Cervical and Lumbal Region Muscle Architecture in Individuals With Low Back and Neck Pain
Condition: Neck Pain; Back Pain
MeSH terms: Back Pain; Neck Pain
Study type: Observational

Summary: 
      Back or neck problems often begin with an injury and often include a muscle injury. Injury of
      muscle fibers can occur due to trauma, disease, myotoxic agents, inflammatory processes, and
      intense exercise. The level of muscle injury in low back or neck problems is unknown.
      However, the relationship between muscle injury and pain has been studied intensively.

      Injury to skeletal muscles occurs when muscle activation begins abruptly and rapidly with
      muscle lengthening. Muscle pain that occurs with eccentric exercise peaks 24-48 hours after
      the exercise. Studies on this subject have generally focused on muscle fatigue, changes in
      the physiological structure of the muscle, and which muscle fiber types are injured more.
      Experimental studies focused on the results of skeletal muscle injury with early activation
      of the muscle during eccentric exercises. For example, it has been shown that mechanical
      changes in the tibialis anterior muscle occur in the first 5-7 minutes of exercise during
      eccentric exercise. Studies on the back and neck muscles are rare, and it has been stated
      that fatigue in these muscles plays an active role in the mechanism of injury. It is very
      difficult to accept this view directly, because there are different types of muscle fibers in
      the lower back and neck muscles. In terms of low back and neck pain and muscle injury,
      specific studies on muscle fiber types are required. In addition, muscle strength together
      with pain can change the load distribution to anatomical structures. However, muscle activity
      alters spinal stability and kinematics. It has been found that the M. Sternocleideomasteideus
      (M.SCM) muscle shows 5%-10% elongation tension during muscle activation, along with
      retraction in whiplash injuries. In deep muscle groups, this rate varies between 10% and 20%.
      It is not known to what extent the architectural features of the muscle change with these
      muscle tensions and to what extent the injury occurs when active extension occurs. It is
      clear that the relationship between muscle pain and injury should be examined in terms of
      biomechanical modeling, muscle architecture and outcomes.

      Muscle length, fiber length, pennation angle, and physiological cross-sectional area (PCSA)
      values of many muscle groups, primarily the M.SCM and M.Transversus Abdominus muscles, were
      analyzed in healthy individuals. However, it is not known how it changes in individuals with
      low back or neck pain. For this reason, if the architectural features of the cervical and
      lumbar region muscles can be determined, since they are the muscles that are most affected by
      low back and neck problems and then exercised the most by physiotherapists, the relationship
      between injury and pain can be examined and correct muscle function can be achieved. The
      emergence of different values from healthy muscle architecture will be valuable in terms of
      correct exercise planning and proper function in individuals with low back and neck problems.
      The aim of working with this idea is to evaluate the architectural features of the cervical
      and lumbar region muscles in individuals with problems characterized by low back and neck
      pain.
    


Intervention name(s): Ultrasonography
Intervention type(s): Device
Intervention description(s): Neck and Low back muscles will be evaluated by ultrasound.
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with neck or low back pain and healthy individuals will be included in to study.
      
Keywords: neck pain; back pain; muscle architecture