scholarly journals Dry Needling Related Short-Term Vasodilation in Chronic Sciatica under Infrared Thermovision

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Elżbieta Skorupska ◽  
Michał Rychlik ◽  
Wiktoria Pawelec ◽  
Włodzimierz Samborski
Keyword(s):  
Temperature Increase ◽  
Trigger Points ◽  
Referred Pain ◽  
Vasomotor Response ◽  
Dry Needling ◽  
Short Term ◽  
Camera Control ◽  
Gluteus Minimus ◽  
Positive Subject ◽  
Chronic Sciatica

Vasomotor responses to dry needling (DN) of trigger points (TrPs) under infrared thermovision (IRT) camera control and TrPs coexistence in chronic sciatica patients have never been studied.Materials and Methods. Fifty consecutive chronic sciatica patients were enrolled in the study. DN under IRT control was performed for all patients regardless of gluteus minimus (GM) active TrPs examination. Then, the vasomotor response and its agreement with TrPs examination were evaluated.Results. The prevalence of GM active TrPs was 32%. DN provokes intensive vasodilatation for TrPs-positive patients only, with the localization dependent on referred pain during the procedure(r=0.896;  P=0.000)not the daily complaint. The increase of vasodilatation was, for example, for thigh, TrPs-positive +30.29%(P<0.05)versus TrPs-negative +4.08%. Additionally, a significant skin temperature increase was observed for TrPs-positive only, for example, thigh +1.5 ± 1.3°C (maximum) and +1.2 ± 1.0°C (average) (bothP<0.05).Conclusion. GM active TrPs prevalence among chronic sciatica patients was around one in three. Every TrPs-positive subject presented with vasodilatation under IRT in the area of DN related referred pain. Although TrPs involvement in chronic sciatica patients is possible, further studies on a bigger group of patients are still required.

scholarly journals Validation and Test-Retest Reliability of New Thermographic Technique Called Thermovision Technique of Dry Needling for Gluteus Minimus Trigger Points in Sciatica Subjects and TrPs-Negative Healthy Volunteers

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Elżbieta Skorupska ◽  
Michał Rychlik ◽  
Włodzimierz Samborski
Keyword(s):  
Healthy Volunteers ◽  
Diagnostic Criteria ◽  
Trigger Points ◽  
Referred Pain ◽  
Maximum Temperature ◽  
Dry Needling ◽  
Retest Reliability ◽  
Gluteus Minimus ◽  
Test Retest Reliability ◽  
Gluteus Minimus Muscle

The aim of this study was to assess the validity and test-retest reliability of Thermovision Technique of Dry Needling (TTDN) for the gluteus minimus muscle. TTDN is a new thermography approach used to support trigger points (TrPs) diagnostic criteria by presence of short-term vasomotor reactions occurring in the area where TrPs refer pain.Method. Thirty chronic sciatica patients (n=15TrP-positive andn=15TrPs-negative) and 15 healthy volunteers were evaluated by TTDN three times during two consecutive days based on TrPs of the gluteus minimus muscle confirmed additionally by referred pain presence. TTDN employs average temperature (Tavr), maximum temperature (Tmax), low/high isothermal-area, and autonomic referred pain phenomenon (AURP) that reflects vasodilatation/vasoconstriction. Validity and test-retest reliability were assessed concurrently.Results. Two components of TTDN validity and reliability,Tavrand AURP, had almost perfect agreement according toκ(e.g., thigh: 0.880 and 0.938; calf: 0.902 and 0.956, resp.). The sensitivity forTavr,Tmax, AURP, and high isothermal-area was 100% for everyone, but specificity of 100% was forTavrand AURP only.Conclusion. TTDN is a valid and reliable method forTavrand AURP measurement to support TrPs diagnostic criteria for the gluteus minimus muscle when digitally evoked referred pain pattern is present.

scholarly journals Short-Term Effects of PENS versus Dry Needling in Subjects with Unilateral Mechanical Neck Pain and Active Myofascial Trigger Points in Levator Scapulae Muscle: A Randomized Controlled Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1665 ◽  
Author(s):  
Santiago Garcia-de-Miguel ◽  
Daniel Pecos-Martin ◽  
Tamara Larroca-Sanz ◽  
Beatriz Sanz-de-Vicente ◽  
Laura Garcia-Montes ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neck Pain ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Trigger Points ◽  
Mean Difference ◽  
Dry Needling ◽  
Short Term ◽  
Myofascial Trigger Points ◽  
Randomized Controlled

