Association between trigger points in hamstring, posterior leg, foot muscles and plantar fasciopathy: A cross- sectional study

Introduction: The obesity on the myofascial pain syndrome (MPS) was reduced the pain thresholds, leads todecreasing of physical functioning and quality of life. The obese group was more sensitive to pain due to the proinflammatorycondition. This study aimed to examined the relationship between the Body Mass Index (BMI)and the pain threshold in MPS patients.Methods and Materials: This study was a cross-sectional study, conducted in an outpatient clinic of MedicalRehabilitation Department of Dr. Cipto Mangunkusumo Hospital, Jakarta. The subjects recruited consecutively.The pain intensity was assessed subjectively by the Visual Analogue Scale (VAS) score from 0 to 10. Thenumber of the trigger points (TP) were examined palpation manually. The pain threshold was evaluated by thealgometer (Kg) on the upper trapezius muscles.Results: The study has recruited 30 patients, aged 40,5 (20-54). The BMI was 24.97 ± 3.39 Kg/M2. The VASscore was 6 (5-8). The number of the TP was 5.83 ± 1.74. The pain threshold was 2.48 ± 0.52 Kg/ cm2. Most ofthe subjects have overweight (20%) and obesity (47%). There was no correlation between the BMI with the painintensity (r=-0.076, p=0.689), with the number of trigger points (r=0.256, p=0.171) and with the pain threshold(r=0.189, p=0.316).Conclusions: Therefore the BMI was not related to the pain intensity, the number of trigger points as wellas with the threshold of pain in the MPS patients. However, the number of the TP tends to increase, and thethreshold of pain has the tendency to reduced in the obese subjects.Keywords: Obesity; Myofascial Pain Syndrome; VAS; Pain Threshold

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Faculty Opinions recommendation of Is There an Association Between Lumbosacral Radiculopathy and Painful Gluteal Trigger Points?: A Cross-sectional Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725389590.793515542 ◽

2016 ◽

Author(s):

César Fernández de las Peñas

Keyword(s):

Trigger Points ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Lumbosacral Radiculopathy

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Stretching and relaxing the plantar fascia may change plantar fascia thickness but not pressure pain thresholds: a cross-sectional study of patients with plantar fasciopathy

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03833-x ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Stefanie Ostermann ◽

Jens Lykkegaard Olesen ◽

Sinéad Holden ◽

Henrik Riel

Keyword(s):

Frontal Plane ◽

Plantar Fascia ◽

Cross Sectional Study ◽

Mean Difference ◽

Sectional Study ◽

Cross Sectional ◽

Pain Thresholds ◽

Pressure Pain ◽

Plantar Fasciopathy ◽

Pressure Pain Thresholds

Abstract Background Despite the established relevance of ultrasonography and assessment of pressure pain thresholds in patients with plantar fasciopathy, patient and probe positioning has been mostly ignored and are not necessarily reported in research. The primary aim of this study was to compare plantar fascia thickness in stretched and relaxed positions in patients with plantar fasciopathy. The secondary aim was to compare plantar heel pressure pain thresholds in these positions. Methods In this cross-sectional study, we measured the plantar fascia thickness with ultrasonography, and localised pressure pain thresholds using pressure algometry of 20 patients with plantar fasciopathy. These were assessed bilaterally, with the plantar fascia in both a stretched and relaxed position. In the stretched position, toes were maximally dorsiflexed, while in the relaxed position participants’ feet were hanging freely over the end of the table. Results The plantar fascia of the most symptomatic foot was significantly thicker when stretched compared with the relaxed position (sagittal: mean difference 0.2 mm, 95%CI: 0.1–0.4, P = 0.013; frontal: mean difference − 0.27, 95%CI: − 0.49 to − 0.06, P = 0.014). The plantar fascia was significantly thinner in the frontal plane compared with the sagittal plane in both positions (stretched: mean difference − 0.2 mm, 95%CI: − 0.42 to − 0.03, P = 0.025; relaxed: mean difference − 0.3 mm, 95%CI:-0.49 to − 0.08, P = 0.008). There was no difference between pressure pain thresholds in stretched or relaxed positions in either foot (P > 0.4). Conclusions The plantar fascia was significantly thicker in a stretched compared with a relaxed position and in the sagittal compared with the frontal plane, but differences were smaller than the standard deviation. Pressure pain thresholds were not different between the positions. These results highlight the importance of how ultrasonography is performed and reported in research to allow for replication. Trial registration The study was pre-registered September 25th, 2017 on ClinicalTrials.gov (NCT03291665).

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Electromyographic Activity Evolution of Local Twitch Responses During Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle: A Cross-Sectional Study

Pain Medicine ◽

10.1093/pm/pnz182 ◽

2019 ◽

Vol 21 (6) ◽

pp. 1224-1229

Author(s):

Luis Baraja-Vegas ◽

Saúl Martín-Rodríguez ◽

Francisco Piqueras-Sanchiz ◽

Julio Martín-Ruiz ◽

Mireia Yeste Fabregat ◽

...

Keyword(s):

Gastrocnemius Muscle ◽

Trigger Points ◽

Cross Sectional Study ◽

Medial Gastrocnemius ◽

Peak Amplitude ◽

Emg Activity ◽

Sectional Study ◽

Dry Needling ◽

Cross Sectional ◽

Gastrocnemius Medialis

Abstract Objective Trigger points (TrPs) are hypersensitive spots within taut bands of skeletal muscles that elicit referred pain and motor changes. Among the variety of techniques used for treating TrPs, dry needling is one of the most commonly applied interventions. The question of eliciting local twitch responses (LTRs) during TrP dry needling is unclear. Our main aim was to investigate the evolution of the electromyographic (EMG) peak activity of each LTR elicited during dry needling into latent TrPs of the gastrocnemius medialis muscle. Methods Twenty asymptomatic subjects with latent TrPs in the gastrocnemius medialis muscle participated in this cross-sectional study. Changes in EMG signal amplitude (root mean square [RMS]) with superficial EMG were assessed five minutes before, during, and five minutes after dry needling. The peak RMS score of each LTR was calculated (every 0.5 sec). Results Analysis of variance revealed a significant effect (F = 29.069, P <0.001) showing a significant decrease of RMS peak amplitude after each subsequent LTR. Differences were significant (P <0.001) during the first three LTRs, and stable until the end of the procedure. No changes (P =0.958) were found for mean RMS data at rest before (mean = 65.2 mv, 95% confidence interval [CI] = 47.3–83.1) and after (61.0 mv, 95% CI = 42.3–79.7) dry needling. Conclusions We found that, in a series of LTRs elicited during the application of dry needling over latent TrPs in the medial gastrocnemius muscle, the RMS peak amplitude of each subsequent LTR decreased as compared with the initial RMS peak amplitude of previous LTRs. No changes in superficial EMG activity at rest were observed after dry needling of latent TrPs of the gastrocnemius medialis muscle.

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