Effectiveness of Strain Counterstrain Technique on Quadratus Lumborum Trigger Point in Low Back Pain

BACKGROUND Scoliotic spine puts undue strain on the back musculature which may lead to the production of myofascial pain syndrome (MPS). The purpose of this study was to find out the association of myofascial pain of iliopsoas and quadratus lumborum in scoliotic patients and to look for any correlation between the degree of deformity (Cobb’s angle) and severity of myofascial pain. METHODS A total of 60 patients of low back pain with spinal deformity were enrolled in the study. The severity of the spinal deformity and pain was calculated with Cobb’s angle and visual analogue scale (VAS) pain scale (0 - 100) respectively. Patients with iliopsoas and quadratus myofascial pain underwent trigger point therapy along with regimen of stretching exercises. VAS scores were recorded at 0 - hour, 2 - hour, 2 - weeks, 1 month and 3 months after the procedure. RESULTS Forty-four patients out of 60 had myofascial pain of iliopsoas or quadratus lumborum or both. 15, 31 and 12 patients had Cobb’s angle of 10 - 20, 21 - 30 and 31 - 40 degree, respectively. Trigger point injections were performed in 38 patients. The pre-procedure median VAS score was 70, at 0 hour 45, at 2 hour 40, at 2 weeks 30, at 1 month 30 and at 3 months 30. A significant reduction (P < 0.001) in VAS score was observed till 3 months. CONCLUSIONS The myofascial pain of iliopsoas and quadratus lumborum is an important source of low back pain in patients with scoliosis. There is no correlation between the degree of scoliosis and severity of low back pain. KEYWORDS Scoliosis, Kyphoscoliosis, Thoraco-Lumbar Spinal Deformity, Myofascial Pain, Iliopsoas, Psoas Major, Quadratus Lumborum, Low Back Pain

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

Brain Sciences ◽

10.3390/brainsci11070893 ◽

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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Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2019.01.015 ◽

2019 ◽

Vol 37 (10) ◽

pp. 1927-1931 ◽

Cited By ~ 6

Author(s):

Abdullah Osman Kocak ◽

Ali Ahiskalioglu ◽

Emre Sengun ◽

Sultan Tuna Akgol Gur ◽

Ilker Akbas

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Trigger Point ◽

Randomized Study ◽

Prospective Randomized Study ◽

Low Back ◽

Point Injection

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Electromyographic Studies on Motor Unit Activity of the Trigger Point in Low Back Pain

Zen Nihon Shinkyu Gakkai zasshi (Journal of the Japan Society of Acupuncture and Moxibustion) ◽

10.3777/jjsam.31.256 ◽

1982 ◽

Vol 31 (3) ◽

pp. 256-262

Author(s):

Kazuhiro Goto ◽

Kazumasa Hiraoka ◽

Yutaka Kagoshima ◽

Ryuhei Takeuchi ◽

Kiyokazu Yoshida ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Motor Unit ◽

Unit Activity ◽

Trigger Point ◽

Low Back ◽

Motor Unit Activity

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Change in Regional Activity of the Quadratus Lumborum During Bridge Exercises

Journal of Sport Rehabilitation ◽

10.1123/jsr.2019-0225 ◽

2020 ◽

pp. 1-9

Author(s):

Tomoki Oshikawa ◽

Gen Adachi ◽

Hiroshi Akuzawa ◽

Yu Okubo ◽

Koji Kaneoka

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Trunk Muscles ◽

Electromyographic Activity ◽

Low Back ◽

Maximal Voluntary Isometric Contraction ◽

Quadratus Lumborum ◽

Activity Measurements ◽

Measurement Design

Context: The quadratus lumborum (QL) is expected to contribute to segmental motor control of the lumbar spine to prevent low back pain. It has different layers (anterior [QL-a] and posterior [QL-p] layers), whose functional differences are becoming apparent. However, the difference between the QL-a and QL-p activities during bridge exercises utilized in rehabilitation is unclear. Objective: To compare QL-a and QL-p activities during bridge exercises. Design: Repeated-measurement design was used to assess electromyographic activity of trunk muscles recorded during 14 types of bridge exercises. Setting: University laboratory. Participants: A total of 13 healthy men with no history of lumbar spine disorders participated. Intervention: The participants performed 14 types of bridge exercises (3, 3, and 8 types of side bridge, back bridge, and front bridge [FB], respectively). Main Outcome Measures: Fine-wire electromyography was used for QL-a and QL-p activity measurements during bridge exercises. Results: Both QL-a and QL-p showed the highest activity during the side bridge with hip abduction (47.3% [29.5%] and 43.0% [32.9%] maximal voluntary isometric contraction, respectively). The activity of the QL-a was significantly higher than that of the QL-p during back bridge with ipsilateral leg lift and FB elbow–toe with ipsilateral arm and contralateral leg lift (P < .05). With regard to the QL-p, the activity of the FB hand–knee with contralateral arm and ipsilateral leg lift, the FB elbow–knee with contralateral arm and ipsilateral leg lift, and the FB elbow–toe with contralateral arm and ipsilateral leg lift were significantly higher than that of the FB elbow–knee and FB elbow–toe (P < .05). Conclusion: This study indicates different regional activities; the QL-a activated during the back bridge with ipsilateral leg lift and FB with ipsilateral arm lift, and the QL-p activated during the FB with ipsilateral leg lift. These results have implications for the rehabilitation of low back pain or lumbar scoliosis patients based on QL recruitment.

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Completion Rates and Clinical Changes of Patients Seeking Non-Invasive Treatment for Low Back Pain in 13 Centres of a Sports Medicine Institute in India

Complementary Medicine Research ◽

10.1159/000504015 ◽

2019 ◽

Vol 27 (2) ◽

pp. 89-96

Author(s):

Priyadarshini Rajamani ◽

Hemant Deepak Shewade ◽

Debashish Kundu ◽

Kishore Kumar Sekaran ◽

Santhanam Daniel Amalan ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Sports Medicine ◽

Functional Disability ◽

Trigger Point ◽

Visual Analogue Scale Pain ◽

Low Back ◽

Completion Rates ◽

Invasive Treatment ◽

Non Invasive

Background/Aim: Low back pain (LBP) is the major cause of disability worldwide. The existing treatments are expensive and associated with complications. The present study aimed to determine the proportion of patients completing therapy and rehabilitation phases and describe the changes in self-reported symptoms and functional disability among LBP patients enrolled in a private sports medicine institute. Methods: This is a cohort study involving review of case records. We studied 2 phases out of 3 of non-invasive treatment of LBP: therapy of around 10 days (myofascial trigger point release therapy, cryotherapy, aqua therapy and acupuncture) and rehabilitation of around 3 weeks (muscle strengthening exercises). Results: A total of 443 patients were enrolled; their mean (SD) age was 46 (15) years, 46% were male, and 193 (44%) presented with chronic (>6 months) pain. The numbers of patients who completed the therapy and rehabilitation phases were 327 (74%) and 115 (26%), respectively. The median (IQR) visual analogue scale pain scores were 7 (6–9) at entry, 2 (1–3) at completion of therapy and 1 (0–2) at completion of rehabilitation (p < 0.001). The median (IQR) functional disability scores were 32 (22–53) at entry, 15 (6–26) at completion of therapy and 4 (0–14) at completion of rehabilitation (p < 0.001). Conclusion: Low completion rates were observed. Patients who completed therapy reported reduction in pain and improved functionalities.

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