Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Patients with Chronic Nonspecific Low Back Pain

Iglesias-González, Juan J.; Muñoz-García, María Teresa; Rodrigues-de-Souza, Daiana Priscila; Alburquerque‐Sendín, Francisco; Fernández‐de‐las‐Peñas, César

doi:10.1111/pme.12224

Cited by 73 publications

(70 citation statements)

References 30 publications

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“…Hyperalgesia in the painful area, which can be caused by sensitization of the central nervous system, was found in patients with chronic LBP in Imamura et al studies but this mechanism should be further investigated [38]. Muscle imbalance, active trigger points, higher myoelectric activity of lumbar muscles in flexion, rigid and less variable patterns of muscle activation in patients with low back pain leads to excessive energy expenditure, fatigue and exhaustion [39,40]. These factors negatively affects the health of adolescents which manifests essentially as aching pain.…”

Section: Discussionmentioning

confidence: 99%

Low back pain in adolescents. An assessment of the quality of life in terms of qualitative and quantitative pain variables

Świerkosz¹,

Nowak

2015

BMR

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Section: Discussionmentioning

confidence: 99%

Low back pain in adolescents. An assessment of the quality of life in terms of qualitative and quantitative pain variables

Świerkosz¹,

Nowak

2015

BMR

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“…Brought to you by | Aalborg University Library Authenticated Download Date | 7/1/19 1:19 PM patients, they are also quite common in healthy controls [53,54]. Whilst such commonplace muscle soreness is insufficient to conceal a group difference in pain thresholds, it does explain the similarity in patterns of variation between groups.…”

Section: Patterns In Topographical Mapping Of Variability Of Pain Thrmentioning

confidence: 99%

Topographic mapping of pain sensitivity of the lower back – a comparison of healthy controls and patients with chronic non-specific low back pain

O’Neill

Larsen

Nim

et al. 2018

Scandinavian Journal of Pain

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AbstractBackground and aimsThe choice of testing site for quantitative sensory testing (QST) of pain sensitivity is important and previous studies have demonstrated patterns in pain sensitivity within discrete areas in different body regions. Some areas are characterized by a relatively high degree of spatial pain discrimination and recognizable patterns of pain referral, whilst others are not. The lumbar region is likely to have relatively low pain acuity and overlapping of pain referral. The current study was conducted to determine whether patterns of pain sensitivity (detection thresholds) could be identified in the lower back, whether differences in such patterns exist between different groups and whether such patterns could help identify a clinical source of pain and localized increased pain sensitivity.MethodsTwenty-one patients with non-specific chronic low back pain and 21 healthy controls were tested for pressure and heat pain thresholds on 30 pre-defined locations over the mid and lower back. Topographical maps of mean pain thresholds and variability were produced, inspected visually and analyzed statistically. Between group differences in pain threshold were analyzed statistically as an indicator of widespread increased pain sensitivity. Evidence of segmental increased pain sensitivity was examined by group statistical comparison of mid-line lower range.ResultsA clear pattern of higher pain thresholds in the mid-line was evident in both groups and for both pain modalities. No discernible patterns were evident for variability within groups, but marked differences were seen between groups: variability for pressure pain thresholds appeared similar between groups, however for heat pain threshold, variability was uniformly low in the control group and uniformly high in the patient group. A highly significant (p<0.0001) difference in pain thresholds for pressure and heat was found with patients exhibiting lower thresholds than controls. No between group difference was found for mid-line lower range for either modality (p>0.05).ConclusionsThe current study supports previous findings of widespread, increased pain sensitivity in chronic non-specific low-back pain patients. It also indicates that there are discernible and similar topographical patterns of pain sensitivity in the dorsal area in both groups, but that this pattern is related to the lateral position of the test site and not the segmental level. Specific segments with increased pain sensitivity could not be identified in the patient group, which casts doubt on the utility of pressure and heat pain thresholds as indicators of the clinical source of spinal pain – at least in a population of chronic non-specific low-back pain.ImplicationsIn a cohort of chronic non-specific low-back pain patients and with the chosen methodology, topographical QST mapping in the lumbar region does not appear useful for identifying the spinal segment responsible for clinical pain, but it does demonstrate widespread group differences in pain sensitivity.

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“…In nonspecific low back pain as well as in the specific conditions mentioned above, a TrP can be a significant cause of low back pain. 33 The key to understanding low back pain caused by a TrP is knowing that TrP pain can be referred from distant sites. Trigger points in the superficial erector spinae longissimus thoracis and iliocostalis muscles, as well as those in the deep lumbar multifidi muscles, produce both local pain and pain that is referred distally, usually caudally.…”

Section: Low Back Painmentioning

confidence: 99%

Myofascial Trigger Point Pain Syndromes

Gerwin

2016

Semin Neurol

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Myofascial pain syndromes caused by trigger points (TrPs) in muscle are a common cause of local and generalized pain. Trigger points are hyperirritable zones in contracted bands of muscle, thought to be caused by muscle overload or stress. Stress TrPs have characteristic electromyographic features, and can be visualized with ultrasound and magnetic resonance elastography. Trigger point needling or injection can be effective in inactivating TrP, but correcting triggers is also critical.

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Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Patients with Chronic Nonspecific Low Back Pain

Cited by 73 publications

References 30 publications

Low back pain in adolescents. An assessment of the quality of life in terms of qualitative and quantitative pain variables

Low back pain in adolescents. An assessment of the quality of life in terms of qualitative and quantitative pain variables

Topographic mapping of pain sensitivity of the lower back – a comparison of healthy controls and patients with chronic non-specific low back pain

Myofascial Trigger Point Pain Syndromes

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