Abstract
The traditional concept that reflex tone is the underlying mechanism for tension of a resting muscle is outdated. Sources of muscle tension include mechanisms that are silent in the electromyogram (EMG) (i.e., viscoelastic tone and contracture in the physiological sense) as well as those contractile activities accompanied by EMG signals (voluntary and involuntary contractions, spasm, cramp). Usually, muscle tone is clinically measured as resistance to passive elongation via joint movements. In normal cases at full relaxation, it mainly reflects viscoelastic tone, but may also include extraneous contractile activity. Thixotropy of muscle reflects a decrease of its viscosity and lowered passive resistance by movement. It is a ubiquitous and functionally important phenomenon that is not commonly recognized. Muscle spasm is defined in this chapter as involuntary and long-lasting muscle contraction. It is distinct from spasticity caused by a CNS lesion. The pain–spasm–pain cycle, which is often assumed to be responsible for chronic muscle pain, is a physiologically untenable concept. Tension-type headache (TTH) is a clinical pain condition that can be associated with increased muscle tension in some patients and without evident EMG activity. TTH may also be caused by myofascial trigger points (TrPs). Painful muscle spasm is present in cases of spasmodic torticollis, trismus, nocturnal leg cramps, and stiff-man (preferably, “stiff-person”) syndrome.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ad hoc Committee on the Classification of Headache (1962) Classification of headache. JAMA 179:717–718
Andersen LL, Suetta C, Andersen JL et al. (2008) Increased proportion of megafibers in chronically painful muscles. Pain 139(3):588–593
Ando T, Kayama T, Saito S et al. (1997) The EMG findings of spasmodic torticollis—the character of the EMG findings of neurogenic torticollis. No to Shinkei 49:619–626
Aramideh M, Koelman JH, Devriese PP et al. (2002) Thixotropy of levator palpebrae as the cause of lagophthalmos after peripheral facial nerve palsy. J Neurol Neurosurg Psychiatry 72(5):665–667
Arena JG, Sherman RA, Bruno GM et al. (1991) Electromyographic recordings of low back pain subjects and non-pain controls in six different positions: Effect of pain levels. Pain 45:23–28
Arokoski JP, Surakka J, Ojala T et al. (2005) Feasibility of the use of a novel soft tissue stiffness meter. Physiol Meas 26:215–228
Ashina S, Bendtsen L, Ashina M (2005) Pathophysiology of tension-type headache. Curr Pain Headache Rep 9:415–422
Basmajian JV (1957) New views on muscular tone and relaxation. Can Med Assoc J 77:203–205
Basmajian JV, Deluca CJ (1985) Muscles alive. Their functions revealed by electromyography, 5th edn. Williams & Wilkins, Baltimore
Benecke R (1989) General aspects of motor physiology and pathology. In: Emre M, Benecke R (eds) Spasticity: the current status of research and treatment. Parthenon, London
Benecke R, Dressler D (2007) Botulinum toxin treatment of axial and cervical dystonia. Disabil Rehabil 29:1769–1777
Borodic GE, Pearce LB, Smith K et al. (1992) Botulinum A toxin for spasmodic torticollis: Multiple vs single injection points per muscle. Head Neck 14:33–37
Brashear A, Ambrosius WT, Eckert GJ et al. (1998) Comparison of treatment of tardive dystonia and idiopathic cervical dystonia with botulinum toxin type A. Mov Disord 13:158–161
Brendenkamp JK, Maceri DR (1990) Inflammatory torticollis in children. Arch Otolaryngol Head Neck Surg 116:310–313
Broetz D, Eichner M, Gasser T et al. (2007) Radicular and nonradicular back pain in Parkinson’s disease: a controlled study. Mov Disord 22:853–856
Bruno C (2002) Myopathies involving glycogen and carbohydrate metabolism. In: Preedy V, Peters T (eds) Skeletal muscle. Pathology, diagnosis and management of diseases. Greenwich Medical Media, London, San Francisco
Buchthal F, Guld C, Rosenfalck P (1955) Innervation zone and propagation velocity in human muscle. Acta Physiol Scand 35:174–190
