Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Segmental Radiculopathic Model and Stimulation Therapy

분절성 신경근병성 모델과 자극요법

  • Ahn, Kang (Chrolic Pain Center, Kang nam CHA Hospital, CHA University) ;
  • Lee, Young-Jin (Chrolic Pain Center, Kang nam CHA Hospital, CHA University)
  • 안강 (포천중문의대 강남차병원 만성통증클리닉) ;
  • 이영진 (포천중문의대 강남차병원 만성통증클리닉)
  • Published : 2003.12.01
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Abstract

Although painful conditions of varying degrees of severity involving the soft tissues (i .e., muscles, tendons, ligaments, periosteum and peripheral nerves) occur frequently, their underlying pathogenesis is poorly understood. The term peripheral neuropathic pain has recently been suggested to embrace the combination of positive and negative symptoms in patients whose pain is due to pathological changes or dysfunction in peripheral nerves or nerve root. The spinal nerve root, because of its vulnerable position, is very easily prone to injury from pressure, stretch, angulation, and friction. Therefore, not a few of musculoskeletal chronic pains are result of nerve root dysfunction. Neuropathic changes due to nerve root dysfunction are primarily in soft tissue especially muscle, tendon and joint. It shows tenderness over muscle motor points and palpable muscle contracture bands and restricted Joint range. Careful palpation and physical examination is the important tool that, be abne to detect all of these phenomena.

