Comparison of location, depth, quality and intensity of experimentally induced pain in six low back muscles

Tucker, Kylie J., Fels, Matthew, Walker, Scott R. and Hodges, Paul W. (2014) Comparison of location, depth, quality and intensity of experimentally induced pain in six low back muscles. Clinical Journal of Pain, 30 9: 800-808. doi:10.1097/AJP.0000000000000026

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Author Tucker, Kylie J.
Fels, Matthew
Walker, Scott R.
Hodges, Paul W.
Title Comparison of location, depth, quality and intensity of experimentally induced pain in six low back muscles
Journal name Clinical Journal of Pain   Check publisher's open access policy
ISSN 0749-8047
Publication date 2014
Year available 2013
Sub-type Article (original research)
DOI 10.1097/AJP.0000000000000026
Open Access Status
Volume 30
Issue 9
Start page 800
End page 808
Total pages 9
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2014
Language eng
Formatted abstract
The pattern of pain originating from experimentally induced low-back pain appears diffuse. This may be because: sensory information from low-back muscles converges; sensory innervation extends over multiple vertebral levels; or people have difficulty accurately representing the painful location on standardised pain maps. We aimed to provide insight into the perception of pain from noxious stimulation of a range of low-back muscles using novel depth and location measures. Hypertonic saline (1 mL, 7%NaCl) was injected into bellies of longissimus (LO), quadratus lumborum (QL), superficial (SM) and deep multifidus (DM) at the level of the 4th lumbar vertebrae (L4) and in SM and DM at L5, using ultrasound guidance, over 6 sessions. Fifteen participants reported depth, location, intensity, size and descriptive quality of pain throughout the painful period (~14 min). Pain was reported deeper (P<0.04) for DML4/5 than SML4/5, LO and QL; more cranial for LO than DML4 and QL (P<0.01); more lateral for LO than DML4 (P<0.02) and for QL than all other muscles at L4 (P<0.0001). Pain intensity was higher in DML4/L5 than all other muscles (P<0.04) for ~3 minutes. Descriptive qualities varied little between muscles. Parameters such as depth and lateral position may be the most critical descriptors to determine the source of acute lumbar muscular pain. Overlapping regions of pain may be explained by convergence of receptive fields, innervation of multifidus fascicles at multiple lumbar segments and convergence of sensory input from different muscles to the same sensory cell bodies as demonstrated in the lumbar spine of animal preparations.
Keyword Low back pain
Hypertonic saline
Quadratus lumborum
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
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Created: Thu, 20 Mar 2014, 11:26:21 EST by Professor Paul Hodges on behalf of School of Health & Rehabilitation Sciences