Year-end Sale % OFF 
Abstract
Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over the past few decades; however, these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting lower back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane, and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies satisfied the following: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, after which data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met the inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in lower back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Additional knowledge of fascial neurological components could impact LBP treatment.
Highlights
The process by which intense thermal, mechanical or chemical stimuli are detected by a subpopulation of nociceptive peripheral nerve endings is called nociception [1,2,3,4,5]
It has been demonstrated that there is nociceptive innervation in connective tissues associated with nerves [32], tendons [33], and joints [34,35,36,37,38]. These findings strongly suggest a role in the etiology of pain, and additional studies of nociceptive innervation of connective tissue will help to relate connective tissue dysfunction with lower back pain (LBP) [39,40]
After the removal of duplicates, 214 articles had their titles and abstracts screened in Phase I, and those articles considered to be eligible for Phase II were screened
Summary
The process by which intense thermal, mechanical or chemical stimuli are detected by a subpopulation of nociceptive peripheral nerve endings is called nociception [1,2,3,4,5]. Nociceptors have a peripheral and central axonal branch that innervates their target organ and spinal cord, respectively [1,2,6,7]. The second class of nociceptor includes small diameter unmyelinated “C” fibers that convey poorly localized nociception. Heat-responsive unmyelinated afferents develop mechanical sensitivity only in the injury setting [11]. These afferents are more responsive to chemical stimuli (capsaicin or histamine) and are likely to come into play when the chemical milieu of inflammation changes their properties [1,2,12,13,14]. Some respond to innocuous cooling, while others respond to innocuous stroking of the hairy skin and appear to mediate pleasant touch [15]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
