Correlation Between Skin Temperature Over Myofascial Trigger Points in the Upper Trapezius Muscle and Range of Motion, Electromyographic Activity, and Pain in Chronic Neck Pain Patients

2018 ◽  
Vol 41 (4) ◽  
pp. 350-357 ◽  
Author(s):  
Carlos Eduardo Girasol ◽  
Almir Vieira Dibai-Filho ◽  
Alessandra Kelly de Oliveira ◽  
Rinaldo Roberto de Jesus Guirro
Keyword(s):  
Neck Pain ◽  
Skin Temperature ◽  
Trapezius Muscle ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Electromyographic Activity ◽  
Myofascial Trigger Points ◽  
Upper Trapezius ◽  
Upper Trapezius Muscle ◽  
Pain Patients

scholarly journals Lidocaine Injection in the Intramuscular Innervation Zone Can Effectively Treat Chronic Neck Pain Caused by MTrPs in the Trapezius Muscle

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E815-E826
Author(s):  
Hong Zheng
Keyword(s):  
Neck Pain ◽  
Trapezius Muscle ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Injection Therapy ◽  
Myofascial Trigger Points ◽  
Innervation Zone ◽  
Upper Trapezius ◽  
Lidocaine Injection ◽  
Lower Trapezius

Background: An increasing number of people suffer from neck pain due to life style and prolonged use of computers. Research has revealed that myofascial trigger points (MTrPs) and the intramuscular innervation zone (IZ) are involved in neck pain. MTrPs are induced mainly by IZ dysfunction of the affected skeletal muscle and the 2 do not overlap in location. The question is whether injection treatment in MTrPs or in the IZ is more effective to relieve MTrPs-associated pains. The precise location and body-surface map of the intramuscular IZ in the trapezius muscle and a clinical injection study in the IZ may provide a useful answer to the question. Objectives: This study aimed to investigate the efficacy of lidocaine injection in the intramuscular IZ for the treatment of chronic neck pain caused by MTrPs in the trapezius muscle. Study Design: Prospective observational study, approved by the local research ethics. Setting: University hospital, departments of Anesthesiology and Anatomy. Methods: First, for the determination of IZ distribution and body-surface mapping, a modified intramuscular Sihler’s neural staining technique was applied to elucidate nerve distribution patterns of the trapezius muscle. Then, 120 patients with myofascial pain syndrome (MPS) of the trapezius muscle were randomly divided into 5 groups for analysis. Group 1 (n = 24) received injections of saline (0.9% NaCl) at the MTrPs. Group 2 (n = 24) received injections of 0.5% lidocaine at the MTrPs. Group 3 (n = 24) received injections of saline (0.9% NaCl) at the mid-upper trapezius (Point E). Group 4 (n = 24) received injections of 0.5% lidocaine at Point E. Group 5 (n = 24) received a combined injection of 0.5% lidocaine treatment at both Point E and the lower trapezius (Point F). The injection dose was 4 mL at each injection site. All patients received injections once a week for 4 weeks. The visual analogue scale (VAS) and the frequency of painful days per month (FPD) were obtained before treatment and at 2, 4, and 6 months after treatment. Results: The intramuscular terminal nerve branches presented a “dendritic” distribution in the trapezius muscle and were connected with each other to form an S-shaped IZ belt in the middle of the muscle belly. Compared with the MTrP injection group, lidocaine-injection therapy in the IZ significantly reduced the degree and frequency of neck pain in patients at 6 months after treatment, especially the combined lidocaine-injection therapy in the IZ of both the mid-upper trapezius and the lower trapezius are more effective (all P < 0.05). Conclusions: This study confirms that lidocaine-injection therapy in the IZ significantly reduces the degree and frequency of neck pain in patients at 6 months after treatment. The combined lidocaine-injection therapy in the IZ of both the mid-upper trapezius and the lower trapezius is more effective. In addition, this study establishes a clear distribution map of intramuscular nerves that will be conducive to the future use of chemical blockers and electrical stimulation in the nervous system in treating MPS of the trapezius muscle. Limitations: The small number of patients and the short duration of follow-up. Key words: Neck pain, intramuscular innervation zone, myofascial trigger points, lidocaine

Association between widespread pressure pain hypersensitivity, health history, and trigger points in subjects with neck pain

2017 ◽  
Vol 16 (1) ◽  
pp. 168-168
Author(s):  
Matteo Castaldo ◽  
Antonella Catena ◽  
César Fernández-de-las-Peñas ◽  
Lars Arendt-Nielsen
Keyword(s):  
Neck Pain ◽  
Tibialis Anterior ◽  
Trapezius Muscle ◽  
Trigger Points ◽  
Pressure Pain ◽  
Pain Hypersensitivity ◽  
Health History ◽  
Upper Trapezius ◽  
Upper Trapezius Muscle ◽  
Extensor Carpi Radialis

