Eccentric muscle contraction and stretching evoke mechanical hyperalgesia and modulate CGRP and P2X3 expression in a functionally relevant manner

Non-invasive, movement-based models were used to investigate muscle pain. In rats, the masseter muscle was rapidly stretched or electrically stimulated during forced lengthening to produce eccentric muscle contractions (EC). Both EC and stretching disrupted scattered myofibers and produced intramuscular plasma extravasation. Pro-inflammatory cytokines (IL-1β, TNF-α, IL-6) and vascular endothelial growth factor (VEGF) were elevated in the masseter 24 h following EC. At 48 h, neutrophils increased and ED1 macrophages infiltrated myofibers while ED2 macrophages were abundant at 4d. Mechanical hyperalgesia was evident in the ipsilateral head 4 h-4d after a single bout of EC and for 7d following multiple bouts (1 bout/d for 4d). Calcitonin gene-related peptide (CGRP) mRNA increased in the trigeminal ganglion 24 h following EC while immunoreactive CGRP decreased. By 2d, CGRP-muscle afferent numbers equaled naive numbers implying that CGRP is released following EC and replenished within 2d. EC elevated P2X3 mRNA and increased P2X3 muscle afferent neuron number for 12d while electrical stimulation without muscle contraction altered neither CGRP nor P2X3 mRNA levels. Muscle stretching produced hyperalgesia for 2d whereas contraction alone produced no hyperalgesia. Stretching increased CGRP mRNA at 24 h but not CGRP-muscle afferent number at 2-12d. In contrast, stretching significantly increased the number of P2X3 muscle afferent neurons for 12d. The sustained, elevated P2X3 expression evoked by EC and stretching may enhance nociceptor responsiveness to ATP released during subsequent myofiber damage. Movement-based actions such as EC and muscle stretching produce unique tissue responses and modulate neuropeptide and nociceptive receptor expression in a manner particularly relevant to repeated muscle damage.