Tension-type headache and low back pain reconsidered

Scientists at the Department of Neurology, University of Copenhagen in Denmark recently suggested to place the cause of tension-type headache and non-specific low back pain within the central nervous system and not in the spine or spinal musculature.

The researchers wrote in Frontiers in Medicine that these two conditions appear to share several specific clinical features. Both are muscular pain conditions along the spine, have a preponderance in women, may occur spontaneously or follow a trivial traumatic incident, and both have a high risk of chronicity. The affected muscles are tender with tender points. EMG indicates diffuse hyperactivity and abnormal activation pattern. Both conditions show impaired motor control of the affected muscles and adjacent muscle groups.

These shared features suggest analogous pathophysiology involving the neuromotor control of affected and adjacent muscle groups in the cervical and lumbar regions, respectively.

As recently suggested for the whiplash condition, the researchers suggest the term spinal dyssynergia for this specific pattern of pathology.

This suggestion provides a new perspective for the understanding of these diseases by placing their cause within the central nervous system and not in the spine or spinal musculature.

However the researchers added that this perspective warrants further clinical, neurophysiological, and neuropharmacological studies of this ‘family’ of common yet poorly understood clinical muscular pain conditions along the spine.