The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review.

Jan Wilke,Robert Schleip,Werner Klingler,Carla Stecco

doi:10.1155/2017/5349620

Jan Wilke, Robert Schleip + Show 2 more

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https://doi.org/10.1155/2017/5349620

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Abstract

The lumbodorsal fascia (LF) has been proposed to represent a possible source of idiopathic low back pain. In fact, histological studies have demonstrated the presence of nociceptive free nerve endings within the LF, which, furthermore, appear to exhibit morphological changes in patients with chronic low back pain. However, it is unclear how these characteristics relate to the aetiology of the pain. In vivo elicitation of back pain via experimental stimulation of the LF suggests that dorsal horn neurons react by increasing their excitability. Such sensitization of fascia-related dorsal horn neurons, in turn, could be related to microinjuries and/or inflammation in the LF. Despite available data point towards a significant role of the LF in low back pain, further studies are needed to better understand the involved neurophysiological dynamics.

Highlights

Disc pathologies, as diagnosed using magnetic resonance imaging (MRI), do not necessarily represent the causal substrate of low back pain [1, 2]
A variety of predictors including psychological, environmental, genetic, or other morphological factors have been discussed [3]. Concerning the latter, Panjabi [4] proposed that microinjuries in lumbar connective tissues may be a contributing factor in idiopathic low back pain. His hypothesis referred to paraspinal connective tissues only, other authors argued that the lumbodorsal fascia (LF) should be considered as a candidate for similar microinjuries [5, 6]
Bednar et al [13] examined the histology of samples from the posterior layer of the LF, which had been obtained during lumbar surgery from 24 patients suffering from low back pain

Summary

Introduction

As diagnosed using magnetic resonance imaging (MRI), do not necessarily represent the causal substrate of low back pain [1, 2]. A variety of predictors including psychological, environmental, genetic, or other morphological factors have been discussed [3]. Concerning the latter, Panjabi [4] proposed that microinjuries in lumbar connective tissues may be a contributing factor in idiopathic low back pain. His hypothesis referred to paraspinal connective tissues only, other authors argued that the lumbodorsal fascia (LF) should be considered as a candidate for similar microinjuries [5, 6]. The present paper aimed to delineate the role of the LF in patients with low back pain, with special focus on combining findings from histological studies and experimental research

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