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DOES AN “ADVERSE” CONSTITUTIONAL FIBRES-TYPE COMPOSITION OF THE PARASPINAL MUSCLES PREDISPOSE TO CHRONIC LOW BACK PAIN DEVELOPMENT?



Abstract

Paraspinal muscle dysfunction is associated with chronic low back pain (CLBP) in prospective studies, some authors suggesting a primary role for muscle in CLBP development. To investigate this possibility, we compared paraspinal muscle electromyographic (EMG) fatigue characteristics with fibre-type composition in ambulant, male CLBP patients and male controls of similar age.

Thirty-five patients with Chronic Pain Grades of III (a high level of residual function, despite pain, negated the effects of disuse atrophy), and 32 controls were studied. Paraspinal surface EMG signals were recorded from the T10/11 and L4/5 regions bilaterally during standard isometric endurance tests. The rate of fatigue-induced median frequency (MF) decline was calculated from the power spectrum. Percutaneous paraspinal muscle biopsies permitted the determination of muscle fibre-type characteristics.

MF decline, mean fibre size and relative area occupied by fibre types did not differ significantly between groups.

The paraspinal muscles of ambulant CLBP patients demonstrate no excessive fatigability, when assessed by EMG, nor a relative paucity in the area occupied by either fibre type. Patients developing CLBP do not demonstrate an adverse paraspinal muscle fibre-type composition.

The abstracts were prepared by Dr C Pither. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN