Nociceptive and Non-nociceptive Hypersensitivity at Latent Myofascial Trigger Points

Li, Liantao; Ge, Hong You; Yue, Shouwei; Arendt-Nielsen, Lars

doi:10.1097/ajp.0b013e3181878f87

Cited by 73 publications

(57 citation statements)

References 28 publications

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“…19,28 The existence of nociception in latent TrPs has been recently confirmed in a study demonstrating the existence of nociceptive (hyperalgesia) and nonnociceptive (allodynia) hypersensitivity at latent TrPs. 33 Other researchers have reported that nociceptive stimulation of latent TrPs induced an attenuated skin blood flow response, 52 not increased by maneuvers that activate sympathetic outflow, 30 suggesting sympathetic vasoconstrictor activity elicited by nociceptive stimulation of latent TrPs. Finally, there is also evidence that latent TrPs induced motor disturbances.…”

Section: Methodsmentioning

confidence: 99%

The Immediate Effects of Atlanto-occipital Joint Manipulation and Suboccipital Muscle Inhibition Technique on Active Mouth Opening and Pressure Pain Sensitivity Over Latent Myofascial Trigger Points in the Masticatory Muscles

Oliveira-Campelo¹,

Rubens-Rebelatto²,

Martín-Vallejo³

et al. 2010

J Orthop Sports Phys Ther

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t desiGn: A randomized controlled trial.t obJectiVe: To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles.t bacKGRound: Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve.t MetHods: One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction.t Results: The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P.01) and temporalis (P = .003) muscle latent TrPs and also for active mouth opening (P.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. t conclusions: The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. t leVel oF eVidence: Therapy, level 1b.

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Section: Methodsmentioning

confidence: 99%

The Immediate Effects of Atlanto-occipital Joint Manipulation and Suboccipital Muscle Inhibition Technique on Active Mouth Opening and Pressure Pain Sensitivity Over Latent Myofascial Trigger Points in the Masticatory Muscles

Oliveira-Campelo¹,

Rubens-Rebelatto²,

Martín-Vallejo³

et al. 2010

J Orthop Sports Phys Ther

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“…[2][3][4][5][6][7][8][9] Researchers around the world have investigated various aspects of MTrPs, including their specific etiology, pathophysiology, histology, referred pain patterns, and clinical applications. [3][4][5][6][7][8][9] The existing literature 1,2 has suggested that the presence of MTrPs in a muscle may lead to weakness. Inhibition of muscle activity has been seen in the upper trapezius after experimentally induced pain.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10] Such altered physiology may affect a muscle's capacity to generate force and, therefore, its strength. Latent MTrPs are clinically significant because they remain clinically quiescent, such that a person will not even be aware of the presence of a trigger point that may render him or her weaker and more susceptible to fatigue.…”

Section: (P1)mentioning

confidence: 99%

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Effect of Latent Myofascial Trigger Points on Strength Measurements of the Upper Trapezius: A Case-Controlled Trial

Doraisamy¹,

Anshul

2011

Physiotherapy Canada

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Purpose: The purpose of this article was to determine whether strength is altered in the upper trapezius in the presence of latent myofascial trigger points (MTrP). Methods: This study was case controlled and used convenience sampling. The sample recruited was homogeneous with respect to age, sex, height, and body mass. Participants were assessed for the presence of latent MTrP in the upper trapezius and placed into two groups: an experimental group that had latent MTrP in the upper trapezius and a control group that did not. Eighteen women (mean age 21.4 y, SD 1.89; mean height 156.9 cm, SD 4.03; and mean body mass 51.7 kg, SD 5.84) made up the experimental group, and 19 women (mean age 20.3 y, SD 1.86; mean height 158.6 cm, SD 3.14; and mean body mass 53.2 kg, SD 5.17) made up the control group. We obtained strength measurements of the non-dominant arm using a handheld dynamometer and compared them between the two groups. Results: The difference in the strength measurements between the two groups was not statistically significant (p ¼ 0.59). Conclusions:The presence of latent MTrPs may not affect the strength of the upper trapezius.

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“…61 It is important to note that allodynia, or pain in response to a nonnociceptive stimulus, has been established only in regard to tactile or cutaneous stimulus of the skin (eg, brushing sensation) 45 (FIGURE), due to the difficulty of assessing this modality in deep tissues. 34 Therefore, the presence clinically of mechanical (tactile) allodynia in relation to musculoskeletal injury is associated with central sensitization.…”

Section: Pain-associated Hypoesthesia and Allodyniamentioning

confidence: 99%

Interpreting Joint Pain: Quantitative Sensory Testing in Musculoskeletal Management

Courtney

Emerson

Lowry

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

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Synopsis Pain is a common complaint among clients seeking physical therapy services, yet interpretation of associated sensory changes can be difficult for the clinician. Musculoskeletal injury typically results in nociceptive pain due to noxious stimuli of the damaged muscle or joint tissues. However, with progression from acute to chronic stages, altered nociceptive processing can give rise to an array of sensory findings. Specifically, patients with chronic joint injury may present with signs and symptoms typically associated with neuropathic injury, due to changes in nociceptive processing. Clinical presentation may include expansion of hyperalgesia into adjacent and remote areas, allodynia, dysesthesias, and perceptual deficits. Quantitative sensory testing (QST) may provide an objective method of examining sensation and, thereby, of recognizing potential changes in the nociceptive pathways. The purpose of this paper is to provide an overview of altered nociceptive processing and somatosensory changes that may occur following a musculoskeletal injury without associated neural injury. Recommendations are made on clinical uses of quantitative sensory testing in orthopaedic physical therapy practice, and supporting clinical and laboratory evidence are presented. Examples related to joint injury are discussed, specifically, osteoarthritis of the knee and low back pain. Quantitative sensory testing may be a useful clinical tool to aid clinical decision making and for determination of prognosis. J Orthop Sports Phys Ther 2010;40(12):818–825. doi:10.2519/jospt.2010.3314

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Nociceptive and Non-nociceptive Hypersensitivity at Latent Myofascial Trigger Points

Cited by 73 publications

References 28 publications

The Immediate Effects of Atlanto-occipital Joint Manipulation and Suboccipital Muscle Inhibition Technique on Active Mouth Opening and Pressure Pain Sensitivity Over Latent Myofascial Trigger Points in the Masticatory Muscles

The Immediate Effects of Atlanto-occipital Joint Manipulation and Suboccipital Muscle Inhibition Technique on Active Mouth Opening and Pressure Pain Sensitivity Over Latent Myofascial Trigger Points in the Masticatory Muscles

Effect of Latent Myofascial Trigger Points on Strength Measurements of the Upper Trapezius: A Case-Controlled Trial

Interpreting Joint Pain: Quantitative Sensory Testing in Musculoskeletal Management

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