scholarly journals Stimulation of Myofascial Trigger Points in the Sternocleidomastoid Evokes Facial Thermal Response Correlated with the Referred Pain

2021 ◽  
Vol 11 (14) ◽  
pp. 6510
Author(s):  
Francesco Caroccia ◽  
Lucia Raimondi ◽  
Francesco Moscagiuri ◽  
Michele D’Attilio
Keyword(s):  
Interstimulus Interval ◽  
Infrared Imaging ◽  
Pressure Pain Threshold ◽  
Thermal Response ◽  
Trigger Points ◽  
Sternocleidomastoid Muscle ◽  
Referred Pain ◽  
Myofascial Trigger Points ◽  
Thermal Infrared Imaging ◽  
Pain Area

The purpose of this research is to identify and correlate the referred pain evocated by myofascial trigger points (TrPs) pressure pain threshold (PPT) in the sternocleidomastoid muscle using thermal infrared imaging (IR). Facial IR images of 46 volunteers (21 male and 25 female, average age 32 ± 6.3) undergoing PPT of five TrPs locations on the sternocleidomastoid belly were recorded. Each PPT lasted 10 s, with an interstimulus interval of 2 min. Sixteen thermal IR images were recorded for each subject: at baseline (t0), 2 s before PPT (t1), 2 s (t2) and 60 s (t3) after PPT of each TrPs location. During the interstimulus interval, subjects were asked to draw over a head–neck template displayed on a computer screen the areas of referred pain eventually evoked by the stimulation and the referred pain intensity by means of a Visual Analogue Scale (VAS). The VAS template was then superimposed with the IR records. Two temperature (T) variations were calculated: ΔT1 = T(t2) − T(t1) and ΔT2 = T(t3) − T(t1). Differences in ∆T range ≥ 0.2 °C have been considered significant. In 77% of the superimpositions, the referred pain area corresponded to a ΔT2 ≥ 0.2 °C while only the 59% corresponded to a ΔT1 ≥ 0.2 °C. In 19% of superimpositions, a ΔT2 ≥ 0.2 °C did not correspond to a referred pain area indicated by the patient, and this percentage lowers to 4% for ΔT1 ≥ 0.2 °C. None of the areas that reported a VAS of 0 or 1 showed a ΔT1 ≥ 0.2 °C or a ΔT2 ≥ 0.2 °C. Considering the limitations of this pilot study, IR could be used to identify referred pain evocated by TrPs on sternocleidomastoid muscle.

The Local and Referred Pain From Myofascial Trigger Points in the Temporalis Muscle Contributes to Pain Profile in Chronic Tension-type Headache

2007 ◽  
Vol 23 (9) ◽  
pp. 786-792 ◽  
Author(s):  
César Fernández-de-las-Peñas ◽  
Hong-You Ge ◽  
Lars Arendt-Nielsen ◽  
Maria Luz Cuadrado ◽  
Juan A. Pareja
Keyword(s):  
Trigger Points ◽  
Tension Type Headache ◽  
Referred Pain ◽  
Temporalis Muscle ◽  
Myofascial Trigger Points ◽  
Chronic Tension Type Headache ◽  
Type Headache

scholarly journals Effectiveness between Dry Needling and Ischemic Compression in the Triceps Surae Latent Myofascial Trigger Points of Triathletes on Pressure Pain Threshold and Thermography: A Single Blinded Randomized Clinical Trial

2019 ◽  
Vol 8 (10) ◽  
pp. 1632 ◽  
Author(s):  
Benito-de-Pedro ◽  
Becerro-de-Bengoa-Vallejo ◽  
Losa-Iglesias ◽  
Rodríguez-Sanz ◽  
López-López ◽  
...  
Keyword(s):  
Skin Temperature ◽  
Pain Threshold ◽  
Myofascial Pain ◽  
Pressure Pain Threshold ◽  
Pain Syndrome ◽  
Trigger Points ◽  
Triceps Surae ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Pressure Pain