Burke D (1983) Critical examination of the case for or against fusimotor involvement in disorders of muscle tone. Adv Neurol 39:133–150
Burke D, Gillies JD, Lance JW (1971) Hamstrings stretch reflex in human spasticity. J Neurol Neurosurg Psychiatry 34:231–235
Butler JV, Mulkerrin EC, O'Keeffe ST (2002) Nocturnal leg cramps in older people. Postgrad Med J 78:596–598
Campbell KS, Lakie M (1998) A cross-bridge mechanism can explain the thixotropic short-range elastic component of relaxed frog skeletal muscle. J Physiol 510:941–962
Chapman MA, Barron R, Tanis DC et al. (2007) Comparison of botulinum neurotoxin preparations for the treatment of cervical dystonia. Clin Ther 29:1325–1337
Childre F, Winzeler A (1995) Cumulative trauma disorder: A primary care provider's guide to upper extremity diagnosis and treatment. Nurse Pract Forum 6:106–119
Christensen MB, Bendtsen L, Ashina M et al. (2005) Experimental induction of muscle tenderness and headache in tension-type headache patients. Cephalalgia 25(11):1061–1067
Clemmesen S (1951) Some studies on muscle tone. Proc R Soc Med 44:637–646
Cohen L (1966) Stiff-man syndrome. Two patients treated with diazepam. JAMA 195:222–224
Cohen-Gadol AA, Ahlskog JE, Matsumoto JY et al. (2003) Selective peripheral denervation for the treatment of intractable spasmodic torticollis: Experience with 168 patients at the Mayo Clinic. J Neurosurg 98:1247–1254
Collins English Dictionary (1991) Collins English Dictionary, 3rd edn. Harper Collins, Glasgow, p 1517
Comella CL, Thompson PD (2006) Treatment of cervical dystonia with botulinum toxins. Eur J Neurol Suppl 13(Suppl 1)1:16–20
Comella CL, Buchman AS, Tanner CM et al. (1992) Botulinum toxin injection for spasmodic torticollis: Increased magnitude of benefit with electromyographic assistance. Neurology 42:878–882
Comella CL, Jankovic J, Brin MF (2000) Use of botulinum toxin type A in the treatment of cervical dystonia. Neurology 55(Suppl 5):S15–S21
Coppin RJ, Wicke DM, Little PS (2005) Managing nocturnal leg cramps — calf-stretching exercises and cessation of quinine treatment: A factorial randomised controlled trial. Br J Gen Pract 55:186–191
Costa J, Espírito-Santo C, Borges A et al. (2005) Botulinum toxin type B for cervical dystonia. Cochrane Database Syst Rev Jan 25(1):CD004315
Couppé C, Torelli P, Fuglsang-Frederiksen A et al. (2007) Myofascial trigger points are very prevalent in patients with chronic tension-type headache: A double-blinded controlled study. Clin J Pain 23:23–27
Crowner BE (2007) Cervical dystonia: Disease profile and clinical management. Phys Ther 87:1511–1526
Dauer WT, Burke RE, Greene P et al. (1998) Current concepts on the clinical features, aetiology and management of idiopathic cervical dystonia. Brain 121:547–60
Davidoff RA (1992) Skeletal muscle tone and the misunderstood stretch reflex. Neurology 42:951–963
DeLong MR (2000) The basal ganglia. In: Kandel ER, Schwartz JH, Jessell TM (eds) Principles of neural science, 4th edn. McGraw Hill, New York, pp 853–867
Denny-Brown D (1953) Clinical problems in neuromuscular physiology. Am J Med 15:368–390
Deuschl G, Heinen F, Kleedorfer B et al. (1992) Clinical and polymyographic investigation of spasmodic torticollis. J Neurol 239:9–15
Di Cola E, Waigh TA, Trinick J et al. (2005) Persistence length of titin from rabbit skeletal muscles measured with scattering and microrheology techniques. Biophys J 88:4095–4106
Diwaker HN, Stothard J (1995) What do doctors mean by tenosynovitis and repetitive strain injury? Occup Med (Lond) 45(2):97–104
Do TT (2006) Congenital muscular torticollis: Current concepts and review of treatment. Curr Opin Pediatr 18:26–29
Donaldson CCS, Skubick DL, Clasby RG et al. (1994) The evaluation of trigger-point activity using dynamic EMG techniques. Am J Pain Manage 4:118–122
Editorial (1967) Stiff-man syndrome. JAMA 201:105–321
