CUTANEOUS PATTERNS OF SYMPATHETIC ACTIVITY IN CLINICAL ABNORMALITIES OF THE MUSCULOSKELETAL SYSTEM.

Abstract

1. These studies on 130 patients have been concerned with topographical patterns of sudomotor activity associated with known musculoskeletal disturbances, myofascial stresses and pain syndromes. 2. The method employed for measuring sudomotor activity, as an indicator of regional variations in sympathetic activity, was that of recording the electrical resistance of the skin (ESR). Radiographic, electromyographic and palpatory examinations, as well as other conventional clinical methods, were used in the evaluation of the musculoskeletal disturbances. 3. The observations frequently showed the presence of regional and segmental patterns of low electrical skin resistance (LRA) in areas of referred pain and dermatomes segmentally related to the musculoskeletal disturbances or myofascial stresses. 4. These patterns of altered electrical skin resistance appear to reflect enduring changes in the patterns of sympathetic activity associated with musculoskeletal disturbances of clinical origin. 5. These studies suggest that the patterns of aberrant areas of sudomotor and vasomotor activity, which we have previously described in apparently normal subjects, may reflect subclinical and asymptomatic sources of afferent bombardment, over selected dorsal roots, or of direct irritation of nerve fibers or ganglion cells. That is, the altered patterns of sympathetic activity appear to be either reflex manifestations of changes in sensory input arising in nerve endings and receptors in the musculoskeletal tessues or the effects of direct insults to nerve fibers (or ganglion cells) or a combination of both.