Background: Deep dry needling (DDN) and ischemic compression technic (ICT) may be considered as interventions used for the treatment of Myofascial Pain Syndrome (MPS) in latent myofascial trigger points (MTrPs). The immediate effectiveness of both DDN and ICT on pressure pain threshold (PPT) and skin temperature of the latent MTrPs of the triceps surae has not yet been determined, especially in athletes due to their treatment requirements during training and competition. Objective: To compare the immediate efficacy between DDN and ICT in the latent MTrPs of triathletes considering PPT and thermography measurements. Method: A total sample of 34 triathletes was divided into two groups: DDN and ICT. The triathletes only received a treatment session of DDN (n = 17) or ICT (n = 17). PPT and skin temperature of the selected latent MTrPs were assessed before and after treatment. Results: Statistically significant differences between both groups were shown after treatment, showing a PPT reduction (p < 0.05) in the DDN group, while PPT values were maintained in the ICT group. There were not statistically significant differences (p > 0.05) for thermographic values before and treatment for both interventions. Conclusions: Findings of this study suggested that ICT could be more advisable than DDN regarding latent MTrPs local mechanosensitivity immediately after treatment due to the requirements of training and competition in athletes’ population. Nevertheless, further studies comparing both interventions in the long term should be carried out in this specific population due to the possible influence of delayed onset muscle soreness and muscle damage on PPT and thermography values secondary to the high level of training and competition.

Evaluation of the Analgesic Effect of Combination Therapy on Chronic Plantar Pain Through the Myofascial Trigger Points Approach

2018 ◽  
Vol 108 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Rocío Melero-Suárez ◽  
José Antonio Sánchez-Santos ◽  
Gabriel Domínguez-Maldonado
Keyword(s):  
Combination Therapy ◽  
Analgesic Effect ◽  
Myofascial Pain ◽  
Pressure Pain Threshold ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Adductor Muscle ◽  
Rank Test ◽  
Myofascial Trigger Points

Background: Closely related pathologic disorders sometimes manifest with the same symptoms, making for a complex differential diagnosis. This is the situation in plantar fasciitis (PF) and myofascial pain syndrome (MPS) with myofascial trigger points (MTPs) in the sole of the foot. This research assessed the analgesic effect on plantar pain of combination therapy with interferential current stimulation therapy (ICST), treating MTPs in the great toe adductor muscle and the short flexor muscles of the toes in patients whose diagnosis was compatible with PF or MPS. Methods: This study included 22 feet of 17 patients with a diagnosis compatible with PF or MPS with MTP. Participants received combination therapy with ICST for 15 sessions, and the decrease in pain was measured with an algometer and the visual analog scale. Both measurements were taken before and after every fifth session. The pressure pain threshold (PPT) results obtained with the Student t test and the pain intensity perception (PIP) results obtained with the Wilcoxon signed rank test were analyzed by comparing the measurements taken before the treatment and after the fifth, tenth, and 15th sessions. Results: The decrease in PIP was significant after the fifth, tenth, and 15th sessions (P &lt; .001). The increase in PPT was also significant after the fifth (P = .010), tenth (P = .023), and 15th (P = .001) sessions (P &lt; .05). Conclusions: The suggested combination therapy of ultrasound with ICST is clinically significant for reducing plantar pain after 15 treatment sessions, with a 6.5-point reduction in mean PIP and a 4.6-point increase in PPT.

scholarly journals Comparison of the Effects of Dry Needling and Low-Level Laser on the Latent Trigger Points of Upper Trapezius

2021 ◽  
Keyword(s):  
Pressure Pain Threshold ◽  
Muscle Thickness ◽  
Trigger Points ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Low Level ◽  
Low Level Laser ◽  
Upper Trapezius ◽  
Level Laser ◽  
Significant Difference

