Background: Individuals with chronic whiplash associated disorders (WAD) present persistent
pain in the absence of structural pathology. In these people, altered central pain processing
and central sensitization are observed. The role of personal factors, such as gender and age,
on pain processing mechanisms in chronic WAD, however, is still unclear.
Objectives: This study investigated possible gender- and age-related differences in selfreported and experimental pain measurements in people with chronic WAD. Besides the
exercise-induced response on pain measurements between gender and age subgroups was
recorded.
Study Design: Case-control study.
Setting: University Hospital, Brussels.
Methods: Self-reported pain and experimental pain measurements (pressure pain thresholds
[PPT], occlusion cuff pressure, temporal summation, and conditioned pain modulation) were
performed in 52 individuals (26 chronic WAD patients and 26 healthy controls), before and
after a submaximal cycle exercise.
Results: Lower PPTs and occlusion cuff pressures were shown in chronic WAD in comparison
with healthy controls. No gender and age differences regarding PPTs, occlusion cuff pressures
and conditioned pain modulation were found in chronic WAD.
Within the chronic WAD group, men showed higher self-reported pain compared to women
and younger adults showed enhanced generalized pain facilitation compared to older adults.
In addition, chronic WAD patients are able to inhibit exercise-induced hyperalgesia, but no
gender and age differences in pain response following exercise were found.
Limitations: This study was sufficiently powered to detect differences between the chronic
WAD and control group. However, a sufficient power was not reached when patients were
divided in age and gender groups. Furthermore, only mechanical stimuli were included in the
experimental pain measurements. Besides, psychosocial factors were not taken into account.
Conclusion: Some alterations of altered pain processing are present in chronic WAD patients,
however not in response to exercise. No gender and age differences in pain measurements
were observed in people with chronic WAD.
The dry needling therapy showed higher improvements in comparison with myofascial release therapy for pain pressure thresholds, the components of quality of life of physical role, body pain, vitality and social function, as well as the total impact of FMS symptoms, quality of sleep, state and trait anxiety, hospital anxiety-depression, general pain intensity and fatigue. Implications for rehabilitation Dry needling therapy reduces myofascial trigger point pain in the short term in patients with fibromyalgia syndrome. This therapeutic approach improves anxiety, depression, fatigue symptoms, quality of life, and sleep after treatment. Dry needling and myofascial release therapies decrease intensity of pain, and the impact of fibromyalgia symptoms in this population. These intervention approaches should be considered in an independent manner as complementary therapies within a multidisciplinary setting.
Background: The etiology of fibromyalgia syndrome (FMS) is inconclusive, but central
mechanisms are well accepted for this pain condition. Myofascial pain syndrome (MPS) is one of
the most common musculoskeletal pain diseases and is characterized by myofascial trigger points
(MTrPs). It has been suggest that MTrPs have an important factor in the genesis of FMS.
Objective: The purpose of the current randomized clinical trial was to compare the effectiveness
of dry needling versus cross tape on spinal mobility and MTrPs in spinal muscles in patients with
FMS.
Study Design: A single-blind randomized controlled trial was conducted on patients with FMS.
Setting: Clinical setting.
Methods: Sixty-four patients with FMS were randomly assigned to an experimental group
receiving dry needling therapy or to a control group for cross tape therapy in the MTrPs in the
latissimus dorsi, iliocostalis, multifidus, and quadratus lumbourum muscles. Spinal mobility
measures and MTrPs algometry were recorded at baseline and after 5 weeks of treatment.
Results: The repeated measures analysis of variance (ANOVA) demonstrated that significant
differences between groups were achieved for the MTrPs in latissimus dorsi muscle (right axillary
portion: F = 9.80, P = 0.003); multifidus muscle (right L2 level: F = 11.80, P = 0.001); quadratus
lumborum (right lateral superficial upper: F = 6.67, P = 0.012; and right lateral superficial lower: F
= 5.38, P = 0.024). In addition, the ANOVA repeated measures test showed significant differences
between groups for the segmental amplitude thoracic spine in the standing erect position (F =
7.33, P = 0.009), and segmental amplitude of lumbar spine (F = 11.60, P = 0.001) in the sitting
erect position.
Limitations: The outcomes were not collected from a long-term follow-up period. Dry needling
therapy or cross tape were used alone when in reality physical therapists usually treat patients with
FMS using a multi-modal approach. A non-treatment control group was not included.
Conclusions: This study has demonstrated that dry needling therapy reduces myofacial trigger
points algometry on thoracic and lumbar muscles. Dry needling and cross tape approaches reported
a similar effect size for spinal mobility measures in patients with FMS.
Key words: Fibromyalgia, trigger points, physical therapy modalities, musculoskeletal
equilibrium, myofascial pain syndromes
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.