• Takayoshi Matsui, Kazuhiro Hara, Takamasa Kayama, Makoto Iwata, Nobuyuki Shitara, Shuntaro Hojo, Yuzo Endo, Hideoki Fukuoka, Noriko Yoshimura, and Hiroshi Kawaguchi.
• Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001, Japan.
• Eur Spine J. 2020 May 1; 29 (5): 1013-1021.

PurposePatients 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.MethodsA 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.ResultsThe 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.ConclusionCervical 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.Trial Registration IdUMIN000035445. These slides can be retrieved under Electronic Supplementary Material.

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