Elert J, Dahlqvist SR, Almay B et al. (1993) Muscle endurance, muscle tension and personality traits in patients with muscle or joint pain — a pilot study. J Rheumatol 20:1550–1556
Fahn S (2003) Description of Parkinson's disease as a clinical syndrome. Ann N Y Acad Sci 991:1–14
Fernández-de-las-Peñas C, Alonso-Blanco C, Cuadrado ML et al. (2006) Trigger points in the suboccipital muscles and forward head posture in tension-type headache. Headache 46(3):454–460
Ferreira JJ, Costa J, Coelho M et al. (2007) The management of cervical dystonia. Expert Opin Pharmacother 8:129–140
Fischer AA (1987) Clinical use of tissue compliance meter for documentation of soft tissue pathology. Clin J Pain 3:23–30
Fischer AA, Chang CH (1985) Electromyographic evidence of paraspinal muscle spasm during sleep in patients with low back pain. Clin J Pain 1:147–154
Fry HJ (1993) The treatment of overuse injury syndrome. Md Med J 42:277–282
Gajdosik RL, Vander Linden DW, McNair PJ et al. (2004) Slow passive stretch and release characteristics of the calf muscles of older women with limited dorsiflexion range of motion. Clin Biomech (Bristol, Avon) 19:398–406
Gavronski G, Veraksits A, Vasar E et al. (2007) Evaluation of viscoelastic parameters of the skeletal muscles in junior triathletes. Physiol Meas 28:625–637
Ghez C, Thach WT (2000) The cerebellum. In: Kandel ER, Schwartz JH, Jessell TM (eds) Principles of neural science, 4th edn. McGraw Hill, New York, pp 832–852
Greene P, Fahn S, Diamond B (1994) Development of resistance to botulinum toxin type A in patients with torticollis. Mov Disord 9:213–217
Grünewald RA, Yoneda Y, Shipman JM et al. (1997) Idiopathic focal dystonia: A disorder of muscle spindle afferent processing? Brain 120:2179–2185
Guidotti TL (1992) Occupational repetitive strain injury. Am Fam Phys 45:585–592
Hagbarth KE, Hägglund JV, Nordin M et al. (1985) Thixotropic behaviour of human finger flexor muscles with accompanying changes in spindle and reflex responses to stretch. J Physiol 368:323–342
Hagberg M (2005) Clinical assessment, prognosis and return to work with reference to work related neck and upper limb disorders. G Ital Med Lav Ergon 27:51–57
Harrison TB, Benatar M (2007) Accuracy of repetitive nerve stimulation for diagnosis of the cramp–fasciculation syndrome. Muscle Nerve 35:776–780
Harver A, Segreto J, Kotses H (1992) EMG stability as a biofeedback control. Biofeedback Self Regul 17:159–164
Headache Classification Committee of the International Headache Society (1988) Classification and diagnostic criteria for headache disorders, cranial neuroalgias and facial pain. Cephalalgia 8(Suppl. 7):1–96
Headley BJ (1997) Physiologic risk factors. In: Sanders M (ed) Management of cumulative trauma disorders, 2nd edn. Butterworth-Heineman, London
Helliwell PS, Howe A, Wright V (1988) Lack of objective evidence of stiffness in rheumatoid arthritis. Ann Rheum Dis 47:754–758
Herman MJ (2006) Torticollis in infants and children: Common and unusual causes. Instr Course Lect 55:647–53
Hildebrand KA, Sutherland C, Zhang M (2004) Rabbit knee model of post-traumatic joint contractures: The long-term natural history of motion loss and myofibroblasts. J Orthop Res 22:313–320
Hoheisel U, Koch K, Mense S (1994) Functional reorganization in the rat dorsal horn during an experimental myositis. Pain 59:111–118
Hsieh JC, Belfrage M, Stone-Elander S et al. (1995) Central representation of chronic ongoing neuropathic pain studied by positron emission tomography. Pain 63:225–236
Headache Classification Committee of the International Headache Society (1993) Classification of headache: Methods and empirical data. Satellite meeting the VIth International Headache Society. Congress Proceedings. Cephalalgia 13(Suppl 12):1–96
Jaeger B (1994) Differential diagnosis and management of craniofacial pain. In: Ingle JI, Bakland LK (eds) Endodontics, Chap 11, 4th edn. Williams & Wilkins, Baltimore, pp 550–607
Jahanshahi M (2000) Factors that ameliorate or aggravate spasmodic torticollis. J Neurol Neurosurg Psychiatry 68:227–229
