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Cited by 32Myofascial pain diagnosis and treatmentTendon Structure and TreatmentAdvanced MRI Techniques and Applications

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T1ρ-Mapping for Musculoskeletal Pain Diagnosis: Case Series of Variation of Water Bound Glycosaminoglycans Quantification before and after Fascial Manipulation® in Subjects with Elbow Pain

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Menon, Rajiv, Oswald, Stephen, Raghavan, Preeti, Regatte, Ravinder, Stecco, Antonio·2020·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph17030708PMC PMC7037807
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Abstract

Diagnosis and management of musculoskeletal pain is a major clinical challenge. Following this need, the first aim of our study was to provide an innovative magnetic resonance technique called T1ρ to quantify possible alterations in elbow pain, a common musculoskeletal pain syndrome that has not a clear etiology. Five patients were recruited presenting chronic elbow pain (>3 months), with an age between 30 and 70 years old. Patients underwent two T1ρ-mapping evaluations, one before and one after the series of Fascial Manipulation® (FM) treatments. After the first MRI evaluation, a Disability of the Arm, Shoulder and Hand (DASH) questionnaire was administered to quantify the symptoms and pain intensity. Patients then received three sessions of FM, once a week for 40 min each. A statistically significant difference was found between bound and unbound water concentration before and after FM treatment. Our preliminary data suggest that the application of the manual method seems to decrease the concentration of unbound water inside the deep fascia in the most chronic patients. This could explain the change in viscosity perceived by many practitioners as well as the decrease of symptoms due to the restoration of the normal property of the loose connective tissue. Being able to identify an altered deep fascial area may better guide therapies, contributing to a more nuanced view of the mechanisms of pain.

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  • Recent studies using T1ρ MR imaging suggested that high levels of unbound water, indicating hyaluronan aggregation, may also contribute to increased stiffness and reduced mobility of fasciae.

    “Recent studies using T1ρ MR imaging suggested that high levels of unbound water, indicating hyaluronan aggregation, may also contribute to increased stiffness and reduced mobility of fasciae [36].”

    From Fascia Mobility, Proprioception, and Myofascial Pain. (2021) · cites this paper as [36]

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Research works printed but not linked: 29

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Metadata

Authors
Menon, R., Oswald, S., Raghavan, P., Regatte, R., & Stecco, A.
Affiliations
  • NYU Langone Health (US)
  • Private Practice, New York, NY 10011, USA
  • Johns Hopkins University (US)
  • Rusk Rehabilitation (US)
Corresponding author
Stecco, Antonio
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2020-01-22
Volume
17
Issue
3
Pages
708
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph17030708
PMC
PMC7037807
OpenAlex
W3000798689
Cited by
32
References
2
Citations by year
2026: 3 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 5 · 2021: 5 · 2020: 3
FWCI
2.49
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR067156, R01AR068966)
  • National Institute of Biomedical Imaging and Bioengineering (P41EB017183)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21HD091559)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Myofascial pain diagnosis and treatment
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
Keywords
T1rho mapping, elbow pain, fascial manipulation, deep fascia, bound water, glycosaminoglycans, unbound water, chronic musculoskeletal pain, DASH questionnaire, loose connective tissue
MeSH terms
Adult, Aged, Elbow, Fascia, Glycosaminoglycans, Humans, Middle Aged, Water, Musculoskeletal Manipulations, Musculoskeletal Pain

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