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Tension-type headache and low back pain reconsidered

The natural history and clinical course of tension-type headache and non-specific low back pain are reconsidered. By closer examination, these two conditions appear to share several specific clinical features. Both are muscular pain conditions along the spine, they have a preponderance in women, the...

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Detalles Bibliográficos
Autores principales: Astrup, Jens, Gyntelberg, Finn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372361/
https://www.ncbi.nlm.nih.gov/pubmed/35968274
http://dx.doi.org/10.3389/fneur.2022.912348
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author Astrup, Jens
Gyntelberg, Finn
author_facet Astrup, Jens
Gyntelberg, Finn
author_sort Astrup, Jens
collection PubMed
description The natural history and clinical course of tension-type headache and non-specific low back pain are reconsidered. By closer examination, these two conditions appear to share several specific clinical features. Both are muscular pain conditions along the spine, they have a preponderance in women, they may occur spontaneously or follow a trivial traumatic incident, and they both have a high risk of chronicity. The affected muscles are tender with tender points. EMG indicates diffuse hyperactivity and abnormal activation pattern, and motor control of the affected muscles and adjacent muscle groups is discoordinated. These shared features suggest analogous pathophysiology involving the neuromotor control of affected and adjacent muscle groups in the cervical and lumbar regions, respectively. As recently suggested for the whiplash disease, we suggest the term spinal dyssynergia for this specific pattern of pathology. This suggestion provides a new perspective for the understanding of these diseases by placing their cause within the central nervous system and not in the spine or spinal musculature. This perspective warrants further clinical, neurophysiological, and neuropharmacological studies of this ‘family’ of common yet poorly understood clinical muscular pain conditions along the spine.
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spelling pubmed-93723612022-08-13 Tension-type headache and low back pain reconsidered Astrup, Jens Gyntelberg, Finn Front Neurol Neurology The natural history and clinical course of tension-type headache and non-specific low back pain are reconsidered. By closer examination, these two conditions appear to share several specific clinical features. Both are muscular pain conditions along the spine, they have a preponderance in women, they may occur spontaneously or follow a trivial traumatic incident, and they both have a high risk of chronicity. The affected muscles are tender with tender points. EMG indicates diffuse hyperactivity and abnormal activation pattern, and motor control of the affected muscles and adjacent muscle groups is discoordinated. These shared features suggest analogous pathophysiology involving the neuromotor control of affected and adjacent muscle groups in the cervical and lumbar regions, respectively. As recently suggested for the whiplash disease, we suggest the term spinal dyssynergia for this specific pattern of pathology. This suggestion provides a new perspective for the understanding of these diseases by placing their cause within the central nervous system and not in the spine or spinal musculature. This perspective warrants further clinical, neurophysiological, and neuropharmacological studies of this ‘family’ of common yet poorly understood clinical muscular pain conditions along the spine. Frontiers Media S.A. 2022-07-29 /pmc/articles/PMC9372361/ /pubmed/35968274 http://dx.doi.org/10.3389/fneur.2022.912348 Text en Copyright © 2022 Astrup and Gyntelberg. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Astrup, Jens
Gyntelberg, Finn
Tension-type headache and low back pain reconsidered
title Tension-type headache and low back pain reconsidered
title_full Tension-type headache and low back pain reconsidered
title_fullStr Tension-type headache and low back pain reconsidered
title_full_unstemmed Tension-type headache and low back pain reconsidered
title_short Tension-type headache and low back pain reconsidered
title_sort tension-type headache and low back pain reconsidered
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9372361/
https://www.ncbi.nlm.nih.gov/pubmed/35968274
http://dx.doi.org/10.3389/fneur.2022.912348
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