Background: The consequences of median nerve compression at the carpal tunnel level require a precise diagnostic evaluation before a frequently applied surgical intervention. Positive Tinel or Phalen signs are not always related to abnormal results in electroneurographic examinations of sensory and motor nerve fibers, which are intended to confirm final diagnoses, thereby confusing both surgeons and neurophysiologists. In the face of contradictory data, this study aims to reinvestigate these correlations in a randomly chosen population of patients with a primary diagnosis of carpal tunnel syndrome (CTS). Methods: Seventy-five randomly chosen patients with clinically detected CTS underwent neurophysiological studies of median nerve sensory (SNAP) and motor (CMAP) fibers conduction at the wrist. Both the median and ulnar nerves were assessed to reduce the risk of misinterpretation related to anatomical variations. Results: This study provides evidence on the relatively high utility of Phalen’s test in the early clinical detection of CTS within a general population of patients, whose positive results moderately correlate (rho = −0.327) with abnormalities in amplitudes rather than the distal latency parameters of SNAP recordings. The axonal injury type is more distinct than slowing-down impulses at the wrist following compression of the sensory nerve fibers in the early course of CTS. Positive Tinel’s test results are useful in diagnosing CTS patients with advanced axonal and demyelinating changes in the motor fibers at the wrist, which weakly correlate with prolonged latency and decreased amplitude in SNAP recordings (rho = −0.214 and rho = −0.235, respectively), but not with abnormalities in recordings of both amplitudes and latencies in CMAP electroneurography. Conclusions: The correlations between clinical signs and neurophysiological findings in CTS indicate that provocative tests, such as Phalen’s and Tinel’s, have limited diagnostic value, demonstrating only weak-to-moderate associations with neural conduction parameters. A positive Tinel’s sign should be regarded mainly as a marker of severe or chronic sensory impairment, often accompanied by motor fibers involvement in advanced pathological stages, rather than as an indicator of motor damage alone. Nerve conduction studies remain essential for confirming CTS, assessing its severity, and guiding treatment decisions, including surgical qualification. The presented correlation of clinical and functional neurophysiological results in CTS diagnosis allows us not only to specify the source and severity of the pathology of the median nerve fibers but also may influence the personalization of physiotherapeutic and surgical treatments.

Background: The diagnostic value of surface electromyography (sEMG) for identifying muscles affected by myofascial trigger points (TrPs) remains controversial. However, advances in pain neurophysiology and discussions regarding TrPs within the International Classification of Diseases (ICD-11) have renewed interest in objective diagnostic approaches. Objective: To synthesize current evidence on the diagnostic utility of sEMG for detecting TrP-related muscle alterations across different electromyographic signal analysis domains. Methods: A scoping review was conducted following JBI guidance and PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, CINAHL and Cochrane were searched for studies involving adults with symptomatic or asymptomatic TrPs, myofascial pain syndrome, or TrP-related referred pain. Fifteen studies met the inclusion criteria. Analyses included amplitude-, frequency-, time–frequency-, and spatial-domain sEMG parameters. Results: Muscles affected by TrPs showed increased resting electromyographic activity and reduced activation during maximal voluntary contraction in several studies. Frequency domain analyses indicated changes in median frequency and muscle fatigue index, whereas time–frequency analyses suggested redistribution of sEMG signal energy toward lower-frequency components or altered spectral power during experimentally provoked referred pain. Spatial analyses revealed altered activation patterns, although these findings did not consistently correspond with TrP anatomical locations. Overall, the limited number of studies assessing diagnostic sensitivity and specificity prevents firm conclusions. Conclusions: sEMG may be useful as a non-invasive complementary tool for functional assessment and monitoring of TrP-related muscle dysfunction. However, current evidence does not support its use as a standalone diagnostic method. Time–frequency, machine learning-supported and spatial analyses appear promising for future clinical research, but standardized protocols and external validation are required before clinical diagnostic criteria can be proposed.

The latest definition of pain describes it as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or resembling such damage. According to this definition, three subtypes of chronic pain are currently distinguished based on their underlying pathological mechanisms: nociceptive, neuropathic, and nociplastic. All three types share certain characteristic features, their symptoms may overlap, and co-occurrence is also possible. This makes diagnostic and treatment decisions difficult. This review provides a brief description of the most reliable tools for diagnosing and treating chronic pain and its sequelae, with a particular emphasis on neurophysiological research available in this field.

Introduction: Clearly manifested neurological symptoms in patients with idiopathic scoliosis (IS) are disputable, and their severity probably depends on the progression of the curvature. Their incidence and how they may affect treatment decisions have not been clearly defined in the current literature. The purpose of this paper was to present the prevalence of neurological symptoms in scoliotic patients qualified for surgical treatment, based on the available reports and the own observations on this topic. Methods and results: Mostly, during neurological evaluation of the scoliotic patients the researchers have documented the average results of Oswestry Disability Index (ODI), abnormalities in radiographic findings, the increased incidences of back pain, radiculopathy, myelopathy and less claudication, and neurological deficits like pain, muscle weakness and less bowel/bladder dysfunction and correlated these findings with operative versus non-operative management. The incidences of severe (Visual Analogue Pain Score – VAS > 5) back pain and radiculopathy were 66% and 47%, respectively. Typical neurological symptoms included muscle weakness in 8% of patients and less claudication, while bladder dysfunction occurred in 3%. Patients with severe radiculopathy had greater mean ODI scores (p < 0.001) and reduced lumbar lordosis (p = 0.04) and were more likely to develop lateral spine curvature (p = 0.009). Reflexes evaluation was mentioned but not precisely described. Our preliminary observations on 60 preoperative cases of Lenke 2 and 3 scoliosis with an average primary and secondary curvature angle of 56 degrees and 35 degrees indicate back pain of 2 on the VAS scale, a low incidence of positive Laseque test and suppression of knee and ankle reflexes, symptoms of slight analgesia in the dermatomal innervation of L3-S1, and decreased muscle strength of the distal lower extremities on the Lovett scale of 4. Conclusions: Neurological symptoms of back pain, moderate muscle weakness and sensory deficits are common among adults with scoliosis. The development of neurological symptoms and/or deficits significantly influences the decision on surgical treatment. More precise clinimetric methods and clinical neurophysiology tests are necessary to define the neurological symptoms of IS, which are difficult to evaluate using classical assessment methods.

Introduction: Stimulation of proprioceptors by the kinesiotherapist determines the initiation of therapy, different manual skills can be replaced with a unified, calibrated electric or magnetic stimulus. Aim: The aim of the study was to check whether stimulation using the motor evoked potentials (MEP) method can be used to verify the activation of the propriospinal system and as a source of stimulus in kinesiotherapy using the Vojta method. Material and methods: The study included 26 healthy subjects who underwent the magnetic stimulation at the acromion (ACR) on the left side and transvertebrally at C3-C4 levels. The MEPs were recorded from the biceps brachii (BB) and rectus femoris (RF) muscles using the surface electrodes (sEMG). Results: Parameters of 52 MEPs potentials recorded from BB bilaterally and 30 recorded from RF were analysed. Based on their frequency value, the sequence of muscles activation was calculated, which with stimulation from left ACR as well as at C3-C4 levels in a midline was as follows: left BB, right BB, right RF and left RF. Latencies of potentials after ACR stimulations were shorter in recordings from both BB and RF muscles than following the stimulation at C3-C4 level. Conclusions: Different fractions of the fibers in the long cervico-lumbar propriospinal system are activated following the magnetic stimulus applied at ACR via the afferent connections or only at C3-C4 cells of origin. However, they both transmit the neural signals in a velocity range characteristic for the propriospinal system.