Myalgia in 30 Patients with Suspected Myopathy

Background: In patients with neuromuscular disorder, only little data of myalgia frequency and characterization exists. To date, only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic whether high pain intensity levels are equivalent to high pain sensitivity levels in neuromuscular disorders. Methods: 30 sequential patients with suspected neuromuscular disorder and myalgia were analyzed with regard to myalgia characteristics and clinical findings, including symptoms of depression and anxiety and pain- threshold. Results: A neuromuscular disorder was diagnosed in 14/30 patients. Muscular pain fasciculation syndrome (MPFS) without evidence for myopathy or myositis was diagnosed in 10/30 patients and 6/30 patients were diagnosed with pure myalgia without evidence for a neuromuscular disorder (e.g., myopathy, myositis, MPFS, polymyalgia rheumatica). Highest median pain scores were found in patients with pure myalgia and polymyalgia rheumatica. Pressure pain threshold measurement showed a significant difference between patients and controls in the biceps brachii muscle. Conclusion: Only a weak correlation between pain intensity and pressure pain threshold has been suggested, which is concordant with our results. The hypothesis that high pain intensity levels are equivalent to high pain sensitivity levels was not demonstrated.

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Influence of different frequencies of transcutaneous electrical nerve stimulation on the threshold and pain intensity in young subjects

Einstein (São Paulo) ◽

10.1590/s1679-45082014ao3092 ◽

2014 ◽

Vol 12 (3) ◽

pp. 318-322 ◽

Cited By ~ 2

Author(s):

Adriana de Oliveira Gomes ◽

Ana Caroline Silvestre ◽

Cristina Ferreira da Silva ◽

Mariany Ribeiro Gomes ◽

Maria Lúcia Bonfleur ◽

...

Keyword(s):

Electrical Stimulation ◽

Pain Intensity ◽

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Cold Pain ◽

Electrical Nerve Stimulation ◽

Pressure Pain ◽

Significant Difference

Objective To investigate the effects of different transcutaneous electrical nerve stimulation frequencies in nociception front of a pressure pain threshold and cold in healthy individuals. Methods Twenty healthy subjects were divided into four groups, all of which have gone through all forms of electrical stimulation at different weeks. Assessments were pre and post-therapy, 20 and 60 minutes after stimulation. To evaluate the pressure pain threshold, an algometer was used with one tapered tip, pressing the hypothenar region until voluntary report the word “pain”. Cold pain intensity was assessed by immersion in water at 5°C for 30 seconds; at the end, the subject was asked to quantify the pain intensity on a Visual Analog Scale for Pain. For electrical stimulation, two electrodes were used near the elbow, for 20 minutes, with an intensity strong, but not painful. The frequency was in accordance with the group: 0Hz (placebo); 7Hz; 100Hz; and 255Hz. Results Both for the assessment of pressure pain threshold as the cold pain intensity, there was no significant difference (p>0.05). Conclusion We conclude that the use of transcutaneous electrical nerve stimulation on dermatomes C6 to C8 produced no significant change in pressure pain threshold or cold discomfort.

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Relative and absolute test-retest reliabilities of pressure pain threshold in patients with knee osteoarthritis

Scandinavian Journal of Pain ◽

10.1515/sjpain-2018-0017 ◽

2018 ◽

Vol 18 (2) ◽

pp. 229-236 ◽

Cited By ~ 4

Author(s):

Neeraja Srimurugan Pratheep ◽

Pascal Madeleine ◽

Lars Arendt-Nielsen

Keyword(s):

Knee Osteoarthritis ◽

Pain Sensitivity ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Individual Variability ◽

Minimal Detectable Change ◽

Systematic Bias ◽

Pressure Pain ◽

Significant Difference ◽

The Individual

Abstract Background and aims: Pressure pain threshold (PPT) and PPT maps are commonly used to quantify and visualize mechanical pain sensitivity. Although PPT’s have frequently been reported from patients with knee osteoarthritis (KOA), the absolute and relative reliability of PPT assessments remain to be determined. Thus, the purpose of this study was to evaluate the test-retest relative and absolute reliability of PPT in KOA. For that purpose, intra- and interclass correlation coefficient (ICC) as well as the standard error of measurement (SEM) and the minimal detectable change (MDC) values within eight anatomical locations covering the most painful knee of KOA patients was measured. Methods: Twenty KOA patients participated in two sessions with a period of 2 weeks±3 days apart. PPT’s were assessed over eight anatomical locations covering the knee and two remote locations over tibialis anterior and brachioradialis. The patients rated their maximum pain intensity during the past 24 h and prior to the recordings on a visual analog scale (VAS), and completed The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and PainDetect surveys. The ICC, SEM and MDC between the sessions were assessed. The ICC for the individual variability was expressed with coefficient of variance (CV). Bland-Altman plots were used to assess potential bias in the dataset. Results: The ICC ranged from 0.85 to 0.96 for all the anatomical locations which is considered “almost perfect”. CV was lowest in session 1 and ranged from 44.2 to 57.6%. SEM for comparison ranged between 34 and 71 kPa and MDC ranged between 93 and 197 kPa with a mean PPT ranged from 273.5 to 367.7 kPa in session 1 and 268.1–331.3 kPa in session 2. The analysis of Bland-Altman plot showed no systematic bias. PPT maps showed that the patients had lower thresholds in session 2, but no significant difference was observed for the comparison between the sessions for PPT or VAS. No correlations were seen between PainDetect and PPT and PainDetect and WOMAC. Conclusions: Almost perfect relative and absolute reliabilities were found for the assessment of PPT’s for KOA patients. Implications: The present investigation implicates that PPT’s is reliable for assessing pain sensitivity and sensitization in KOA patients.

