Effects of mechanical intervention on cutaneous sensory change and pressure pain threshold in the same spinal segment of myofascial pain

다국어 초록 (Multilingual Abstract)

Objective: The purpose of this study was to identify whether cutaneous sensory (CS) changes induced by mechanical intervention (MI) increases the trigger point threshold of the same spinal segment as well as to investigate the relationship between the amounts of change in CS pressure pain thresholds (PPT).
Design: Randomized controlled trial.
Methods: Thirty-nine persons with myofacial pain (MFP) were recruited in this experiment. The subjects consisted of 20 men and 19 women (age 20-39). MI was applied on the subjects using the Graston technique for 5 minutes to induce CS changes. The CS changes were measured with sensory tests by using the Von Frey Filament, and PPT changes were estimated by using the pressure threshold meter. For the observation of sensory and PPT changes with time, the test was conducted for 15 minutes including a pre, post, and after intervention session.
Results: CS threshold increased significantly when MI was applied (p<0.001). On the same spinal segment, changes in the right infraspinatus PPT was observed (p<0.001) but the PPT changes in other muscles were not significantly different. Furthermore, the control group CS and PPT were not significantly different. In addition, regression analysis showed that the CS changes have a larger impact on PPT in the same spinal segment (p<0.001).
Conclusions: CS changes induced by MI make to change PPT on the same spinal segment. In other words, it is possible to identify PPT changes following CS changes except for the muscle which belongs to a different spinal segment. Therefore, application of MI is necessary for the CS changes in the same spinal segment. Furthermore, it can be useful in the clinical fields as a method of providing pain control and increasing the PPT.

참고문헌 (Reference)

1 Rivner MH, "The neurophysiology of myofascial pain syndrome" 5 : 432-440, 2001

2 Kim Y, "The hypoalgesic effect of remote tactile sensory modulation on the mechanical sensitivity of trigger points: a randomized controlled study" 35 : 607-614, 2014

3 Hammer WI, "The effect of mechanical load on degenerated soft tissue" 12 : 246-256, 2008

4 Wang C, "Spatial pain propagation over time following painful glutamate activation of latent myofascial trigger points in humans" 13 : 537-545, 2012

5 Simons DG, "Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction" 14 : 95-107, 2004

6 Fernández-de-Las-Peñas C, "Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache" 11 : 475-482, 2007

7 Hong CZ, "Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points" 79 : 863-872, 1998

8 Russell IJ, "Neurochemical pathogenesis of fibromyalgia syndrome" 4 : 61-92, 1996

9 Yap EC, "Myofascial pain--an overview" 36 : 43-48, 2007

10 Wheeler AH, "Myofascial pain disorders: theory to therapy" 64 : 45-62, 2004

11 Alonso-Blanco C, "Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity" 27 : 405-413, 2011

12 Cuypers K, "Longterm TENS treatment improves tactile sensitivity in MS patients" 24 : 420-427, 2010

13 Gerwin RD, "Interrater reliability in myofascial trigger point examination" 69 : 65-73, 1997

14 Mense S, "How do muscle lesions such as latent and active trigger points influence central nociceptive neurons?" 18 : 348-353, 2010

15 Leonard G, "Deciphering the role of endogenous opioids in high-frequency TENS using low and high doses of naloxone" 151 : 215-219, 2010

16 Solecki TJ, "Chiropractic management of a postoperative complete anterior cruciate ligament rupture using a multimodal approach: a case report" 10 : 47-53, 2011

17 Ruiz-Sáez M, "Changes in pressure pain sensitivity in latent myofascial trigger points in the upper trapezius muscle after a cervical spine manipulation in pain-free subjects" 30 : 578-583, 2007

18 Hollins M, "Changes in pain from a repetitive thermal stimulus: the roles of adaptation and sensitization" 152 : 1583-1590, 2011

19 Latremoliere A, "Central sensitization: a generator of pain hypersensitivity by central neural plasticity" 10 : 895-926, 2009

20 Roussel NA, "Central sensitization and altered central pain processing in chronic low back pain: fact or myth?" 29 : 625-638, 2013

21 Srbely JZ, "Capsaicin-induced central sensitization evokes segmental increases in trigger point sensitivity in humans" 11 : 636-643, 2010

22 Pappagallo M, "Aggressive pharmacologic treatment of pain" 25 : 193-213, 1999

23 Burke J, "A pilot study comparing two manual therapy interventions for carpal tunnel syndrome" 30 : 50-61, 2007