A Systematic Comparison Between Subjects With No Pain and Pain Associated With Active Myofascial Trigger Points

Abstract

Objective To determine whether standard evaluations of pain distinguish subjects with no pain from those with myofascial pain syndromes (MPS) and active trigger points (MTrPs); and to assess whether self-reports of mood, function and health-related quality of life differ between these groups. Design Prospective, descriptive study. Setting University Patients Adults with and without neck pain Methods We evaluated adults with MPS and active (painful) MTrPs and those without pain. Subjects in the “Active” (‘A’) group had at least one active MTrP with spontaneous pain which was persistent, lasted more than 3 months and had characteristic pain on palpation. Subjects in the “No pain” (‘Np’) group had no spontaneous pain. However, some had discomfort on MTrP palpation (latent MTrP) while others in the Np group had no discomfort on palpation of nodules or had no nodules. Outcome Measures Each participant underwent range of motion (ROM) measurement, 10-point manual muscle test, and manual and algometric palpation. The latter determined the pain/pressure threshold using an algometer of 4 pre-determined anatomical sites along the upper trapezius. Participants rated pain using a verbal analogue scale (0–10); completed the Brief Pain Inventory and Oswestry Disability Scale (ODS), which included a sleep sub-scale; Short Form 36(SF36) and the Profile of Mood States (POMS). Results here were 24 in the ‘A’ group (mean 36 yrs, 16 women) and 26 in the ‘Np’ group (mean 26 yrs, 12 women). Subjects in group ‘A’ differed from ‘Np’ in number of latent MTrPs (p=.0062); asymmetrical cervical ROM (p=.01 side bending and p=.002 rotation); in all pain reports (p<.0001); algometry (p<.03); POMS (p<.038); SF36 (p<.01) and ODS (p<.0001). Conclusion A systematic musculoskeletal evaluation of people with MPS reliably distinguishes them from subjects with no pain. The two groups are significantly different in their physical findings and self-reports of pain, sleep disturbance, disability, health status and mood. These findings support the view that a “local” pain syndrome has significant associations with mood, health-related quality of life and function..

Comparison of hand grip strength and upper limb pressure pain threshold between older adults with or without non-specific shoulder pain

“…Active MTrPs produce spontaneous and recognized pain while latent MTrPs generate local or referred pain after stimulation (Ge & Arendt-Nielsen, 2011; Gerber et al, 2013). Indeed, the presence of latent MTrPs in the upper limb may influence the peripheral and central sensitization process and alter the strength and PPT in the upper limb of patients with shoulder pain (Calvo, Pacheco & Hita, 2015; Calvo-Lobo et al, 2016; Ge et al, 2008; Celik & Yeldan, 2011; Coronado et al, 2014).…”

Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain

“…8–11 We have also developed a standard evaluation approach that distinguishes people with trigger points and myofascial pain from those without pain. 12 …”

Shock Wave Therapy Versus Progressive Pressure Release on Myofascial Trigger Points

“…The health impact of myofascial pain can be quite severe as patients with the disorder not only suffer from decreased functional status associated with musculoskeletal pain and loss of function, but also suffer from impaired mood as well as decreased quality of life. 21 The current study was conducted to compare the effect of shock wave therapy and progressive pressure release on active myofascial trigger points in the upper trapezius muscle. The pain pressure threshold was assessed and considered by pressure algometer which is an objective, valid, reliable method in assessment of pain threshold, the pain and function level of the neck was assessed by neck disability index which is a valid instrument for assessing suffering disability in patients with neck pain.…”