Jahanshahi M, Sartory G, Marsden CD (1991) EMG biofeedback treatment of torticollis: A controlled outcome study. Biofeedback Self Regul 16:413–448
Jansen PH, Lecluse RG, Verbeek AL (1999) Past and current understanding of the pathophysiology of muscle cramps: why treatment of varicose veins does not relieve leg cramps. J Eur Acad Dermatol Venereol 12:222–229
Jho HD, Jannetta PJ (1995) Microvascular decompression for spasmodic torticollis. Acta Neurochir (Wien) 134:21–26
Johnson EW (1989) The myth of skeletal muscle spasm. Am J Phys Med Rehabil 68:1
Kanovský P, Streitová H, Dufek J et al. (1997) Lateralization of the P22/N30 component of somatosensory evoked potentials of the median nerve in patients with cervical dystonia. Mov Disord 12:553–560
Khasani S, Becker K, Meinck HM (2004) Hyperekplexia and stiff-man syndrome: Abnormal brainstem reflexes suggest a physiological relationship. J Neurol Neurosurg Psychiatry 75:1265–1269
Kimura J (1989) Electrodiagnosis in diseases of nerve and muscle: principles and practice, ed. 2. F. A. Davis, Philadelphia
Kniffki KD, Schomburg ED, Steffens H (1981) Synaptic effects from chemically activated fine muscle afferents upon alpha-motoneurones in decerebrate and spinal cats. Brain Res 206(2):361–370
Konijnenberg HS, de Wilde NS, Gerritsen AA et al. (2001) Conservative treatment for repetitive strain injury. Scand J Work Environ Health 27:299–310
Kumar RT, Pandyan AD, Sharma AK (2006) Biomechanical measurement of post-stroke spasticity. Age Ageing 35:371–375
Lakie M, Robson LG (1988) Thixotropic changes in human muscle stiffness and the effects of fatigue. Quart J Exp Physiol 73:487–500
Lakie M, Walsh EG, Wright G (1979) Wrist compliance. J Physiol proceedings 295:98–99
Lakie M, Tsementzis ST, Walsh EG (1980) Anesthesia does not (and cannot) reduce muscle tone? J Physiol 301:32P
Lakie M, Walsh EG, Wright GW (1984) Resonance at the wrist demonstrated by the use of a torque motor: An instrumental analysis of muscle tone in man. J Physiol 353:265–285
Larsson B, Björk J, Elert J et al. (2000) Mechanical performance and electromyography during repeated maximal isokinetic shoulder forward flexions in female cleaners with and without myalgia of the trapezius muscle and in healthy controls. Eur J Appl Physiol 83:257–67
Larsson B, Björk J, Elert J et al. (2001) Fibre type proportion and fibre size in trapezius muscle biopsies from cleaners with and without myalgia and its correlation with ragged red fibres, cytochrome-c-oxidase-negative fibres, biomechanical output, perception of fatigue, and surface electromyography during repetitive forward flexions. Eur J Appl Physiol 84:492–502
Layzer RB (1994) Muscle pain, cramps, and fatigue. In: Engel AG, Franzini-Armstrong C (eds) Myology: Basic and Clinical, 2nd edn. McGraw-Hill, New York, pp 1754–1768
Le Pera D, Graven-Nielsen T, Valeriani M et al. (2001) Inhibition of motor system excitability at cortical and spinal level by tonic muscle pain. Clin Neurophysiol 112(9):1633–1641
Leistad RB, Sand T, Westgaard RH et al. (2006) Stress-induced pain and muscle activity in patients with migraine and tension-type headache. Cephalalgia 26(1):64–73
Leonard CT, Deshner WP, Romo JW et al. (2003) Myotonometer intra- and interrater reliabilities. Arch Phys Med Rehabil 84:928–932
Leplow B, Stubinger C (1994) Visuospatial functions in patients with spasmodic torticollis. Percept Motor Skills 78(3 Pt 2):1363–1375
Letchuman R, Deusinger RH (1993) Comparison of sacrospinalis myoelectric activity and pain levels in patients undergoing static and intermittent lumbar traction. Spine (Phila Pa.) 18:1361–1365
Lin CC, Ju MS, Lin CW (2003) The pendulum test for evaluating spasticity of the elbow joint. Arch Phys Med Rehabil 84:69–74
Lobbezoo F, Thu Thon M, Rémillard G et al. (1996) Relationship between sleep, neck muscle activity, and pain in cervical dystonia. Can J Neurol Sci 23:285–90
