Neuroanatomical pathway of nociception originating in a low back muscle (multifidus) in the rat.

The neural mechanisms of low back pain (LBP) are still enigmatic. Presently, low back muscles are being discussed as an important source of LBP. Here, the neuroanatomical pathway of the nociceptive information from the caudal multifidus muscle (MF) was studied. True blue was injected into the MF at the level L5 to visualize the dorsal root ganglion (DRG) cells that supply this muscle. The distribution of the stained cells had a maximum in the DRG L3, not in L5. Injection of 5% formalin into the MF at levels L4 and L5 induced a significant increase in the number of c-Fos-immunoreactive (-ir) nuclei in the dorsal horn in many lumbar segments. Cells expressing c-Fos were particularly numerous in the most lateral part of the ipsilateral laminae I-II. The number of c-Fos-ir nuclei in the dorsal horn of segment L3 was significantly higher than that in segment L5. To visualize supraspinal projections, fluorogold (FG) was injected into the contralateral ventrolateral periaqueductal gray (vlPAG) 6 days prior to formalin or saline injection into the MF. The number of double-labeled dorsal horn neurons (FG-positive plus c-Fos-ir) in all lumbar segments was significantly higher in the formalin group than in the saline group. These results show that (1) the origin of the sensory supply of the MF is shifted two segments cranially relative to the location of the muscle, (2) the spinal cells processing nociceptive input from the caudal MF are widely distributed, and (3) the vlPAG is a supraspinal center of nociception from the MF.