Patients with various and indefinite symptoms in the whole body occasionally have coincident with stiffness or tenderness of the cervical muscles. This prospective case series examined the effect of local modulation of the cervical muscles in patients with cervical disorders reporting indefinite whole-body symptoms.
A total of 1863 hospitalized patients with cervical disorders accompanying three or more indefinite whole-body symptoms, who were resistant to outpatient care, were enrolled in this study for 12 years. All patients underwent daily physical therapies to the cervical muscles during hospitalization. Self-rated records on the medical interview sheets documenting 30 representative symptoms including cervical/shoulder pain or stiffness and 28 representative indefinite whole-body symptoms at admission and discharge were compared across the population.
The number of symptoms decreased significantly with the local modulation of the cervical muscles during hospitalization. All of the 28 indefinite whole-body symptoms at admission showed recovery rates greater than 50% at discharge. The mean number of symptoms decreased significantly from 17.8 at admission to 7.4 at discharge (p < 0.0001). The percentages of patients reporting 10 or more symptoms were 91.1% and 29.3% at admission and discharge, respectively. Moreover, 8.2% of patients reported no residual symptoms at discharge.
Cervical muscle lesions may contribute to indefinite whole-body symptoms, possibly through dysfunction of the parasympathetic nervous system in the muscles. Local modulation of cervical muscles could lead to a breakthrough in the management of patients with indefinite whole-body symptoms.
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The authors thank Mrs. Hiroki Fujii, Tomohiko Kaneko, and Naoto Yanagi at our institutions for their invaluable technical assistance.
There was no funding associated with this study. The patients were hospitalized for intensive treatment and detailed examinations, but not for this study. The cost of treatment was borne partly by the patients and partly by the Japanese national insurance.
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The authors declare that they have no conflict of interest.
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The study was conducted with the approval of the institutional review board of Tokyo Neurological Center and Matsui Hospital. All participants provided written consent to participate in the study. All rights of the patients were protected against any kind of disadvantage and individual matters.
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Matsui, T., Hara, K., Kayama, T. et al. Cervical muscle diseases are associated with indefinite and various symptoms in the whole body. Eur Spine J 29, 1013–1021 (2020). https://doi.org/10.1007/s00586-019-06233-5