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MG is an autoimmune neuromuscular disease leading to fluctuating muscle weakness and fatiguability.
24) The association between pain and decreased endurance in the back extensor muscles has been linked with increased muscular fatiguability (27, 28) precipitated by increased muscle metabolite from prolonged tension and spasm, (29) muscle ,deconditioning, (30) and inhibition of the paraspinal muscles, (30) which results in overloading of the soft tissue and the passive structures of the lumbar spine.
In the placebo group, two of the 22 patients (5%) experienced adverse effects in the form of generalized bodyaches and increased fatiguability and they discontinued treatment at 2 wk and 2 days respectively.