Effects of experimental myofascial insults on cutaneous patterns of sympathetic activity in man

Document Type

Article

Publication Title

Acta Neurovegetativa

Abstract

1. The purpose of these studies was to examine the changes in sudomotor patterns in the skin of the human trunk produced by experimentally induced irritation and stresses, in the musculoskeletal tissues, as a step toward understanding the origins of the patterns found in apparently normal individuals. 2. Irritation of the musculoskeletal tissues was produced by the injection of hypertonic saline into paravertebral tissues. Postural stresses were produced by the insertion and removal of heel lifts and by the lateral inclination of the pelvis by the use of tilt-chairs. 3. Sudomotor patterns were revealed by recording electrical skin resistance on the dorsal skin of the thoracic and lumbar regions in relation to segmental level. 4. New areas of low electrical resistance appeared when the saline injection produced referred pain; the areas were distributed in the reference zone, in dermatomes related to the injection site. 5. Postural changes produced changes in patterns which included a) exaggeration of existing patterns and b) the appearance of new areas of low resistance (increased sweat gland secretion), according to the applied stress, the individual's vertebral adaption to the stress and the areas of discomfort. 6. We believe the findings support the following hypotheses: a) That the manifestations of altered sympathetic activity observed in these studies represent distortions of normally existing patterns of efferent activity. b) That the distortions begin, as responses to exaggerations of segmental or local afferent influences which ordinarily have only local adjustive influences on the patterns, and that these impulses may be visceral or somatic in origin. c) That although the aberrant areas of low resistance described in normal subjects, may reflect chronically altered or intensified patterns of afferent bombardment from foci in visceral or somatic tissues, other factors, such as adaptive or pathological changes in those tissues and altered central excitability, may eventually become involved. 7. Since, however, the affected areas may be limited in extent to single dermatomes, it appears that individual ganglia, gray rami communicantes ventral roots, spinal nerves or their branches may in some cases be directly, rather than reflexly, irritated. 8. Some of the functional implications of chronically altered activity in localized portions of the sympathetic outflow are identified. 9. The relation of these findings to mechanisms involved in such clinical phenomena as reflex sympathetic dystrophy, myofascial triggers, referred pain, etc., is briefly examined. © 1962 Springer-Verlag.

First Page

329

Last Page

355

DOI

10.1007/BF01239851

Publication Date

9-1-1962

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