Lous I, Olesen J (1982) Evaluation of pericranial tenderness and oral function in patients with common migraine, muscle contraction headache and “combination headache”. Pain 12:385–393
Lund JP, Donga R, Widmer CG et al. (1991) The pain-adaptation model: A discussion of the relationship between chronic musculoskeletal pain and motor activity. Can J Physiol Pharmacol 69(5):683–694
Masi AT, Hannon JC (2008) Human resting muscle tone (HRMT): Narrative introduction and modern concepts. J Bodyworks Movement Ther 12:320–332
Masi AT, Walsh EG (2003) Ankylosing spondylitis: Integrated clinical and physiological perspectives. Clin Exp Rheumatol 21:1–8
Masi AT, Dorsch JL, Cholewicki J (2003) Are adolescent idiopathic scoliosis and ankylosing spondylitis counteropposing conditions? A hypothesis on biomechanical contributions predisposing to these spinal disorders. Clin Exp Rheumatol 21:573–580
Masi AT, Sierakowski S, Kim JM (2005) Jacques Forestier’s vanished bowstring sign in ankylosing spondylitis: a call to test its validity and possible relation to spinal myofascial hypertonicity. Clin Exp Rheumatol 23:760–766
Masi AT, Benjamin M, Vleeming A (2007) Anatomical, biomechanical, and clinical perspectives on sacroiliac joints: an integrative synthesis of biodynamic mechanisms related to ankylosing spondylitis. In: Vleeming A, Stoeckart R, Mooney V (eds) Movement, stability, and lumbopelvic pain: A multidisciplinary approach, 2nd edn. Elsevier, Edinburgh, pp 205–227 Ch 14
Mathies H (1988) Problems of terminology. In: Emre M, Mathies H (eds) Muscle spasms and pain. Parthenon, London
Mattle H (1988) A review of involuntary muscle contractions and muscular pain. In: Emre M, Mathies H (eds) Muscle spasms and pain. Parthenon, London
Mazzini L, Zaccala M, Balzarini C (1994) Abnormalities of somatosensory evoked potentials in spasmodic torticollis. Mov Disord 9:426–430
McDonough Jr JT (ed) (1994) Stedman’s Concise Medical Dictionary Illustrated, 2nd edn. Williams & Wilkins, Baltimore, p 1054
McEvoy KM (1991) Stiff-man syndrome. Mayo Clin Proc 66:300–304
Mense S, Gerwin RD (eds) (2010) Muscle pain: diagnosis and treatment. Springer, Heidelberg
Mense S, Skeppar P (1991) Discharge behaviour of feline gamma-motoneurones following induction of an artificial myositis. Pain 46:201–210
Merskey H, Bogduk N (1994) Classification of chronic pain, 2nd edn. IASP Press, Seattle
Middaugh SJ, Kee WG, Nicholson JA (1994) Muscle overuse and posture as factors in the development and maintenance of chronic musculoskeletal pain. In: Grezesiak R, Ciccone D (eds) Psychological vulnerability to chronic pain. Springer, New York
Miller TM, Layzer RB (2005) Muscle cramps. Muscle Nerve 32:431–442
Minajeva A, Kulke M, Fernandez JM et al. (2001) Unfolding of titin domains explains the viscoelastic behavior of skeletal myofibrils. Biophys J 80:1442–1451
Molloy FM, Dalakas MC, Floeter MK (2002) Increased brainstem excitability in stiff-person syndrome. Neurology 59:449–451
Münchau A, Palmer JD, Dressler D et al. (2001) Prospective study of selective peripheral denervation for botulinum- toxin resistant patients with cervical dystonia. Brain 124:769–783
Mutungi G, Ranatunga KW (1996) The viscous, viscoelastic and elastic characteristics of resting fast and slow mammalian (rat) muscle fibres. J Physiol 496(3):827–836
Naumann M, Yakovleff A, Durif F; BOTOX Cervical Dystonia Prospective Study Group (2002) A randomized, double-masked, crossover comparison of the efficacy and safety of botulinum toxin type A produced from the original bulk toxin source and current bulk toxin source for the treatment of cervical dystonia. J Neurol 249:57–63
Norris FH Jr, Gasteiger EL, Chatfield PO (1957) An electromyographic study of induced and spontaneous muscle cramps. Electroencephalogr Clin Neurophysiol 9:139–154
Oba T, Koshita M, Aoki T et al. (1997) BAY K 8644 and ClO4– potentiate caffeine contracture without Ca2+ release channel activation. Am J Physiol 272(1 Pt 1):C41–C47
