The Journal of Bone and Joint Surgery, Vol 58, Issue 6 815-825, Copyright © 1976 by Journal of Bone and Joint Surgery, Inc
Tenderness at motor points. A diagnostic and prognostic aid for low-back injury
CC Gunn and WE Milbrandt
In patients with low-back injury the motor points of some muscles may be
tender. Of fifty patients with low-back "strain", twenty-six had tender
motor points and twenty-four did not, while forty-nine of fifty patients
with radicular signs and symptoms suggesting disc involvement had tender
motor points, and the one without such tender points had a hamstring
contusion which limited straight leg raising. Of fifty controls with no
back disability, only seven had mild tender points after strenuous
activity, while forty-six of another fifty controls with occasional back
discomfort had mild motor-point tenderness. In all instances the tender
motor points were located in the myotomes corresponding to the probable
segmental levels of spinal injury and of root involvement, when present.
Patients with low-back strain and no tender motor points were disabled for
an average of 6.9 weeks, while those with the same diagnosis but tender
motor points were disabled for an average of 19.7 weeks, or almost as long
as the patients with signs of radicular involvement, who were disabled for
an average of 25.7 weeks. Tender motor points may therefore be of
diagnostic and prognostic value, serving as sensitive localizers of
radicular involvement and differentiating a simple mechanical low-back
strain from one with neural involvement.
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