Journal
NEUROSCIENCE
Volume 194, Issue -, Pages 302-308Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neuroscience.2011.07.066
Keywords
thoracolumbar fascia; low back pain; immunohistochemistry; sensory innervation; nociception; peptidergic free nerve endings
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Funding
- German Federal Ministry of Education and Research (Bundesministerium fur Bildung und Forschung: LOGIN consortium)
- Schweizer Arztegesellschaft fur Manuelle Medizin (SAMM)
- Arzteseminar fur Manuelle Medizin (MWE)
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The available data on the innervation of the thoracolumbar fascia (TLF) are inconsistent and partly contradictory. Therefore, the role of the fascia as a potential source of pain in the low back is difficult to assess. In the present study, a quantitative evaluation of calcitonin gene-related peptide (CGRP) and substance P (SP)-containing free nerve endings was performed in the rat TLF. A preliminary non-quantitative evaluation was also performed in specimens of the human TLF. The data show that the TLF is a densely innervated tissue with marked differences in the distribution of the nerve endings over the fascial layers. In the rat, we distinguished three layers: (1) Outer layer (transversely oriented collagen fibers adjacent to the subcutaneous tissue), (2) middle layer (massive collagen fiber bundles oriented obliquely to the animal's long axis), and (3) inner layer (loose connective tissue covering the paraspinal muscles). The subcutaneous tissue and the outer layer showed a particularly dense innervation with sensory fibers. SP-positive free nerve endings which are assumed to be nociceptive were exclusively found in these layers. Because of its dense sensory innervation, including presumably nociceptive fibers, the TLF may play an important role in low back pain. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.
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