Procedures such as dry needling (DN) or percutaneous electrical nerve stimulation (PENS) are commonly proposed for the treatment of myofascial trigger points (MTrP). The aim of the present study is to investigate if PENS is more effective than DN in the short term in subjects with mechanical neck pain. This was an evaluator-blinded randomized controlled trial. Subjects were recruited through announcements and randomly allocated into DN or PENS groups. Pain intensity, disability, pressure pain threshold (PPT), range of motion (ROM), and side-bending strength were measured. The analyses included mixed-model analyses of variance and pairwise comparisons with Bonferroni correction. The final sample was composed of 44 subjects (22 per group). Both groups showed improvements in pain intensity (ηp2 = 0.62; p < 0.01), disability (ηp2 = 0.74; p < 0.01), PPT (ηp2 = 0.79; p < 0.01), and strength (ηp2 = 0.37; p < 0.01). The PENS group showed greater improvements in disability (mean difference, 3.27; 95% CI, 0.27–6.27) and PPT (mean difference, 0.88–1.35; p < 0.01). Mixed results were obtained for ROM. PENS seems to produce greater improvements in PPT and disability in the short term.

scholarly journals Amplified Vasodilatation within the Referred Pain Zone of Trigger Points Is Characteristic of Gluteal Syndrome—A Type of Nociplastic Pain Mimicking Sciatica

2021 ◽  
Vol 10 (21) ◽  
pp. 5146
Author(s):  
Elzbieta Skorupska ◽  
Tomasz Dybek ◽  
Michał Rychlik ◽  
Marta Jokiel ◽  
Jarosław Zawadziński ◽  
...  
Keyword(s):  
Trigger Points ◽  
International Classification Of Diseases ◽  
Referred Pain ◽  
Positive Test ◽  
New Disease ◽  
Pain Sensation ◽  
Average Temperature ◽  
Gluteus Minimus ◽  
Classification Of Diseases

Gluteal syndrome (GS) mimicking sciatica is a new disease that has been recently recognized and included in the International Classification of Diseases, 11th Revision. The present study examines nociplastic pain involvement in GS and sciatica patients using a new Skorupska protocol (SP) test that provokes amplified vasodilatation in the area of expected muscle-referred pain. A positive test is confirmed if there is (i) a development of autonomic referred pain (AURP) and (ii) an increase in the delta of average temperature (Δ₸°) > 0.3 °C at the end of the stimulation and during the observation SP phases. Chronic GS (n = 20) and sciatica (n = 30) patients were examined. The SP test confirmed muscle-referred pain for (i) all GS patients with 90.6% positive thermograms (Δ₸° 0.6 ± 0.8 °C; maximum AURP 8.9 ± 13.6% (both p < 0.05)) and (ii) those sciatica (n = 8) patients who reported pain sensation during the test with 20.6% positive thermograms (Δ₸° 0.7 ± 0.7 °C; maximum AURP 15.1 ± 17.8% (both p < 0.05)). The remaining sciatica (n = 22) patients did not report pain during the test and presented a Δ₸° decrease and the AURP size below 1%. Conclusion: Amplified vasodilatation suggesting nociplastic pain involvement was confirmed for all GS and sciatica patients who reported painful sensations in the zone typical for gluteus minimus referred pain during the test.

scholarly journals Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck Pain Symptoms: An Updated Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3300
Author(s):  
Marcos J. Navarro-Santana ◽  
Jorge Sanchez-Infante ◽  
César Fernández-de-las-Peñas ◽  
Joshua A. Cleland ◽  
Patricia Martín-Casas ◽  
...  
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Trigger Points ◽  
Dry Needling ◽  
Short Term ◽  
Pressure Pain ◽  
Cervical Range Of Motion ◽  
Pressure Pain Thresholds ◽  
Mean Differences ◽  
Pain Symptoms

