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Review
. 2021 Sep 24;10(19):4342.
doi: 10.3390/jcm10194342.

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Larissa Sinhorim  1   2 , Mayane Dos Santos Amorim  1   3 , Maria Eugênia Ortiz  1   2 , Edsel Balduino Bittencourt  1   4 , Gianluca Bianco  1   5   6 , Fabiana Cristina da Silva  7 , Verônica Vargas Horewicz  1   2 , Robert Schleip  8   9 , William R Reed  10   11 , Leidiane Mazzardo-Martins  12 , Daniel F Martins  1   2
Affiliations
Review

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Larissa Sinhorim et al. J Clin Med. .

Abstract

Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over the past few decades; however, these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting lower back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane, and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies satisfied the following: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, after which data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met the inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in lower back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Additional knowledge of fascial neurological components could impact LBP treatment.

Keywords: ex vivo; fascia; in vivo; innervation; lower back pain; nociceptor; pain; scoping review; thoracolumbar fascia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart diagram (file in attachment).
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