Prevalence of Pain and Dysfunction in the Cervical and Thoracic Spine

Berglund KM, Persson BH, Denison E. Prevalence of Pain and Dysfunction in the Cervical and Thoracic Spine in Persons With and Without Lateral Elbow Pain. Manual Therapy August 2008; 13(4):295-299.

ABSTRACT: The purpose of this study was to survey the prevalence of pain in the cervical and thoracic spine (C2–T7) in persons with and without lateral elbow pain. Thirty-one subjects with lateral elbow pain and 31 healthy controls participated in the study. The assessment comprised a pain drawing, provocation tests of the cervical and thoracic spine, a neurodynamic test of the radial nerve, and active cervical range of motion. Seventy percent of the subjects with lateral elbow pain indicated pain in the cervical or thoracic spine, as compared to 16% in the control group (p=0.001). The frequency of pain responses to the provocation tests of the cervical and thoracic spine was significantly higher (p=.05) in the lateral elbow pain (LEP) group, as was the frequency of pain responses to the neurodynamic test of the radial nerve (po0.001). Cervical flexion and extension range of motion was significantly lower (p=0.01) in the LEP group. The results indicate a relation between lateral elbow pain and pain in the vertebral spine (C2–T7). The cervical and thoracic spine should be included in the assessment of patients with lateral elbow pain.

COMMENTS: As we always say, even if the pain is primarily in an extremity, check the spine. This article and other articles cited by the authors makes the same statement.
The authors found that 70% of the subjects with lateral elbow pain also had cervical and/or thoracic spine pain. Only 16% of the control group had pain in the c- and t-spine. ROM test of the cervical spine was more restricted in the elbow pain group, as were positive findings in neurodynamic tests to the radial nerve (forearm pain at less then 40° of shoulder abduction in a supine subject) and provocation tests (foramen compression test, palpation of the cervical nerve trunk after it exits the foramen, and Springing test to thoracic spine.
Fraser JS, Lang JK, Ali TA, et al. Statin Treatment of Adult Human Glial Progenitors Induces PPARc-Medi-ated Oligodendrocytic Differentiation. Glia 2008; 56:954-962.

QUICK NOTES: They state that statins are being considered as treatment for multiple sclerosis and inflammatory demyelinations due to its anti-inflammatory effects. Based upon their studies, statins may increase the loss of competent progenitor cells and therefore may “accelerate the loss of ambient progenitor pools in MS, impeding myelin repair. In addition, long term statin use “may deplete the population of progenitors available for later recruitment during aging or in response to minor injury or vascular assault.” This may lead to “premature cognitive decline.”

Alarming facts in the paper: they write that in the U.S. in 2005, 12,000,000 statin prescriptions were given each month. This amounts to over 10% of the American adult population and over 25% of those age 65 years or older.