Ochala J, Frontera WR, Dorer DJ et al. (2007) Single skeletal muscle fiber elastic and contractile characteristics in young and older men. J Gerontol A Biol Sci Med Sci 62:375–381
Ottaviani LB, Childers MK (1995) Localization of the neuromuscular junction through needle electromyography. Arch Phys Med Rehabil 76:1045
Pappert EJ, Germanson T, Myobloc/Neurobloc European Cervical Dystonia Study Group (2008) Botulinum toxin type B vs type A in toxin-naïve patients with cervical dystonia: Randomized, double-blind, noninferiority trial. Mov Disord 23:510–517
Peterson AL, Talcott GW, Kelleher WJ et al. (1995) Site specificity of pain and tension in tension-type headaches. Headache 35(2):89–92
Peyron R, Laurent B, García-Larrea L (2000) Functional imaging of brain responses to pain. A review and meta-analysis (2000). Neurophysiol Clin 30:263–288
Poewe W (1989) The clinical spectrum of spastic syndromes. In: Endre M, Benecke R (eds) Spasticity: The current status of research and treatment. Parthenon, Park Ridge, New Jersey
Rachlin ES (1994) Part II, Trigger point management. In: Rachlin ES (ed) Myofascial pain and fibromyalgia: Trigger point management. Mosby, St. Louis, pp 143–360 Chaps. 7–10
Ralston HJ, Libet B (1953) The question of tonus in skeletal muscle. Am J Phys Med 32:85–92
Reinöhl J, Hoheisel U, Unger T et al. (2003) Adenosine triphosphate as a stimulant for nociceptive and non-nociceptive muscle group IV receptors in the rat. Neurosci Lett 338:25–28
Roggenbuck DJ, Yablon SA (1995) Suboptimal response of index distal phalanx spasticity following treatment with botulinum toxin A: Indications for precise muscle localization with needle stimulation. Arch Phys Med Rehabil 76:1070
Saito S, Moller AR, Jannetta PJ et al. (1993) Abnormal response from the sternocleidomastoid muscle in patients with spasmodic torticollis: Observations during microvascular decompression operations. Acta Neurochir (Wien) 124:92–98
Sakai F, Ebihara S, Akiyama M et al. (1995) Pericranial muscle hardness in tension-type headache. A non-invasive measurement method and its clinical application. Brain 118(Pt 2):523–531
Schulman EA (2001) Overview of tension-type headache. Curr Pain Headache Rep 5:454–462
Sekihara C, Izumizaki M, Yasuda T et al. (2007) Effect of cooling on thixotropic position-sense error in human biceps muscle. Muscle Nerve 35:781–787
Sherman RA, Arena JG, Searle JR et al. (1991) Development of an ambulatory recorder for evaluation of muscle tension-related low back pain and fatigue in soldiers' normal environments. Milit Med 156:245–248
Sherrington CS (1915) Postural activity of muscle and nerve. Brain 38:191–234
Simons DG (1996) Clinical and etiological update on myofascial pain from trigger points. J Musculoskel Pain 4(1):93–122
Simons DG, Mense S (1998) Understanding and measurement of muscle tone as related to clinical muscle pain. Pain 75:1–17
Simons DG, Travell JG, Simons LS (1999) In: Travell JG, Simons DG (eds) Travell and Simons’ Myofascial pain and dysfunction: The trigger point manual, Vol 1. The upper half of body, 2nd edn. Williams & Wilkins, Baltimore
Stedman’s Concise Medical Dictionary (1994) 2nd edn. Williams and Wilkins, Baltimore
Szabo RM (2006) Determining causation of work-related upper extremity disorders. Clin Occup Environ Med 5:225–234
Tahmoush AJ, Alonso RJ, Tahmoush GP et al. (1991) Cramp–fasciculation syndrome: A treatable hyperexcitable peripheral nerve disorder. Neurology 41:1021–1024
Tassorelli C, Mancini F, Balloni L et al. (2006) Botulinum toxin and neuromotor rehabilitation: An integrated approach to idiopathic cervical dystonia. Mov Disord 21:2240–3
Thewlis J (1979) Concise dictionary of physics and related topics, 2nd edn. Pergamon, Oxford
Thiel A, Dressler D, Kistel C et al. (1994) Clozapine treatment of spasmodic torticollis. Neurology 44:957–958
Thilmann AF, Fellows SJ, Garms E (1991) The mechanism of spastic muscle hypertonus. Variation in reflex gain over the time course of spasticity. Brain 114:233–244
