PURPOSE Patients with various and indefinite symptoms in the whole body occasionally have coincident with stiffness or tenderness of the cervical muscles. This prospective case series examined the effect of local modulation of the cervical muscles in patients with cervical disorders reporting indefinite whole-body symptoms. METHODS A total of 1863 hospitalized patients with cervical disorders accompanying three or more indefinite whole-body symptoms, who were resistant to outpatient care, were enrolled in this study for 12 years. All patients underwent daily physical therapies to the cervical muscles during hospitalization. Self-rated records on the medical interview sheets documenting 30 representative symptoms including cervical/shoulder pain or stiffness and 28 representative indefinite whole-body symptoms at admission and discharge were compared across the population. RESULTS The number of symptoms decreased significantly with the local modulation of the cervical muscles during hospitalization. All of the 28 indefinite whole-body symptoms at admission showed recovery rates greater than 50% at discharge. The mean number of symptoms decreased significantly from 17.8 at admission to 7.4 at discharge (p < 0.0001). The percentages of patients reporting 10 or more symptoms were 91.1% and 29.3% at admission and discharge, respectively. Moreover, 8.2% of patients reported no residual symptoms at discharge. CONCLUSION Cervical muscle lesions may contribute to indefinite whole-body symptoms, possibly through dysfunction of the parasympathetic nervous system in the muscles. Local modulation of cervical muscles could lead to a breakthrough in the management of patients with indefinite whole-body symptoms. TRIAL REGISTRATION ID UMIN000035445. These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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宫颈肌肉疾病与全身不确定和各种症状有关。

目的在全身出现各种不确定症状的患者偶尔会出现颈肌僵硬或压痛。该前瞻性病例系列研究了在报告了不确定的全身症状的宫颈疾病患者中宫颈肌肉的局部调节作用。方法共有1863名住院的颈椎病患者出现三种或更多种不确定的全身症状，他们对门诊治疗有抵抗力，该研究入选了12年。住院期间，所有患者每天都要对颈肌进行物理疗法。在医疗访问表上对自评记录进行了比较，记录了人群中包括颈椎/肩部疼痛或僵硬在内的30种代表性症状以及入院和出院时的28种不确定的全身症状。结果住院期间，随着宫颈肌肉局部调节，症状数量明显减少。入院时全部28种不确定的全身症状均显示出院时恢复率大于50％。症状的平均数从入院时的17.8明显下降到出院时的7.4（p <0.0001）。报告有10种或更多症状的患者入院和出院的百分比分别为91.1％和29.3％。此外，有8.2％的患者报告出院时没有残留症状。结论子宫颈肌肉病变可能导致不确定的全身症状，可能是由于副交感神经系统的功能异常所致。颈部肌肉的局部调节可能会导致全身症状不确定的患者管理上的突破。试用注册ID UMIN000035445。这些幻灯片可以在电子补充材料下找到。