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.

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

2017 ◽  
Vol 16 (1) ◽  
pp. 167-168 ◽  
Author(s):  
Matteo Castaldo ◽  
Antonella Catena ◽  
Alessandro Chiarotto ◽  
Jorge Hugo Villafañe ◽  
César Fernández-de-las-Peñas ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Tibialis Anterior ◽  
Trigger Points ◽  
Pressure Pain ◽  
Pain Hypersensitivity ◽  
Upper Trapezius ◽  
Pain Disability ◽  
Neck Disability ◽  
Pain Patients

AbstractAimsMechanical neck pain (MNP) and whiplash-associated disorders (WAD) represents two groups of subjects with a different pathogenesis, since current evidence supports that WAD subjects presents greater sensitization than MNP. Nevertheless, it is still unclear the relationship between neck pain, neck disability, widespread pressure pain hypersensitivity (sign of sensitization) and trigger points (TrPs) in these two groups of neck pain subjects. The aim of the current study was to investigate these associations in MNP and WAD subjects.MethodsForty-six MNP and fifty-one WAD subjects underwent the following examination: pressure pain thresholds (PPTs) in the upper trapezius and tibialis anterior muscles, TrP examination in the upper trapezius, and collection of neck disability and neck pain intensity. The examination was performed by an assessor blinded to subjects’ condition.ResultsA significant positive association between pain and disability (P < 0.003), pain and PPT in the upper trapezius (P < 0.041), pain and PPT in tibialis anterior (P < 0.038), disability and PPT in upper trapezius (P = 0.006) was found in both groups. Subjects with MNP showed significantly negative association between disability and PPT in the tibialis anterior (P = 0.003). Subjects with active TrPs in the upper trapezius exhibited significantly higher neck pain intensity and neck disability and lower PPTs (all, P < 0.015), than those with latent TrPs in both groups.ConclusionsOur results suggest that the association between pain, disability, and PPTs is similar in subjects with neck pain and not influenced by the origin of neck pain. The presence of active TrPs in upper trapezius in neck pain patients was related to higher pain intensity, related-disability and lower PPTs, compared to neck pain patients with latent TrPs in upper trapezius. Future studies are needed to determine the clinical role of these associations.

Widespread Pressure Pain Hypersensitivity, Health History, and Trigger Points in Patients with Chronic Neck Pain: A Preliminary Study

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2516-2527 ◽  
Author(s):  
Matteo Castaldo ◽  
Antonella Catena ◽  
César Fernández-de-las-Peñas ◽  
Lars Arendt-Nielsen
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pain Hypersensitivity ◽  
Health History ◽  
Upper Trapezius ◽  
Pressure Pain Thresholds ◽  
Pain Patients

Abstract Background Pain sensitivity in chronic neck pain patients may be influenced by health conditions related to higher levels of widespread pressure pain hypersensitivity (sensitization). Trigger points have also been reported to play a role in the sensitization process. Objectives To investigate the association between pressure pain thresholds, trigger points, and health conditions in patients with chronic neck pain. Design Original research, preliminary study. Setting A private clinic. Subjects Thirty-four chronic mechanical neck pain patients and 34 chronic whiplash-associated neck pain patients, giving a final sample of 68 chronic neck pain patients. Methods Patients underwent an assessment of pressure pain thresholds over the upper trapezius, extensor carpi radialis longus, and tibialis anterior muscles and were screened for the presence of trigger points in the upper trapezius muscle. Further, information about health history conditions was obtained and collected in a form. Results Significantly negative correlations between all pressure pain thresholds and duration of health history conditions were found (all P &lt; 0.02). Significantly lower pressure pain thresholds (all P &lt; 0.01) were found in patients with active trigger points as compared with those with latent trigger points. Conclusion Widespread pressure pain hypersensitivity was associated with duration of health history conditions, suggesting that long-lasting health complaints may act as a triggering/perpetuating factor, driving sensitization in individuals with chronic neck pain. Active trigger points may be associated with higher widespread pressure hypersensitivity.

Bilateral, wide-spread, mechanical pain sensitivity in children with frequent episodic tension-type headache suggesting impairment in central nociceptive processing

Cephalalgia ◽  
2010 ◽  
Vol 30 (9) ◽  
pp. 1049-1055 ◽  
Author(s):  
César Fernández-de-las-Peñas ◽  
Daniel M Fernández-Mayoralas ◽  
Ricardo Ortega-Santiago ◽  
Silvia Ambite-Quesada ◽  
Antonio Gil-Crujera ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Trapezius Muscle ◽  
Tension Type Headache ◽  
Healthy Children ◽  
Wide Spread ◽  
Pressure Pain ◽  
Upper Trapezius ◽  
Pressure Pain Thresholds ◽  
Upper Trapezius Muscle ◽  
Type Headache

Introduction: The aim was to investigate bilateral, wide-spread pressure pain hyperalgesia in symptomatic (trigeminocervical) and non-symptomatic (pain-free distant) regions in children with frequent episodic tension-type headache (FETTH). Methods: Twenty-five children, 6 boys and 19 girls (mean age, 8.9 ± 1.8 years) with FETTH and 50 age- and sex-matched healthy children (12 boys, 38 girls; mean age: 8.8 ± 1.7 years) were recruited. Pressure pain thresholds (PPTs) were bilaterally assessed over temporalis muscle, upper trapezius muscle, second metacarpal and tibialis anterior muscles in a blinded design. Results: The results showed that PPT levels were significantly decreased bilaterally over the temporalis, upper trapezius and tibialis muscles, and the second metacarpal in children with FETTH as compared to controls (all sites, P < 0.001). No significant differences in the magnitude of PPT decrease between the upper trapezius muscle, second metacarpal and tibialis anterior muscles were found. PPT over both upper trapezius muscles were negatively correlated with the history and intensity of headache (rs = −0.415; P = 0.045). Conclusions: The findings revealed bilateral, wide-spread pressure pain hypersensitivity in children with FETTH suggesting that wide-spread central sensitisation is involved in children with this headache pain condition.

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