Is There Significant Correlation between Self-Reported Low Back Pain Visual Analogue Scores and Low Back Pain Scores Determined by Pressure Pain Induction Matching?

Local heating of trigger points reduces neck and plantar fascia pain

BACKGROUND

Heating the skin and muscles is a commonly accepted method of pain relief and a modality to increase relaxation in muscles and increase tissue blood flow.

OBJECTIVE

The purpose of the present study was to examine the effect of local heat applied to trigger points and to determine if there was pain relief in the neck and plantar fascia.

METHODS

Forty adults were divided into 2 different groups according to their pain; twenty subjects had plantar foot pain and the other 20 had nonspecific neck pain. The 20 subjects in each group were randomly subdivided into a heat and a sham group. Sensitivity to pressure was measured with an algometer. A stopwatch was given to the subject and started when either the heat patch or placebo was applied. Heat cells were applied at trigger points on the pain area.

RESULTS

Subjective pain significantly decreased in both sham and heat group patients with neck pain (p< 0.05), however, the change was greater in the heat group and there was a significant difference between the heat and sham groups (p= 0.002, d= 0.81). For the plantar pain group, a significant decrease in subjective pain was found in the heat group but not in the sham group. Pressure pain threshold significantly decreased in the heat group patients both with neck and plantar pain but for the sham group there was an increase in the pressure after sham treatment. Pain relief during the intervention was also significantly different between the heat and sham group in both patients with neck and plantar pain.

CONCLUSION

The effect of local heat on trigger points of the body on pain relief was significantly better in the heat groups than in the sham groups. This finding is significant because using heat on trigger points could be an alternative to dry needling performed by healthcare professionals. This modality can be alternative for home use and avoids opioids.

Correlations between lumbar neuromuscular function and pain, lumbar disability in patients with nonspecific low back pain: A cross-sectional study

This study aims to examine the correlations between lumbar neuromuscular function and pain, lumbar disability in patients with nonspecific low back pain (NSLBP).Ninety patients, with ages 18 to 37 years old, with NSLBP were recruited in this study. The lumbar neuromuscular function was tested by the CON-TREX multijoint isokinetic test and training machine. This study uses the visual analog scale (VAS) and Roland-Morris Disability Questionnaire (RMDQ) to evaluate the pain and the dysfunction index of patients who have low back pain, respectively.Pearson correlation coefficient is used to evaluate the correlation between lumbar neuromuscular function and the VAS and RMDQ scores. VAS and RMDQ scores have correlations with the proprioception in the flexion of the lumbar vertebra flexion; the peak torque of both flexion and extension muscle groups; and average power and endurance at different angular velocities. The decrease of lumbar muscle strength, endurance, and lumbar proprioception of the lumbar vertebra leads to an increase in pain intensity and lumbar disability.This study suggests that patients with chronic low back pain require targeted training in muscle strength, endurance, and lumbar proprioception, providing a theoretical basis for prevention and treatment of chronic NSLBP patients.

At Completion of a Multidisciplinary Treatment Program, Are Psychophysical Variables Associated with a VAS Improvement of 30% or More, a Minimal Clinically Important Difference, or an Absolute VAS Score Improvement of 1.5 cm or More?

OBJECTIVES

Objectives were to determine at completion of a multidisciplinary pain program: 1) what percentage of chronic low back pain (CLBP) patients had improved at 30% or more (minimal clinically important difference [MCID]) and by 1.5 cm or more (minimal important change [MIC]) on the visual analog scale (VAS) and 2) whether that improvement is associated with pain matching (PM), pain threshold (PTRE), and pain tolerance (PTOL) improvements.

METHODS

One hundred and six CLBP patients had admission and discharge scores for VAS, PM, PTRE, and PTOL. Improvement was determined by absolute, MCID, and MIC VAS improvement. Logistic regression analysis controlling for age, gender, race, education, psychoactive substance dependence, and depression was utilized to develop models for the dependent variables of improvement of overall VAS; of MCID of 50% or more; and of MIC with PM, PTOL, and PTRE as independent variables.

RESULTS

Thirty-two percent and 35% of the CLBP patients were at MCID and MIC, respectively, at discharge (68% and 65% not at MCID and MIC, respectively), and 54.7% were improved overall. Of the improved patients, 59% were at MCID and 63.7% at MIC. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID improvement. MIC and 50% or above models could not be estimated.

LIMITATIONS

The VAS was treated as a ratio scale.

CONCLUSIONS

A significant percentage of CLBP patients were at MCID and at MIC at completion of multidisciplinary treatment. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID.