ArticleFrontiers in pain research (Lausanne, Switzerland)2021
Impaired Lymphatic Drainage and Interstitial Inflammatory Stasis in Chronic Musculoskeletal and Idiopathic Pain Syndromes: Exploring a Novel Mechanism.
Article in Frontiers in pain research (Lausanne, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06060925 (Multimodal Imaging Biomarkers for Investigating Fascia, Muscle and Vasculature in Myofascial Pain), which is not on this map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multimodal Imaging Biomarkers for Investigating Fascia, Muscle and Vasculature in Myofascial Pain
Who cites it
19 citing papers in PubMed, 26 citations in OpenAlex.
- Rapid Reduction in Posttraumatic Stress Disorder Symptom Severity after Three Fascial Counterstrain Manual Treatments: A Proof-of-Concept Study.Military medicine · 2026Trial
- One year follow-up on a randomized study investigating serratus anterior muscle and pectoral nerves type I block to reduced neuropathic pain descriptors after mastectomy.Scientific reports · 2023Trial
- Inflammatory Signal Persistence in Pain: Lymphatic Regulation and Neuroimmune Integration.Biology · 2026Review
- TWOJournal of clinical medicine · 2026Review
- Identification of synovial lymphatic system in the temporomandibular joint and their roles in arthritis and pain.Nature communications · 2026Article
- Multidimensional analysis of the clinical spectrum and symptom burden of unexplained myofascial pain.medRxiv : the preprint server for health sciences · 2026Article
- Article
- MASSAG model: Towards an integrative neuroscience framework linking emotional trauma, pain, and mechanisms of force-based manipulations.Neuroscience and biobehavioral reviews · 2026Review
- The neuroimmune axis and chronic pain disorders.iScience · 2026Review
- Mechanisms of Mucoid Degeneration in the Cruciate Ligament: Role of Denatured Aggrecan Accumulation and Tissue Dysfunction.Orthopedic research and reviews · 2026Review
- Lymphatic dysfunction and impaired interstitial clearance in sarcopenic obesity: a hypothesis-generating review.Frontiers in endocrinology · 2026Review
- Looking Inwards: The Role of Self-Care, Self-Management and Self-Healing in Musculoskeletal Pain.Musculoskeletal care · 2025Article
- Identification of Synovial Lymphatics in the TMJ and their Roles in Arthritis and Pain.Research square · 2025Article
- ISSLS Prize in Basic Science 2025: Structural changes of muscle spindles in the multifidus muscle after intervertebral disk injury are resolved by targeted activation of the muscle.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Additional evidence from a case report supports a novel hypothesis on the association between complex regional pain syndrome and lymphedema.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Case Report: The effect of automated manual lymphatic drainage therapy on lymphatic contractility in 4 distinct cases.Frontiers in medical technology · 2024Article
- Temporal model for central sensitization: A hypothesis for mechanism and treatment using systemic manual therapy, a focused review.MethodsX · 2023Review
- A model for personalized diagnostics for non-specific low back pain: the role of the myofascial unit.Frontiers in pain research (Lausanne, Switzerland) · 2023Article
- The peripheral Epac1/p-Cav-1 pathway underlies the disruption of the vascular endothelial barrier following skin/muscle incision and retraction-induced chronic postsurgical pain.Annals of translational medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A normal functioning lymphatic pump mechanism and unimpaired venous drainage are required for the body to remove inflammatory mediators from the extracellular compartment. Impaired vascular perfusion and/or lymphatic drainage may result in the accumulation of inflammatory substances in the interstitium, creating continuous nociceptor activation and related pathophysiological states including central sensitization and neuroinflammation. We hypothesize that following trauma and/or immune responses, inflammatory mediators may become entrapped in the recently discovered interstitial, pre-lymphatic pathways and/or initial lymphatic vessels. The ensuing interstitial inflammatory stasis is a pathophysiological state, created by specific pro-inflammatory cytokine secretion including tumor necrosis factor alpha, interleukin 6, and interleukin 1b. These cytokines can disable the local lymphatic pump mechanism, impair vascular perfusion via sympathetic activation and, following transforming growth factor beta 1 expression, may lead to additional stasis through direct fascial compression of pre-lymphatic pathways. These mechanisms, when combined with other known pathophysiological processes, enable us to describe a persistent feed-forward loop capable of creating and maintaining chronic pain syndromes. The potential for concomitant visceral and/or vascular dysfunction, initiated and maintained by the same feed-forward inflammatory mechanism, is also described.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.