The myth of skeletal muscle spasm
Five pages 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.”
related content
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:
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.