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Magnitude of spinal muscle damage is not statistically associated with exercise-induced low back pain intensity.

dc.contributor.author Arpan, I
dc.contributor.author Bishop, Mark D
dc.contributor.author George, Steven Z
dc.contributor.author Horn, Maggie Elizabeth
dc.contributor.author Lott, DJ
dc.coverage.spatial United States
dc.date.accessioned 2016-09-14T14:24:40Z
dc.date.issued 2011-12
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/22208857
dc.identifier S1529-9430(11)01397-0
dc.identifier.uri http://hdl.handle.net/10161/12765
dc.description.abstract BACKGROUND CONTEXT: Findings on imaging of noncontractile anatomic abnormalities and the intensity of low back pain have weak associations because of false-positive rates among asymptomatic individuals. This association might be stronger for contractile tissues. PURPOSE: The purpose of this study was to examine the relationship between location and reports of pain intensity in the low back and exercise-induced muscle damage to the lumbar paraspinal muscles. STUDY DESIGN: Nondiagnostic observational study in a laboratory setting. METHODS: Delayed onset muscle soreness was induced in the low back of healthy pain-free volunteers. Measures of pain intensity (100-mm visual analog scale [VAS]) and location (area on the pain diagram) were taken before and 48 hours after exercise. Muscle damage was quantified using mechanical pain thresholds, motor performance deficits, and transverse relaxation time (T2)-weighted magnetic resonance imaging (MRI). Changes pre- to postexercise in signal intensity on T2-weighted imaging within the erector spinae, pain intensity, pain area, mechanical pain threshold, and isometric torque were assessed using paired t tests. Bivariate correlations were conducted to assess associations among muscle damage, pain intensity, and pain drawing area. RESULTS: Twenty participants volunteered (11 women; average age, 22.3 years; average body mass index, 23.5) for study participation. Reports of pain intensity at 48 hours ranged from 0 to 59 mm on the VAS. Muscle damage was confirmed by reductions in mechanical threshold (p=.011) and motor performance (p<.001) and by changes in T2-weighted MRI (p=.007). This study was powered to find an association of at least r=0.5 to be statistically significant. Correlations of continuous variables revealed no significant correlations between pain intensity and measures of muscle damage (ranging between -0.075 and 0.151). There was a significant association between the remaining torque deficit at 48 hours and pain area. CONCLUSIONS: The results of this study indicate that there was no association between the magnitude of muscle damage in the lumbar erector spinae and reported pain intensity in the low back. In future studies, larger cohorts may report statistically significant associations, but our data suggest that there will be low magnitude potentially indicating limited clinical relevance.
dc.language eng
dc.relation.ispartof Spine J
dc.relation.isversionof 10.1016/j.spinee.2011.11.005
dc.subject Exercise
dc.subject Exercise Test
dc.subject Exercise Tolerance
dc.subject Female
dc.subject Humans
dc.subject Low Back Pain
dc.subject Magnetic Resonance Imaging
dc.subject Male
dc.subject Muscle Contraction
dc.subject Muscle Fatigue
dc.subject Muscle, Skeletal
dc.subject Musculoskeletal Pain
dc.subject Pain Measurement
dc.subject Spine
dc.subject Young Adult
dc.title Magnitude of spinal muscle damage is not statistically associated with exercise-induced low back pain intensity.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/22208857
pubs.begin-page 1135
pubs.end-page 1142
pubs.issue 12
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Orthopaedics
pubs.organisational-group Orthopaedics, Physical Therapy
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 11
dc.identifier.eissn 1878-1632


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