A large number of people suffer from musculoskeletal disorders (MSDs), including regional pain in the neck-shoulder region and lower back, or more widespread pain, e.g., fibromyalgia [1]. Chronic MSDs are characterized by a localized, regional or widespread sensation of pain affecting muscles, joints, tendons or ligaments, accompanied by symptoms such as fatigue, tenderness at palpation and muscle stiffness. An autonomic imbalance may also reflect altered regulation of the entire stress response system and may have detrimental consequences in terms of pathological conditions as mentioned above [6]. In particular, this study paid attention to the involvement of the ANS in the initiation and maintenance of chronic muscle pain. We had incorporated patients to study the Autonomic function imbalance in the Neck Shoulder Pain and Low Back Pain patients. We intended to include 15 patients in both the test groups and 15 normal subjects (Age and Sex matched) for comparative analysis. A detailed clinical history was taken from all the patients and subjects to exclude the presence of diabetes mellitus, hypertension, alcohol dependence and other diseases that can affect autonomic functions. Both the limbs of ANS were studied using standard battery of autonomic function tests: l Deep Breathing Test l Lying to Standing Test l Valsalva Maneuver l Hand Grip Test l Cold Pressor Test The results were recorded and carefully evaluated. It was found that Sympathetic over activity in low back pain patients can be the cause of this autonomic imbalance or it may be a predictor of prognostic evaluation in such patients. We conclude that sympathetic overactivity plays a major role in the patients suffering from low back pain whereas the role of parasympathetic reactivity from the presence study is not clear.  The best way to arrive at investigative & prognostic evaluation of patients suffering from low back pain would be CPT and HGT as a standard marker of sympathetic reactivity.

Keywords: Musculoskeletal Disorders; Fibromyalgia; Palpation; Tendons; Ligaments.