of tension to various muscular attachments. Spine 29:129–138PubMedCrossRef

Barker PJ, Guggenheimer KT, Gskovic I et al (2006) Effects of tensioning the lumbar fasciae on segmental stiffness during flexion and extension. Spine 31:397–405PubMedCrossRef

Bednar DA, Orr FW, Simon GT (1995) Observations on the pathomorphology of the thoracolumbar fascia in chronic mechanical back pain. A microscopic study. Spine 20:1161–1164PubMedCrossRef

Flor H (2003) Cortical reorganisation and chronic pain: implications for rehabilitation. J Rehabil Med 41(Suppl):66–72PubMedCrossRef

Flor H, Diers M, Birbaumer N (2004) Peripheral and electrocortical responses to painful and non-painful stimulation in chronic pain patients, tension headache patients and healthy controls. Neurosci Lett 361:147–150PubMedCrossRef

Holt CA, Evans SL, Dillon D et al (2005) Three-dimenional measurement of intervertebral kinematics in vitro using optical motion analysis. Proc Inst Mech Eng [H] 219:393–399

Johnson GM, Zhang M (2002) Regional differences within the human supraspinous and interspinous ligaments: a sheet plastination study. Eur Spine J 11:382–388PubMedCrossRef

Kettler A, Marin F, Sattelmayer G et al (2004) Finite helical axes of motion are a useful tool to describe the three-dimensional in vitro kinematics of the intact, injured and stabilised spine. Eur Spine J 13:553–559PubMedCrossRef

10.

Kojima Y, Maeda T, Arai R et al (1990) Nerve supply to the posterior longitudinal ligament and the intervertebral disc of the rat vertebral column as studied by acetylcholinesterase histochemistry. II. Regional differences in the distribution of the nerve fibres and their origins. J Anat 169:247–255PubMed

11.

Little JS, Khalsa PS (2005) Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain. Ann Biomed Eng 33:391–401PubMedCrossRef

12.

Panjabi MM (2006) A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J 15:668–676PubMedCrossRef

13.

Prestar FJ (1982) Morphology and function of the interspinal ligaments and the supraspinal ligament of the lumbar portion of the spine. Morphol Med 2:53–58PubMed

14.

Sakada S (1974) Mechanoreceptors in fascia, periosteum and peridontal ligament. Bull Tokyo Med Dent Univ 21(Suppl):11–13PubMed

15.

Schleip R, Naylor IL, Ursu D et al (2006) Passive muscle stiffness may be influenced by active contractility of intramuscular connective tissue. Med Hypotheses 66:66–71PubMedCrossRef

16.

Schleip R, Klingler W, Lehmann-Horn F (2004) Active contraction of the thoracolumbar fascia—indications of a new factor in low back pain with implications for manual therapy. In: Vleeming A, Mooney V, Hodges P (eds) Proceedings of the 5th interdisciplinary world congress on low back and pelvic pain, Melbourne, pp 319–321

17.

Schleip R, Klingler W (2006) Is fascia able to contract and relax in a smooth muscle-like manner and thereby influence musculoskeletal dynamics? In: Remvig L, Beyer L, Vacek J (eds) Proceedings of the 1st FIMM international academy conference, Leipzig, pp 19–20

18.

Sekine M, Yamashita T, Takebayashi T et al (2001) Mechanosensitive afferent units in the lumbar posterior longitudinal ligament. Spine 26:1516–1521PubMedCrossRef

19.

Soyka D, Haase C, Lindner V et al (1996) Forgotten pain. Schmerz 10:36–39PubMedCrossRef

20.

Stillwell DL (1957) Regional variations in the innervation of deep fasciae and aponeuroses. Anat Rec 127:635–648CrossRef

21.

Tanaka S, Ito T (1977) Histochemical demonstration of adrenergic fibers in the fascia periosteum and retinaculum. Clin Orthop Relat Res 126:276–281PubMed

22.

Tesh KM, Dunn JS, Evans JH (1987) The abdominal muscles and vertebral stability. Spine 12:501–508PubMedCrossRef

23.

Vleeming A, Pool-Goudzwaard AL, Stoeckart R et al (1995) The posterior layer of the thoracolumbar fascia. Spine 20:753–758PubMedCrossRef

24.

Vshivtseva VV, Lesova LD (1985) Features of the innervation of fascia and their microcirculatory bed in the rat. Arkh Anat Gistol Embriol 88:16–22PubMed

25.

Willard FH (1997) The muscular, ligamentous and neural structure of the low back and its relation to back pain. In: Vleeming A (ed) Movement, stability and low back pain. The essential role of the pelvis. Churchill Livingstone, New York, pp 3–35

26.

Yahia LH, Pigeon P, DesRosiers EA (1993) Viscoelastic properties of the human lumbodorsal fascia. J Biomed Eng 15:425–429PubMedCrossRef

27.

Yahia L, Rhalmi S, Newman N, Isler M (1992) Sensory innervation of human thoracolumbar fascia. An immunohistochemical study. Acta Orthop Scand 63:195–197PubMedCrossRef

28.

Yamashita T, Cavanaugh JM, el-Bohy AA et al (1990) Mechanosensitive afferent units in the lumbar facet joint. J Bone Joint Surg Am 72:865–870PubMed

Title: Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi)
Authors: Robert Schleip
Andry Vleeming
Frank Lehmann-Horn
Werner Klingler
Publication date: 01-10-2007
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 10/2007
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-006-0298-2

At a glance: The STEP trials

Springer Medicine

Letter to the Editor concerning “A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction” (M. Panjabi)

Excerpt

At a glance: The STEP trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 10/2007

BIOSPINE 2: 2nd International Congress, Biotechnologies for Spinal Surgery, Leipzig, Germany, 20–22 September, 2007

Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain

Scoliosis associated with syringomyelia: analysis of MRI and curve progression

Inter- and intraobserver reliability assessment of the Cobb angle: manual versus digital measurement tools

Concave rib osteotomy: a modified technique revisited

Letter to the Editor concerning “Infrahyoid muscle flap for pharyngeal fistulae after cervical spine surgery: a novel approach—report of six cases” (by R.O. Seidl et al.)