{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T18:44:08Z","timestamp":1775328248576,"version":"3.50.1"},"posted":{"date-parts":[[2026,4,2]]},"group-title":"Rehabilitation Medicine and Physical Therapy","reference-count":78,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,4,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Myofascial pain (MP) is a leading cause of disability globally. Pain quality and severity vary widely for people with MP, making it difficult to accurately assess the spectrum of symptoms and develop appropriate treatments. We assessed potential contributors to variability in the clinical spectrum of unexplained neck\/shoulder pain and associated myofascial component(s).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cross-sectional study of adults reporting neck\/shoulder pain and pain-free individuals.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Outcomes Measures<\/jats:title>\n                  <jats:p>Pain intensity and interference (PEG); Symptom burden measured using patient-reported outcomes and objective measures: pain catastrophizing (PCS); PROMIS physical function (PF); sleep disturbance; anxiety (GAD-2); depression (PHQ-2); hypermobility (Beighton\/Brighton); Objective measures in the medial upper trapezius: pressure pain threshold (PPT) and quantitative sensory testing (QST).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Of the 96 adults recruited for the study, 82 had complete records (age 32.2 +\/\u221213.1 years, 57% women). On physical exam, 23 were assessed to be in an\n                    <jats:italic>active<\/jats:italic>\n                    group (those with spontaneous MP without provocation), 38 in a\n                    <jats:italic>latent<\/jats:italic>\n                    group (those with MP upon provocation), and 21 in a\n                    <jats:italic>normal<\/jats:italic>\n                    group (no MP in neck and shoulder). The symptom burden explained 75% of the variance in PEG in the overall sample, 85% in the\n                    <jats:italic>active<\/jats:italic>\n                    group and 92% in the\n                    <jats:italic>normal<\/jats:italic>\n                    group. PF and PCS are key predictors of PEG. Network analysis identified unique symptom clusters in the\n                    <jats:italic>active<\/jats:italic>\n                    and\n                    <jats:italic>latent<\/jats:italic>\n                    groups.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The symptom burden explains the variability in the clinical spectrum of pain intensity and interference in unexplained neck\/shoulder MP. Network analysis can further improve clinical risk stratification. These findings represent a step towards an eventual goal of developing multidisciplinary clinical guidance for managing the whole patient, rather than the current emphasis on regional pain contributors in MP.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.03.27.26349456","type":"posted-content","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:45:17Z","timestamp":1775151917000},"source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional analysis of the clinical spectrum and symptom burden of unexplained myofascial pain"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6426-2320","authenticated-orcid":false,"given":"Siddhartha","family":"Sikdar","sequence":"first","affiliation":[{"name":"Department of Bioengineering, George Mason University, Fairfax, VA, USA"},{"name":"Center for Advancing Systems Science and Bioengineering Innovation, George Mason University, Fairfax, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Secili","family":"DeStefano","sequence":"additional","affiliation":[{"name":"Center for Advancing Systems Science and Bioengineering Innovation, George Mason University, Fairfax, VA, USA"},{"name":"Optimal Motion Physical Therapy, Herndon, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9 Guzm\u00e1n","family":"Pav\u00f3n","sequence":"additional","affiliation":[{"name":"Facultad de Fisioterapia y Enfermer\u00eda, University of Castilla-La Mancha, Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Lin","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Statistics, George Mason University, Fairfax, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiyon","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Advancing Systems Science and Bioengineering Innovation, George Mason University, Fairfax, VA, USA"},{"name":"Department of Statistics, George Mason University, Fairfax, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Srbely","sequence":"additional","affiliation":[{"name":"Department of Health and Nutritional Science, University of Guelph, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Shah","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Rosenberger","sequence":"additional","affiliation":[{"name":"Center for Advancing Systems Science and Bioengineering Innovation, George Mason University, Fairfax, VA, USA"},{"name":"Department of Statistics, George Mason University, Fairfax, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Acu\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, George Mason University, Fairfax, VA, USA"},{"name":"Center for Advancing Systems Science and Bioengineering Innovation, George Mason University, Fairfax, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonathan","family":"Assefa","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matin Jahani","family":"Jirsaraei","sequence":"additional","affiliation":[{"name":"Department of Civil Engineering, George Mason University, Fairfax, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Stecco","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, NYU Grossman School of Medicine, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn H.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Center for Advancing Systems Science and Bioengineering Innovation, George Mason University, Fairfax, VA, USA"},{"name":"Medicine Service Line, INOVA Health System, Falls Church, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2026040410450859000_2026.03.27.26349456v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"2026040410450859000_2026.03.27.26349456v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00163-7"},{"key":"2026040410450859000_2026.03.27.26349456v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(11)60610-7"},{"key":"2026040410450859000_2026.03.27.26349456v1.4","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.jbmt.2017.03.025","article-title":"A myofascial component of pain in knee osteoarthritis","volume":"21","year":"2017","journal-title":"J. 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