Paraspinal muscles and intervertebral dysfunction: part one.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanistic, animal, and clinical literature without systematic appraisal.
PubMed 15148466 · doi:10.1016/j.jmpt.2004.02.006
What was done
The author reviewed literature from MEDLINE, CINAHL, bibliographies, and textbooks on the nature and detection of altered paraspinal tissue texture, explanations for muscle spasm, and electromyographic (EMG) paraspinal dysfunction in low back pain (LBP).
What was found
No quantitative data, sample sizes, or effect estimates were reported in the abstract. The review found little direct evidence explaining the nature of palpatory tissue texture changes. Palpation for tenderness was reported to be more reliable than palpation for tissue texture change. Indirect evidence from animal models and experimental inflammation supports the plausibility of reactive muscle contraction, while increased paraspinal EMG activity in LBP reflects voluntary and nonvoluntary motor control changes modified by psychophysiological stress rather than a simple protective reflex.
Why it matters
Manual therapists frequently use palpatory tissue texture changes to guide spinal manipulation. This review highlights that such palpatory signs lack direct evidence of their underlying pathology and that paraspinal muscle hyperactivity is driven by complex neuromuscular and stress adaptations.
Limits
As a narrative review, systematic search protocols, inclusion criteria, and formal risk-of-bias assessments are absent. The abstract provides no quantitative metrics or counts of included studies and relies heavily on indirect animal models rather than direct human pathology.
Cited by
- context Muscle spasms often occur to provide artificial stability as a protective mechanism for an area of underlying muscular weakness.