Abstract Aims Health history (medical conditions, comorbid musculoskeletal pain, surgical operation, long term intake of medications) may contribute to central sensitization. The duration and the number of the peripheral nociceptive input seem to play a crucial role in the development and maintenance of sensitization. No study has previously investigated these relationships. Our aim was to investigate the association between pressure pain thresholds (PPTs) and health history in patients with neck pain, and the role of active trigger points (TrPs) on PPTs. Methods Thirty-four subjects with mechanical neck pain and 34 with whiplash-associated neck pain participated. They underwent an assessment of PPTs over upper trapezius, extensor carpi radialis longus, and tibialis anterior muscles, and were screened for the presence of active TrPs in upper trapezius muscle. Further, patients fulfilled a questionnaire investigating health history outcomes number and duration. Results Significant negative correlations between all PPTs and the duration of health history outcomes were found in both groups (all, P < 0.02), with no correlations between PPTs and the number of health history outcomes (all, P > 0.15). Significant lower PPTs over upper trapezius, extensor carpi radialis longus, and tibialis anterior (all, P < 0.01) muscles were found in subjects with active TrPs as compared to those with latent TrPs. Conclusions Widespread pressure pain hypersensitivity was associated with the duration, but not the number, of health history outcomes suggesting that long-lasting health complains may act as triggering factor driving sensitization in individuals with neck pain regardless the origin of neck pain. Patients with active TrPs in the upper trapezius muscle showed higher widespread pressure sensitivity than those with latent TrPs. These data should be included in the assessment of neck pain subjects, as they may be useful for planning the management of their symptoms.

scholarly journals Effects of Conventional Physical Therapy with or without Strain Counterstrain in Patients with Trigger Points of Upper Trapezius; a Randomized Controlled Clinical Trial

2016 ◽  
Vol 22 (3) ◽  
Author(s):  
Hafiz Muhammad Waseem Javaid ◽  
Ashfaq Ahmad ◽  
Fareeha Ajmad ◽  
Sidrah Liaqat ◽  
Saba Tahir
Keyword(s):  
Physical Therapy ◽  
Range Of Motion ◽  
Trapezius Muscle ◽  
Trigger Points ◽  
Control Group ◽  
Myofascial Trigger Points ◽  
Upper Trapezius ◽  
Group A ◽  
Upper Trapezius Muscle ◽  
Group B

<p><strong>Background:</strong><strong>  </strong>Non-specific neck pain has potential contributing factors. One of the factors being emphasized in the modern era is the Myofascial trigger points in the upper trapezius muscle. These could be treated by strain counterstrain method whose effectiveness needs to be evaluated. Hence, the objective of the study was to compare the effects of conventional Physical therapy with or without strain counterstrain in patients with trigger points of upper trapezius muscle.</p><p> <strong>Patients and Methods</strong></p><p>It is randomized controlled clinical trial.</p><p>48 patients with treatment group A (24 patients) and control group B (24 patients).</p><p class="Default">48 patients with treatment group A (24 patients) and control group B (24 patients).</p><p>Patients with non-specific neck pain, having active myofascial trigger points in upper trapezius muscle presented to physical therapy department. Effects of interventions were recorded on neck disability index, visual analogue scale and cervical range of motion goniometer.</p><p><strong>Results</strong> of this study using repeated measure ANOVA demonstrated that within group from day 1 to 7, there was mean reduction of pain by 32.13 (26.99, 37.27) in conventional physical therapy group with Strain counterstrain group (group A) and conventional physical therapy only group (group B) by 12.62 (8.28, 16.96). Less significant improvement was seen within groups for day 1, 4 and 7 in cervical range of motion. There was significant improvement seen in pain, neck disability index and neck range of motions on day 7 between group A and B measured by independent sample t test.</p><p><strong>Conclusion:</strong><strong>  </strong>Conventional physical therapy with strain counterstrain was found effective in reducing pain, functional disability and improving range of motion at cervical region.</p>

scholarly journals Visceral Manipulation Decreases Pain, Increases Cervical Mobility and Electromyographic Activity of the Upper Trapezius Muscle in Non-Specific Neck Pain Subjects with Functional Dyspepsia: Two Case Reports

2019 ◽  
Vol 12 (2) ◽  
pp. 25-30
Author(s):  
Andréia C. O. Silva, PT, MSc ◽  
Claudia S. Oliveira, PT, PhD ◽  
Daniela A. Biasotto-Gonzalez, PT, PhD ◽  
Marco A. Fumagalli, Eng, PhD ◽  
Fabiano Politti, PT, PhD
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Case Reports ◽  
Trapezius Muscle ◽  
Emg Activity ◽  
Electromyographic Activity ◽  
Upper Trapezius ◽  
Emg Signal ◽  
Upper Trapezius Muscle ◽  
One Year

Background and Purpose: The lack of clear knowledge about the etiology of nonspecific neck pain (NS-NP) strengthens the need for other mech-anisms, still poorly described in the literature, to be investigated. Therefore, a quantitative analysis of two cases of NS-NP in subjects with functiona dyspepsia was conducted in order to verify the immediate and seven-day postintervention effects of visceral manipulation (VM) to the stomach and liver on neck pain, cervical range of motion (ROM), and electromyographic (EMG) activity of the upper trapezius muscle. Case Description: Case A was an 18-year-old female with a complaint of nonspecific neck pain for one year, with reported pain on waking, momentary intermittent pain, and occasional symptoms of paresthesia in the upper limbs. Case B was a 25-year-old female with a complaint of cervical pain for one year, accompanied by pain in the unilateral temporomandibular joint, and medial thoracic region. Both cases presented functional dyspepsia.Outcomes: The results demonstrated (sub-jects A and B, respectively) a general increase in cervical ROM (range: 12.5% to 44.44%) and amplitude of the EMG signal (immediately postintervention: 57.62 and 20.78; post seven days: 53.54% and 18.83%), and an increase in muscle fiber conduction velocity immediately postintervention (4.44% and 7.44%) and a de-crease seven days postintervention (25.25% and 21.18%). For pain, a decrease was observed immediately postintervention (23.07% and 76.92%) and seven days postintervention (100% for both subjects). Discussion: A single VM provided important clinical improvement in neck pain, cervical spine range of motion, and EMG activity of the upper trapezius muscle, immediately and seven days postintervention in two NS-NP subjects with func-tional dyspepsia.

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