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Visualization of chronic neck-shoulder pain: impaired microcirculation

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By Larsson R, Cai H, Zhang Q, Oberg PA, Larsson SE • www.ProHealth.com • April 15, 1998


This study pertains to the 71 patients who had received a diagnosis
of cervico-brachial pain syndrome after thorough clinical
examination of a total series of 300 patients, who had been
referred to the National Insurance Hospital in Tranas because
of chronic neck pain that interfered with their ability to
work. Changes in trapezius muscle blood flow and EMG were
examined and related to the anamnesis and physical findings.
The microcirculation in the upper part of the right and left
trapezius muscles was examined simultaneously by using optical
laser-Doppler single-fibres after insertion into the muscle
directly via the skin. Continuous recordings were made during
stepwise increased static contraction determined
electro-myographically. Signal processing was performed
on-line by computer. MRT of the cervical spine was performed
in 12 patients. None showed nerve root affliction. Ten showed
a bulging intervertebral disc and two, a narrowed nerve hole
(lateral stenosis). The muscle blood flow (LDF) was
significantly lower in the most painful side compared with the
opposite side in the group of 41 patients with predominantly
unilateral pain (21 women and 20 men). A lowered blood flow
was also found when the 21 females in this group was compared
with a normal control group of 20 healthy women. The patients
had lower rms-EMG and EMG mean power frequency (MPF) in the
painful side compared with the opposite side. A further
lowering of the MPF was observed with induced fatigue. It was
concluded that the chronic neck pain in cervico-brachial
syndrome can become visualized by the finding of lowered blood
flow of the trapezius muscle which seems to be an expression
of the chronic neck pain.




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