Background and Aims: Myofascial pain syndrome (MPS) is one of the most frequent causes of chronic musculoskeletal pain which is characterized by myofascial trigger points (MTrPs). Hence, it is of crucial importance to identify practical approaches for the treatment of these points. Upper trapezius muscle (UT) is highly susceptible to the development of MTrPs that are commonly resulted from overuse and micro-trauma. In this regard, the present study aimed to compare the effects of dry needling (DN) and low-level laser therapy (LLLT) regarding the reduction of pain and muscle thickness and improvement of the range of motion (ROM) and pressure pain threshold (PPT) in patients with latent MTrPs (LTrPs) in their UT muscles. Materials and Methods: In total, 60 patients with LTrPs in UT muscle participated in this randomized clinical trial. The subjects were randomly divided into two treatment groups of DN and LLLT. The PPT was evaluated by visual analog scale (VAS) and algometer while ROM and muscle thickness were assessed using goniometer and ultrasonography, respectively. It should be noted that the variables were evaluated before the first and after the sixth sessions. Finally, the collected data were analyzed using independent and paired t-tests. Results: Based on the results, the VAS and muscle thickness significantly reduced, while the PPT and cervical ROM increased in both groups after treatment (P<0.001). The independent t-test revealed a statistically significant improvement in the DN group in terms of PPT (9.9-14.17, P=0.009) and ROM (37.33-42.67, p=0.005), compared to the LLLT group. Nevertheless, no significant difference was found between the two groups regarding VAS and muscle thickness variables (P>0.05). Conclusion: The DN and LLLT effectively improved symptoms in the UT muscles of patients with LTrPs. However, the DN was more effective in the improvement of ROM and PPT variables.

Thermal Evaluation of Myogenous Temporomandibular Disorders and Myofascial Trigger Points in the Masticatory Muscles

2017 ◽  
pp. 329-350
Author(s):  
Denise Sabbagh Haddad ◽  
Marcos Leal Brioschi ◽  
Emiko Saito Arita
Keyword(s):  
Temporomandibular Disorders ◽  
Infrared Imaging ◽  
Trigger Points ◽  
Masticatory Muscles ◽  
Imaging Method ◽  
Myofascial Trigger Points ◽  
Functional Changes ◽  
Cutaneous Temperature ◽  
Vasomotor Activity ◽  
Temperature Levels

It is known that the myofascial trigger points (MTP) and myogenous temporomandibular disorders (TMDs) cause regional sympathetic hyperactivity in local temperature due to the cutaneous vasomotor activity and, for detection of functional changes, thermography is used as a complementary diagnostic imaging method. This chapter intends to study two masticatory muscles, masseter and anterior temporalis, in measurement of the cutaneous temperature of volunteers with and without myogenous TMD and MTP. Results: The temperature levels measured at both muscles regions in myogenous TMD volunteers were significantly lower than those measured in controls. Infrared imaging indicated differences between referred and local pain in MTPs of 0.5ºC. Conclusions: Infrared imaging measurements seem to indicate that it can be used as an aid in complimentary diagnosing of TMDs and MTPs in masticatory muscles.

Immediate Effects of Ischemic Compression Therapy on Myofascial Trigger Points on Pain, Mobility and Strength in Individuals With Subacromial Impingement Syndrome: A Single-arm Study

2020 ◽  
Author(s):  
José Diego Sales do Nascimento ◽  
Francisco Alburquerque-Sendín ◽  
Laysla Carla de Castro Ferreira ◽  
Catarina de Oliveira Sousa
Keyword(s):  
External Rotation ◽  
Pressure Pain Threshold ◽  
Compression Therapy ◽  
Deltoid Muscle ◽  
Trigger Points ◽  
Subacromial Impingement Syndrome ◽  
Myofascial Trigger Points ◽  
Evaluation Protocol ◽  
Before And After ◽  
Pre Treatment

