The myth of skeletal muscle spasm
Five articles on PainSci cite Johnson 1989: 1. The Complete Guide to IT Band Syndrome 2. The Complete Guide to Low Back Pain 3. The Complete Guide to Neck Pain & Cricks 4. Does Hip Strengthening Work for IT Band Syndrome? 5. Cramps, Spasms, Tremors & Twitches
PainSci notes on Johnson 1989:
In this editorial from 1989, Dr. Ernst W. Johnson decries the “preposterous” widespread attribution of unexplained musculoskeletal pain to “spasm,” describing “overwhelming evidence that skeletal muscle spasm is nonexistent.” He believes that it’s a simplistic non-diagnosis with strong emotional appeal to both doctors and patients, and therefore cynically exploited by pharmaceutical companies to sell a treatment (muscle relaxants).
Although I agree that most unexplained musculoskeletal pain has nothing to do with “spasms,” I wish I knew what “overwhelming evidence” debunks the myth: he only mentions one 1950 study that I can’t find, and a replication of it that he was involved in that I also cannot find. He describes a study of 50 people with neck and/or shoulder discomfort, none of whom “had EMG evidence of muscle activity in the area of pain or in the proximal paraspinal muscle.”
Specifically regarding Johnson 1989:
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.