The myth of skeletal muscle spasm

PainSci summary of Johnson 1989?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆?3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

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.”

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Specifically regarding Johnson 1989:

• A selection (p. 259) from the book Muscle pain, by Siegfried Mense, David G Simons, and IJ Russell.

• PS Save Yourself from IT Band Syndrome! — All your treatment options for Iliotibial Band Syndrome reviewed in great detail, with clear explanations of recent scientific research supporting every key point
• PS Save Yourself from Neck Pain! — A complete guide to chronic neck pain and the disturbing sensation of a “crick”
• PS Does Hip Strengthening Work for IT Band Syndrome? — The popular “weak hips” theory is itself weak
• PS Cramps, Spasms, Tremors & Twitches — The biology and treatment of unwanted muscle contractions

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:

• A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
• The neck and headaches. Bogduk 2014 Neurol Clin.
• Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
• Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
• Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.