Thompson JS, Phelps TH (1990) Repetitive strain injuries. How to deal with “the epidemic of the 1990's”. Postgrad Med 88:143–149
Throckmorton GS, Ellis E 3rd, Hayasaki H (2004) Masticatory motion after surgical or nonsurgical treatment for unilateral fractures of the mandibular condylar process. J Oral Maxillofac Surg 62:127–38
Tintner R, Jankovic J (2001) Botulinum toxin for the treatment of cervical dystonia. Expert Opin Pharmacother 2:1985–1994
Travell JG, Simons DG (1992) Myofascial pain and dysfunction: The trigger point manual, Vol 2. The lower extremities. Williams & Wilkins, Baltimore
Troullos ES, Hargreaves KM, Butler DP et al. (1990) Comparison of nonsteroidal anti-inflammatory drugs, ibuprofen and flurbiprofen, with methylprednisolone and placebo for acute pain, swelling, and trismus. J Oral Maxillofac Surg 48:945–952
Vaillancourt DE, Prodoehl J, Verhagen Metman L et al. (2004) Effects of deep brain stimulation and medication on bradykinesia and muscle activation in Parkinson's disease. Brain 127:491–504
Valle MS, Casabona A, Sgarlata R et al. (2006) The pendulum test as a tool to evaluate passive knee stiffness and viscosity of patients with rheumatoid arthritis. BMC Musculoskelet Disord 7:89. doi: 10.1186/1471-2474-7-89
van Herwaarden GM, Anten HW, Hoogduin CA et al. (1994) Idiopathic spasmodic torticollis: a survey of the clinical syndromes and patients' experiences. Clin Neurol Neurosurg 96:222–225
Viir R, Laiho K, Kramarenko J et al. (2006) Repeatability of trapezius muscle tone assessment by a myometric method. J Mech Med Biol 6:215–228
Vogels RL, van Orshoven NP, de Koning-Tijssen MA et al. (2003) ‘Stiff-person’-syndrome. Ned Tijdschr Geneeskd 147:1228–1232
Walsh EG (1992) Muscles, masses and motion: The physiology of normality, hypotonicity, spasticity and rigidity. Mac Keith Press, London
Walsh EG, Wright GW, Powers N et al. (1989) Biodynamics of the wrist in rheumatoid arthritis — the enigma of stiffness. Proc Inst Mech Eng H 203:197–201
Wartenberg R (1951) Pendulousness of the legs as a diagnostic test. Neurology 1:18–24
Webster DD (1970) Quantitative measurements of L-dopa therapy in Parkinson's disease. Neurology 20:376–377
Wöber C, Schnider P, Steinhoff N et al. (1999) Posturographic findings in patients with idiopathic cervical dystonia before and after local injections with botulinum toxin. Eur Neurol 41:194–200
Wright V, Johns RJ (1960) Physical factors concerned with the stiffness of normal and diseased joints. Bull Johns Hop Hosp 106:215–231
Ylinen J, Teittinen I, Kainulainen V et al. (2006) Repeatability of a computerized muscle tonometer and the effect of tissue thickness on the estimation of muscle tone. Physiol Meas 27:787–796
Young W (1966) The stiff-man syndrome. Br J Clin Practice 20(10):507–510
Yung P, Unsworth A, Haslock I (1986) Measurement of stiffness in the metacarpophalangeal joint: The effects of physiotherapy. Clin Phys Physiol Meas 7:147–156
Zaki MS, Abdel-Aleem A, Abdel-Salam G et al. (2008) The molar tooth sign: A new Joubert syndrome and related cerebellar disorders classification system tested in Egyptian families. Neurology 70:556–565
Acknowledgment
Jessica Debis is acknowledged for her invaluable technical assistance in the preparation and completion of this manuscript, which was supported in part by the Department of Medicine, University of Illinois College of Medicine at Peoria, and a grant from the MTM Foundation.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Mense, S., Masi, A.T. (2010). Increased Muscle Tone as a Cause of Muscle Pain. In: Mense, S., Gerwin, R. (eds) Muscle Pain: Understanding the Mechanisms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85021-2_6
Download citation
DOI: https://doi.org/10.1007/978-3-540-85021-2_6
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-85020-5
Online ISBN: 978-3-540-85021-2
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)