Myofascial Trigger Points and Central Sensitization Signs, but No Anxiety, Are Shown in Women with Dysmenorrhea: A Case-Control Study

Abstract

Background primary dysmenorrhea (PD) is considered to be a cyclic chronic pelvic pain, with its onset in menstrual periods, often accompanied by the presence of myofascial trigger points (MTP). Most MTPs in subjects with chronic pelvic pain are in the inferior part of the abdomen, in the rectus abdominis (RA) area. Central sensitization is closely related to chronic pain processes. Previous studies in women with chronic pelvic pain reported central sensitization signs in their subjects, such as lower pain pressure threshold (PPT). Several authors agree that PPT in the tibialis anterior (TA) muscle, seems to be a reliable reference for signs of central sensitization. Amongst the factors that seem to accompany central sensitization, the presence of anxiety needs to be considered. The aim of the present study was to analyze the existence of hyperalgesic MTPs in RA, central sensitization signs and anxiety in women with PD, in comparison with a control group (CG). Methods: This study was designed following an observational, cross-sectional, case-control model. A total sample of 80 subjects was recruited trough social webs and advertising (PD n = 39) (CG n = 41). PPT in RA and AT was assessed bilaterally through algometry, and anxiety was evaluated through the State–Trait Anxiety Inventory. Results: Statistically significant differences (p < 0.001) were shown for NRS average and maximum increase, as well as lower bilaterally RA and TA PPT in favor of PD group compared to CG. State or trait STAI did not show any statistically significant differences (p > 0.05) between groups. Conclusions: In this study, women with PD reported symptoms of myofascial pain syndrome and central sensitization, when compared with healthy controls, without any sign of anxiety acting as a confounder for pain sensitivity.

Myofascial Pain Syndrome: A Nociceptive Condition Comorbid with Neuropathic or Nociplastic Pain

“…The final step involves screening for sensitivity to other stimuli, including sensitivity to sound (phonophobia), light (photophobia), and to the presence of comorbid medical conditions, as well as central nervous system-associated symptoms such as poor sleep quality, fatigue, and cognitive problems [ 14 ]. It is important to emphasize that even though myofascial TrPs can be a primary dysfunction not associated with any medical condition, and would therefore fulfil the nociceptive pain phenotype criteria, they can also be comorbid with other medical conditions associated with central sensitization, such as painful knee osteoarthritis [ 81 ], migraine [ 82 ], cancer, [ 83 ], and dysmenorrhea [ 84 ]. For example, TrP activation due to visceral nociception may persist after appropriate treatment due to nociceptive input from TrPs located in the referred visceral area related to centrally induced visceral hyperalgesia [ 85 ].…”

The Association of Central Sensitisation with Depression, Anxiety, and Somatic Symptoms: A Cross-Sectional Study of a Mental Health Outpatient Clinic in Japan

“…In chronic lower back pain, high trait anxiety-related personality characteristics predict the extent of CS symptoms [16]. However, some studies have found negative relationships between CS and depression and anxiety [17][18][19]. The relationship between CS and depression and anxiety has been inconsistent in previous studies, and the study population has been limited to specific pain-related diseases.…”