Abstract Background: The myofascial trigger points (MTPs) may be associated with in shoulder dysfunction.Objective: To evaluate the immediate effect of ischemic compression therapy (ICT) and to verify the effect of the evaluation protocol on MTPs, pain, mobility and strength of shoulder.Methods: 15 individuals were assessed for the amount of MTPs, pressure pain threshold (PPT), range of motion (ROM), isometric strength of shoulder muscles and pain in performing these tests. The evaluations took place 48 hours before the ICT, immediately before, and after the ICT.Results: There was a reduction in the total amount of MTPs (p<0.01; Cliff’s d=0.24-0.35) and an increase in the PPT in the middle deltoid muscle (p=0.03) in the comparisons pre and post treatment, while there was no difference in ROMs and strength measures (p>0.05). The pain was less during the sagittal elevation ROM (p<0.01; d=0.80) and internal rotation (p=0.05; d=0.57), and during the performance of strength in arm elevation and external rotation (p=0.01; d=0.72 and d=0.68). There was generally no difference in the variables assessed between baseline and pre-treatment (p>0.06).Conclusion: The ICT immediately reduced the amount of MTPs and pain during mobility and strength. The evaluation protocol did not influence the studied variables.Trial registration: ReBEC (RBR-3DDG2K). Registered in July 5th, 2017 – Retrospectively registered, http://www.ensaiosclinicos.gov.br/rg/RBR-3ddg2k/.

Myofascial Trigger Points and Sensitization: An Updated Pain Model for Tension-Type Headache

Cephalalgia ◽  
2007 ◽  
Vol 27 (5) ◽  
pp. 383-393 ◽  
Author(s):  
C Fernández-de-las-Peñas ◽  
ML Cuadrado ◽  
L Arendt-Nielsen ◽  
DG Simons ◽  
JA Pareja
Keyword(s):  
Central Sensitization ◽  
Trigger Point ◽  
Trigger Points ◽  
Tension Type Headache ◽  
Referred Pain ◽  
Tender Points ◽  
Myofascial Trigger Points ◽  
Pain Model ◽  
Type Headache ◽  
Chemical Mediators

Present pain models for tension-type headache suggest that nociceptive inputs from peripheral tender muscles can lead to central sensitization and chronic tension-type headache (CTTH) conditions. Such models support that possible peripheral mechanisms leading to pericranial tenderness include activation or sensitization of nociceptive nerve endings by liberation of chemical mediators (bradikinin, serotonin, substance P). However, a study has found that nonspecific tender points in CTTH subjects were not responsible for liberation of algogenic substances in the periphery. Assuming that liberation of algogenic substances is important, the question arising is: if tender muscle points are not the primary sites of on-going neurogenic inflammation, which structure can be responsible for liberation of chemical mediators in the periphery? A recent study has found higher levels of algogenic substances, and lower pH levels, in active myofascial trigger point (TrPs) compared with control tender points. Clinical studies have demonstrated that referred pain elicited by head and neck muscles contribute to head pain patterns in CTTH. Based on available data, an updated pain model for CTTH is proposed in which headache can at least partly be explained by referred pain from TrPs in the posterior cervical, head and shoulder muscles. In this updated pain model, TrPs would be the primary hyperalgesic zones responsible for the development of central sensitization in CTTH.

Referred pain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache

2010 ◽  
Vol 14 (4) ◽  
pp. 391-396 ◽  
Author(s):  
César Fernández-de-las-Peñas ◽  
Hong-You Ge ◽  
Cristina Alonso-Blanco ◽  
Javier González-Iglesias ◽  
Lars Arendt-Nielsen
Keyword(s):  
Trigger Points ◽  
Tension Type Headache ◽  
Referred Pain ◽  
Myofascial Trigger Points ◽  
Chronic Tension Type Headache ◽  
Shoulder Muscles ◽  
Type Headache ◽  
Head Neck

scholarly journals Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache

2011 ◽  
Vol 12 (1) ◽  
pp. 35-43 ◽  
Author(s):  
César Fernández-de-las-Peñas ◽  
Daniel M. Fernández-Mayoralas ◽  
Ricardo Ortega-Santiago ◽  
Silvia Ambite-Quesada ◽  
Domingo Palacios-Ceña ◽  
...  
Keyword(s):  
Head And Neck ◽  
Trigger Points ◽  
Tension Type Headache ◽  
Referred Pain ◽  
Myofascial Trigger Points ◽  
Chronic Tension Type Headache ◽  
Head Pain ◽  
Shoulder Muscles ◽  
Type Headache
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