Our aim was to evaluate the effect of dry needling alone as compared to sham needling, no intervention, or other physical interventions applied over trigger points (TrPs) related with neck pain symptoms. Randomized controlled trials including one group receiving dry needling for TrPs associated with neck pain were identified in electronic databases. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The Cochrane risk of bias tool and the Physiotherapy Evidence Database (PEDro) score were used to assessed risk of bias (RoB) and methodological quality of the trials. The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Between-groups mean differences (MD) and standardized mean differences (SMD) were calculated (3) Twenty-eight trials were finally included. Dry needling reduced pain immediately after (MD −1.53, 95% CI −2.29 to −0.76) and at short-term (MD −2.31, 95% CI −3.64 to −0.99) when compared with sham/placebo/waiting list/other form of dry needling and, also, at short-term (MD −0.51, 95% CI −0.95 to −0.06) compared with manual therapy. No differences in comparison with other physical therapy interventions were observed. An effect on pain-related disability at the short-term was found when comparing dry needing with sham/placebo/waiting list/other form of dry needling (SMD −0.87, 95% CI −1.60 to −0.14) but not with manual therapy or other interventions. Dry needling was effective for improving pressure pain thresholds immediately after the intervention (MD 55.48 kPa, 95% CI 27.03 to 83.93). No effect on cervical range of motion of dry needling against either comparative group was found. No between-treatment effect was observed in any outcome at mid-term. Low to moderate evidence suggests that dry needling can be effective for improving pain intensity and pain-related disability in individuals with neck pain symptoms associated with TrPs at the short-term. No significant effects on pressure pain sensitivity or cervical range of motion were observed.

Dry Needling for the Treatment of Musculoskeletal Ailments With Trigger Points

2021 ◽  
Vol 1 (5) ◽  
pp. 263502542110237
Author(s):  
Simon J. Padanilam ◽  
Steven R. Dayton ◽  
Ryan Jarema ◽  
Michael J. Boctor ◽  
Vehniah K. Tjong
Keyword(s):  
Pain Relief ◽  
Musculoskeletal Pain ◽  
Functional Outcomes ◽  
Trigger Points ◽  
Invasive Technique ◽  
Dry Needling ◽  
Short Term ◽  
Myofascial Trigger Points ◽  
Pain Scores

Background: Dry needling is an increasingly popular technique for relieving musculoskeletal pain, through targeting myofascial trigger points. Existing evidence indicates that dry needling is effective in short-term management of pain, with research showing efficacy in improving functional outcomes when compared to other treatments. Indications: Myofascial trigger points may result in range of motion limitations and muscle weakness. Noninvasive treatments for musculoskeletal pain associated with myofascial trigger points, such as stretching or warm compresses, may not provide significant benefit for patients. Dry needling is a minimally invasive technique that provides significant short-term functional improvement and analgesia for musculoskeletal pain associated with myofascial trigger points, seen with reductions in visual analog scale (VAS) pain scores and decreased need for pharmacologic therapies. Technique Description: This video demonstrates dry needling at the tensor fascia latae, extensor carpi radialis longus, and gastrocnemius muscles. Myofascial trigger points and important anatomical landmarks are identified and labeled. A needle is inserted into the region of the myofascial trigger point to a depth of 10 to 100 mm and remains in situ for about 10 to 20 seconds with the use of a piston technique, although this time varies dependent upon patient response. Results: Dry needling may significantly decrease pain and improve functional outcomes in patients with short-term musculoskeletal ailments. Randomized controlled trials have examined dry needling for fibromyalgia, mechanical neck pain, myofascial pain, and following total knee arthroplasty, with these finding significant reductions in pain scores in short-term follow-up. A randomized single-blind placebo-controlled trial found dry needling with exercise to be more effective than sham dry-needling and exercise. Dry needling may provide improved long-term analgesia but also results in increased pain during the procedure and increased soreness afterwards. Pain relief may not last beyond 6 months, although little research investigating long-term outcomes has been performed. Discussion/Conclusion: The usage of dry needling in clinical settings is increasing, as it has shown strong efficacy in providing short-term pain relief and ability to improve functional outcomes. Dry needling is a simple, minimally invasive technique that is easily and quickly learned by physical therapists and may provide great benefits to patients.