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References

  1. Gunn CC: Radiculopathic pain: Diagnosis & Treatment of segmental irritation or sensitization. J Musculoskeletal pain 1998;6(4):117-118. https://doi.org/10.1300/J094v06n04_11
  2. Fields HL: Pain.1st Ed. New York, McGraw-Hill. 1978, pp90-1.
  3. Meyer RA; Campbell JN; Raja SN: Peripheral neural mechanisms of cutaneous hyperalgesia: In: advances in pain research and therapy, Raven Press,. 1985;9:53-71.
  4. Kellgren JH: On the distribution of pain arising from deep somatic structures with charts of segmental pain areas. Clin Sei 1939;4:35-41
  5. Kellgren JH: Observations on referred pain arising from muscle. Clin Sci 1937;3:176-182.
  6. Le Bars D, Willer JC, de Broncker T, Villanneva L: Neurophysiological mechanisms involved in the pain-relieving effects of counterirritation and related techniques including AP. Scientific bases of AP, Heidelberg, 1989, pp79-105.
  7. Russell A, Scudds AR: Sphenopalatine ganglion block: the final gate to switching off pain. J Musculoskel Pain 1994;2:137-141.
  8. Murray M: Spinal Cord.: Philadelphia, JB Lippincott Co. 1995, pp197-209.
  9. Waxman GS, De Groot J: Correlative neuroanatomy. USA, Appleton & Lange. 1995, pp45-68.
  10. Hammermeister EK: Cardiac and aortic pain. The management of pain, 2nd ed. Edited by Bonica J. Philadelphia. Lea & Febiger, 1990, 2:1001-1016.
  11. Fields HL: Chapter 67, Peripheral neuropathic pain. Textbook of Pain, 4th ed. Churchill Livingstone. 1999, pp1523-1533.
  12. Olmarker K, Rydevik B, Hansson T, Holm S: Compression-induced changes of the nutritional supply to the porcine cauda equina. J Spinal Disord 1990;3:25-29.
  13. Fidone E: Physiology of the nervous system, Chapter 14, Sensory-motor integration at the segmental level. 2nd ed. Chicago, Year book medical publisher. 1975, pp180-193.
  14. Devor M, Rappaport ZH: Pain and pathophysiology of damaged nerve. Pain syndromes in neurology. Edited by Fields HL, Oxford. Butterworth Heinemann. 1990, 47-83.
  15. Raza SN: Chapter 1, Peripheral neural mechanisms of nociception. Textbook of pain. 4th ed., Churchill livingstone, 1999, pp11-39.
  16. Asbury F: Pain due to peripheral nerve damage: An Hypotheses. Neurology 1984;34:1587-90. https://doi.org/10.1212/WNL.34.12.1587
  17. Gunn CC: Neuropathic myofascial pain syndrome, Chapter 28, The management of pain, 3rd Ed. Edited by Bonica J. Philadelphia. Lippincott William and wilkins. 2001;pp522-29.
  18. Byers MR., and Bonica JJ: Peripheral pain mechanism and nociceptor plasticity. Chapter 3, The management of pain, 3rd ed. Edited by Bonica J. Philadelphia. Lippincott William and wilkins. 2001;pp85-103.
  19. Canon WB, Rosenblueth A: The supersensitivity of denervated structures. New York, The Macmillan company. 1949;pp195-203.
  20. Xavier, AV, Farrell CE, McDanal J, Kissin I: Does antidromic activation of nociceptors play a role in sciatic radicular pain? Pain. 1990;40:77-79. https://doi.org/10.1016/0304-3959(90)91053-L
  21. Korr IM: Neuronal basis of the osteopathic lesion: J Am Osteopath Ass 1947;47:191-8.
  22. Maigne R: Segmental vertebral cellulotenoperiosteomyalgic syndrome. Chapter 18, Pain of vertebral origin, William & Wilkins. 1996;pp109-20.
  23. Gunn CC: "Prespondylosis" and some pain syndromes following denervation supersensitivity. Spine 1978;5:185-192.
  24. Culp WJ, Ochoa JL: Abnormal Nerves ands Muscles as Impulse Generators. New York; Oxford University Press, 1982;393-418.
  25. Gunn CC: Radiculopathic Pain: Diagnosis And Treatment Of Segmental Irritation or Sensitization. J Musculoskeletal Pain, 1997;5(4):119-38. https://doi.org/10.1300/J094v05n04_11
  26. Lomo T.: New neurophysiological concepts of pain. Nord Med. 1968;79(21):692-4.
  27. Lomo T, Loyning Y: Pain. Mechanisms, manifestations and therapeutic principles. Tidsskr Nor Laegeforen.1974;94(2):77-85.
  28. Fields HL: Pain. New York, McGraw-Hill. 1987, pp133-169.
  29. Matsju, H, Kitagawa, Kawaguchi, Tsujo: Physiologic changes of nerve root during posterior lumbar discectomy. Spine 1995;6:654-659.
  30. Ogata K, Ngaito M: Blood flow of peripheral nerve effects of dissection, stretching and compression. J Hand Surg 1986;11B:10-14.
  31. Lundborg G, Gelbermann R, Minteer-Convery M: Median nerve compression in the carpal tunnel - functional response to experimentally induced controlled pressure. J Hand Surg 1982;7:252-259. https://doi.org/10.1016/S0363-5023(82)80175-5
  32. Michael OS: Moving in on pain. Australia, Butterworth-Heinemann. 1995, pp 125.
  33. Pratt NE: Neurovascular entrapment in the regions of the shoulder girdle and posterior triangle of the neck. Phys Ther 1986;66:1894-1900.
  34. Lindblom U: Neuralgia: mechanisms and therapeutic prospects. Advances in pain research and therapy, Edited by Benedetti C, Chapman CR, Moricca G: New York. Raven Press. 1984, 427-38.
  35. Lindblom U, Verrilo RT: Sensory functions in neuralgia. J Neural Neurosurg Psychiatr 1979;42:422-3528. https://doi.org/10.1136/jnnp.42.5.422
  36. Ochoa JL, Torebjdrk E, Marchettini P, Sivak M: Mechanisms of neuropathic pain: cumulative observations, new experiments and further speculation. Edited by Fields HL, Dubner R, Cervero F, Jones LE. New Yorks Raven Presss. 1985, 431-50.
  37. Looser JD: Medical evaluation of the patient with pain. Chapter 12, The management of pain. 3rd Ed. Edited by Bonica J. Philadelphia. Lippincott William and wilkins. 2001;pp267-278.
  38. Lomo T, Waerhaug O: Motor endplates in fast and slow muscles of the rat: What determines their difference? J Physiol 1985;80(4):290-7.
  39. Thesleff S, Sellin LC: Denervation supersensitivity. Trends Neurosci 1980; August:122-6.
  40. Travell JG, Simons DG: Myofascial pain and dysfunction: The trigger point manual. Baltimore, Williams & Wilkins. 1983;11-93.
  41. Klein L, Dawson MH, Heiple KG: Turnover of ccllagen in the adult rat after denervation. J Bone joint Surg 1977;59A:1065-7.
  42. Jarvinen M: Histopathological findings in chronic tendon disorders. Scand J Med Sci Sports. 1997;7(2):86-95.
  43. Khan KM: Histopathology of common tendinopathies. Update and implications for clinical management. Sports med 1999;27(6):393-408. https://doi.org/10.2165/00007256-199927060-00004
  44. Wyland DJ, Dahners LE: The effects of nerve injury on ligament healing in a rat model. Clin Orthop 1994;307:255-9.
  45. Faryniarz DA: Myofibroblasts in the healing lapine medial collateral ligament: possible mechanism of contraction. J Orthop Res 1996;14(2):228-37. https://doi.org/10.1002/jor.1100140210
  46. Kikuchi T: Pathological study of experimental osteoporosis. Ann Phys Med 1968;9(5):193-6.
  47. Yu JK: The relationship between experimental changes in the stress-strain distribution and the tissues structural abnormalities of the cervical column. Nippon Seikeigeka Gakkai Zasshi 1984;58(6):543-53.
  48. Yu JK, The relationship between experimental changes in the stress-strain distribution and the tissues structural abnormalities of the cervical column. Zhonghua Wai Ke Za Zhi: 1993;31(8):456-9.
  49. Kornberg C, McCarthy T: The effects of neural stretching techniques on sympathetic outflow to the lower limbs. JOPST, 1992;16(6).
  50. Nordin, M, Nystrom B, Wallin V, Hagbarth KE: Ectopic sensory discharges and paresthesiae in patients with disorders of peripheral nerves dorsal roots and dorsal columns. Pain 1984;20:231-245. https://doi.org/10.1016/0304-3959(84)90013-7
  51. Cheng, S.S.R: Neurophysiology of electroacupuncture analgesia. Scientific bases of acupuncture, Edited by B. Pomeranz, G. Stux. Germany. Springer-Verlag Ed 1989, 119-135.
  52. Garrison WD, Foreman, DR: Deacreased activity of spontaneous and noxiously evoked dorsal horn cells during transcutaneous electrical nerve stimulation (TENS). Pain 1994;48:309-15.
  53. Lomo T: Stimulation of denervated rat soleus muscle with fast and slow activity patterns induces different expression of acetylcholinesterase molecular forms. J Neurosci. 1985;5(5):1180-7.
  54. Gunn CC: The Gunn's approach to the treatment of chronic pain, New York, Churchill Livingstone.1996;p16.
  55. Takeshige C, Sato M: Comparisons of pain relief mechanisms between needling to the muscle, static magnetic field, external qigong and needling to the acupuncture point. Acupunct Electrother Res 1996 Apr-Jun;21(2):119-31.
  56. Becker RO, Induced dedifferentiation: a possible alternative to embryonic stem cell transplants. NeuroRehabilitation 2002;17(1):23-31.