Morphology and histochemistry of myogelosis

Myogelosis is a common diagnosis in the case of chronic pain conditions, es pecially in the region of the pectoral girdle musculature, the glutei muscl es, and the erector, spinae muscle. Although such indurative areas continue to be palpable even on the cadaver, few studies concerning the morphologic al substrate of these areas have been undertaken. Selected biopsies as well as larger tissue samples were taken from 11 corpses and prepared for histo logical study. Following staining, the frozen sections were examined morpho metrically;. A histologically constant, significant morphological alteratio n was found in the areas of concern. The spaces between the individual musc le fibers of healthy muscle tissue appear relatively Ride, the endomysium o f the myogelotic area are clearly narrow ed, Split fibers, ragged red fiber s, Type II fiber atrophy, and fibers with a moth-eaten appearance have been detected. The morphometry shows considerable increase in thickness of the affected muscle fibers, suggestive of a pathological, local hypertrophy. Th e changes described may well represent a fixed condition, so that, it shoul d not be surprising that myogelosis therapy is difficult. and protracted. ( C) 1999 Wiley-Liss, Inc.