Trigger Point-Related Sympathetic Nerve Activity in Chronic Sciatic Leg Pain: A Case Study

2014 ◽  
Vol 32 (5) ◽  
pp. 418-422 ◽  
Author(s):  
Elżbieta Skorupska ◽  
Michał Rychlik ◽  
Wiktoria Pawelec ◽  
Agata Bednarek ◽  
Włodzimierz Samborski
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Referred Pain ◽  
Leg Pain ◽  
Gluteus Minimus ◽  
Vertebral Disc ◽  
History Of

Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the gluteus minimus muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm2 and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points.

The effect of dry needling of myofascial trigger points on muscle stiffness and motoneuron excitability in healthy subjects

2021 ◽  
pp. 096452842110275
Author(s):  
Carolina Jiménez-Sánchez ◽  
Julio Gómez-Soriano ◽  
Elisabeth Bravo-Esteban ◽  
Orlando Mayoral-del Moral ◽  
Pablo Herrero-Gállego ◽  
...  
Keyword(s):  
Muscle Tone ◽  
Intervention Group ◽  
Trigger Points ◽  
Muscle Stiffness ◽  
Invasive Technique ◽  
Control Group ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Motoneuron Excitability

Background: Myofascial trigger points (MTrPs) are hypersensitive nodules in a taut band (TB) of skeletal muscle. Dry needling (DN) is an invasive technique recommended for the treatment of MTrPs. However, to our knowledge, no studies have investigated the influence of the DN technique on modification of muscle stiffness and neurophysiological properties of MTrPs. Objective: The objective was to examine the effect of DN on muscle stiffness and motoneuron excitability of a latent medial MTrP (nodule and TB) of the soleus muscle in non-injured subjects. Methods: A double-blinded randomised controlled trial of 46 subjects with latent medial MTrPs of the soleus was conducted, in which all received one session of DN. The intervention group (n = 23) were subjected to DN into the MTrP (the nodule), while the control group (n = 23) were subjected to DN into the TB. Assessment was carried out at baseline (pre-test), after the intervention (post-test) and 1 week after the intervention (follow-up). Biomechanical variables (muscle resistive force at 10°/s and 180°/s, muscle extensibility and strength), as measured with an isokinetic dynamometer, and neurophysiological variables (H-reflex), were recorded. Results: There were no statistically significant differences in biomechanical or neurophysiological assessments between groups. Considering the intra-group analysis, subjects in the intervention group exhibited increased maximal isometric voluntary force to ankle plantarflexion (MIVFp) at both post-intervention and follow-up assessment (p < 0.0125; 0.2 < d < 0.5), while no changes were found in the control group. Conclusion: One session of DN targeting latent MTrPs did not change muscle stiffness, muscle extensibility or motoneuron excitability. Further research on subjects with muscle tone disorders should be considered to better address the impact of DN on muscle tone. Trial registration number: NCT02575586 (ClinicalTrials.gov).

scholarly journals The Automatization of a New Thermography Method Using Invasive Nociceptive Stimulation to Confirm an Autonomic Phenomenon within a Trigger Point Referred Pain Zone

2021 ◽  
Vol 11 (7) ◽  
pp. 893
Author(s):  
Elżbieta Skorupska ◽  
Tomasz Dybek ◽  
Michał Rychlik ◽  
Marta Jokiel ◽  
Paweł Dobrakowski
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Trigger Point ◽  
Invasive Procedure ◽  
Trigger Points ◽  
International Classification Of Diseases ◽  
Referred Pain ◽  
Low Back ◽  
Classification Of Diseases ◽  
Software Utility

The trigger points (TrPs) related to chronic low back pain that mimic sciatica have been lately recognized and included in the International Classification of Diseases, 11th Revision. This study examined the MATLAB software utility for the objective stratification of low back pain patients using the Minimally Invasive Procedure (MIP). The two diagnostic MIP parameters were: average temperature (ΔTavr) and autonomic referred pain (AURP). Chronic sciatica patients with TrPs (n = 20) and without TrPs (n = 20) were examined using the MIP. A significant increase in both parameters was confirmed for the thigh ROI of the TrP-positive patients, with ΔTavr being the leading parameter (p = 0.016, Exp(β) = 2.603). A continued significance of both parameters was confirmed from 6′00″ to 15′30″ (p < 0.05). The maximum AURP value was confirmed at 13′30″ (p < 0.05) (TrPs(+) 20.4 ± 19.9% vs. TrPs(-) 3.77 ± 9.14%; p = 0.000; CI (0.347,0.348)).

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