Pain threshold in selected trigger points of superficial muscles of the back in young adults

BACKGROUND

Monitoring of pain threshold is the basis for verification of the effectiveness of therapy or assessment of the patient's condition. This study aimed to determine the pain threshold of selected superficial muscles of the back taking into account trigger point activity in young and healthy males and females, with the evaluation of intrarater reliability of algometric measurements.

MATERIAL AND METHODS

The study examined 30 young adult participants (15 males and 15 females) aged 26.23 ± 3.21, and BMI of 23.80 ± 3.43. The Pain Test FPX Algometer (Wagner) was used for the study. Trigger points on the levator scapulae and trapezius muscles (superior and inferior portion) on both sides were examined. It was also verified whether the trigger points studied are active or inactive. Furthermore, an author's survey questionnaire was used.

RESULTS

Within the trigger points of the right (p = 0.04) and left (p = 0.02) superior trapezius muscle and the left (p = 0.04) levator scapulae muscle, the pain threshold values were higher in the male group. There was a statistically significantly higher number of active trigger points in the female group compared to that in the male group (2.49 ± 1.51 vs. 1.07 ± 1.16, respectively), p = 0.01. For all muscles tested, mean pain threshold values were significantly higher for inactive trigger points. A greater number of active trigger points is associated with lower pain thresholds at these points (left: the superior trapezius, r = -0.597, the inferior trapezius, r = -0.609; the levator scapulae, r = -0.746; right: the superior trapezius, r = -0.610, the inferior trapezius, r = -0.604; the levator scapulae, r = -0.747). The evaluation of the intrarater reliability showed excellent agreement between the first and second measurements, ICC > 0.987 for all examined trigger points.

CONCLUSIONS

(1) Women who reported pain more than once a week in the studied muscles showed a greater number of active trigger points. (2) A greater number of active trigger points in female is related to a lower pain threshold (which is associated with greater pain sensitivity) in female than in male. (3) A sample size of 30 people seems sufficient to detect variations in the pain threshold at active and inactive trigger points of selected back muscles, especially when the frequency of occurrence of both types of points is comparable.

Comparison of Kinesio Taping and manual therapy in the treatment of patients with bruxism using shear-wave elastography-A randomised clinical trial

BACKGROUND

Bruxism is significantly associated with craniofacial pain, feeling of stiffness or fatigue of the jaw and neck pain. Various physiotherapeutic strategies are used in the treatment of bruxism; however, it is not clear which method leads to greater decrease in pain.

OBJECTIVE

The aim of this study is to compare the effects of two physiotherapy methods (manual therapy [MT] and Kinesio taping with manual therapy [KTMT]) in patients with bruxism.

METHODS

Patients were randomised into MT or KTMT groups. Evaluations were performed at baseline and following 4 weeks of physiotherapy. Muscle thickness and stiffness were assessed via shear wave elastography; pain thresholds were evaluated using algometer. Sleep quality was assessed using Pittsburgh Sleep Quality Index, and quality of life was assessed with Likert scales regarding the associated symptoms.

RESULTS

Significant decreases were found in muscle stiffness, pain threshold, sleep quality and quality of life (P < .05) in both MT and KTMT groups. Pain in bilateral temporalis and right occipital region of the trapezius muscle decreased more in the KTMT group compared with the MT group (P < .05). No significant differences in muscle thickness (P > .05) were found in either of the groups.

CONCLUSION

Both MT and KTMT methods were effective in the treatment of bruxism. Kinesio Tape used in conjunction with MT has additionally decreased jaw pain and temporal region pain compared with MT intervention only. Therefore, if jaw pain is the primary complaint of a patient, our results recommend including Kinesio Tape application in the physiotherapeutic treatment program.

Myofascial Pain Syndrome in the Elderly and Self-Exercise: A Single-Blind, Randomized, Controlled Trial

OBJECTIVE

This study aimed to demonstrate the effect of self-exercise with a therapeutic inflatable ball (SEIB) in elderly patients with myofascial pain syndrome.

DESIGN

Single-blind, randomized, controlled noninferiority trial.

SETTING

University campus.

PARTICIPANTS

Forty elderly patients with myofascial pain syndrome completed the study. They were randomly allocated to SEIB (n = 22; mean age, 70.23 ± 6.11 years) or ultrasound (US) therapy (n = 18; mean age, 67.99 ± 5.64 years).

INTERVENTION

SEIB and US therapy (twice weekly for 4 consecutive weeks).

OUTCOME MEASURES

Visual analog scale (VAS), pressure pain threshold (PPT), and cervical lateral flexion (CLF) were measured at baseline and at 1, 2, 3, and 4 weeks.

RESULTS

The noninferiority test indicated that SEIB was not inferior to US for VAS, PPT, and CLF. Between-group comparisons showed no significant differences in the VAS (F = 2.579; p = 0.117), the PPT (F = 0.245; p = 0.624), and the CLF (F = 2.072; p = 0.159). In within-group comparisons, both groups presented significant differences in VAS (SEIB after 1 week and US after 1 week), PPT (SEIB after 3 weeks and US after 4 weeks), and CLF (SEIB after 4 weeks and US after 4 weeks) compared with baseline values.

CONCLUSIONS

SEIB for 4 weeks has an effect similar to that of US for desensitizing myofascial pain and increasing joint flexibility. High accessibility and low cost would make SEIB a practical self-treatment method in elderly patients with myofascial pain syndrome.