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Percutaneous Fascia Release for Treating Chronic Recurrent Gluteal Myofascial Pain—A Pilot Study of a New Technique

Rehabilitation Process and Outcome ◽

10.4137/rpo.s30483 ◽

2015 ◽

Vol 4 ◽

pp. RPO.S30483 ◽

Cited By ~ 1

Author(s):

Hsin-Shui Chen ◽

Ming-Ta Lin ◽

Chang-Zern Hong ◽

Yueh-Ling Hsieh ◽

Li-Wei Chou

Keyword(s):

Pilot Study ◽

Pain Intensity ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Small Sample ◽

Myofascial Trigger Points ◽

Pressure Pain ◽

Hip Abduction ◽

Abduction Strength

Objective To investigate the therapeutic effectiveness of percutaneous fascia release to treat chronic recurrent gluteal myofascial pain related to recurrent tendonitis or bursitis at the attachment sites. Methods Five patients (three males, two females; aged 48.6 ± 8.9 years) with myofascial trigger points in the gluteus medius muscle were treated. Outcome measures, including pain intensity, pressure pain threshold, and the relative strength of hip abduction, were assessed before, immediately after, and six months after the treatment. The data measured before and after treatment (different times) on visual analog scale, pressure pain threshold, and relative hip abduction strength were analyzed by Wilcoxon signed-rank test and paired t-test, respectively, for the comparisons between time points. Results Reduction in pain intensity and increase in the pressure pain threshold and the relative hip abduction strength were found in all five patients after treatment when compared with those of before treatment ( P < 0.05). Moreover, all of these improvements existed for at least six months ( P > 0.05). Conclusions Percutaneous fascia release of gluteal muscle insertion sites can be used to treat chronic gluteal pain related to subtrochanteric bursitis to avoid recurrence, if other treatment cannot control the recurrence, although this was demonstrated only on a small sample size without control and blind assessment in the pilot study.

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The Distinction of Hot Herbal Compress, Hot Compress, and Topical Diclofenac as Myofascial Pain Syndrome Treatment

Journal of Evidence-Based Integrative Medicine ◽

10.1177/2156587217753451 ◽

2018 ◽

Vol 23 ◽

pp. 215658721775345 ◽

Cited By ~ 1

Author(s):

Jurairat Boonruab ◽

Netraya Nimpitakpong ◽

Watchara Damjuti

Keyword(s):

Quality Of Life ◽

Pain Intensity ◽

Range Of Motion ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Pressure Pain ◽

Cervical Range Of Motion ◽

Topical Diclofenac ◽

Hot Compress

This randomized controlled trial aimed to investigate the distinctness after treatment among hot herbal compress, hot compress, and topical diclofenac. The registrants were equally divided into groups and received the different treatments including hot herbal compress, hot compress, and topical diclofenac group, which served as the control group. After treatment courses, Visual Analog Scale and 36-Item Short Form Health survey were, respectively, used to establish the level of pain intensity and quality of life. In addition, cervical range of motion and pressure pain threshold were also examined to identify the motional effects. All treatments showed significantly decreased level of pain intensity and increased cervical range of motion, while the intervention groups exhibited extraordinary capability compared with the topical diclofenac group in pressure pain threshold and quality of life. In summary, hot herbal compress holds promise to be an efficacious treatment parallel to hot compress and topical diclofenac.

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Percutaneous Soft Tissue Release for Treating Chronic Recurrent Myofascial Pain Associated with Lateral Epicondylitis: 6 Case Studies

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/142941 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Ming-Ta Lin ◽

Li-Wei Chou ◽

Hsin-Shui Chen ◽

Mu-Jung Kao

Keyword(s):

Soft Tissue ◽

Pain Intensity ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Lateral Epicondylitis ◽

Soft Tissue Release ◽

Recurrent Pain ◽

Myofascial Trigger Points ◽

Pressure Pain

Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis.Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs) due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin’s technique. Pain intensity (measured with a numerical pain rating scale), pressure pain threshold (measured with a pressure algometer), and grasping strength (measured with a hand dynamometer) were assessed before, immediately after, and 3 months and 12 months after the treatment.Results. For every individual case, the pain intensity was significantly reduced(P<0.01)and the pressure pain threshold and the grasping strength were significantly increased(P<0.01)immediately after the treatment. This significant effectiveness lasts for at least one year.Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain.

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Immediate Effects of Region-Specific and Non–Region-Specific Spinal Manipulative Therapy in Patients With Chronic Low Back Pain: A Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20120256 ◽

2013 ◽

Vol 93 (6) ◽

pp. 748-756 ◽

Cited By ~ 36

Author(s):

Ronaldo Fernando de Oliveira ◽

Richard Eloin Liebano ◽

Lucíola da Cunha Menezes Costa ◽

Lívia Leticia Rissato ◽

Leonardo Oliveira Pena Costa

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Spinal Manipulation ◽

Pain Threshold ◽

Controlled Trial ◽

Pressure Pain Threshold ◽

Low Back ◽

Pressure Pain ◽

Upper Thoracic

Background Manual therapists typically advocate the need for a detailed clinical examination to decide which vertebral level should be manipulated in patients with low back pain. However, it is unclear whether spinal manipulation needs to be specific to a vertebral level. Objective The purpose of this study was to analyze the immediate effects of a single, region-specific spinal manipulation defined during the clinical examination versus a single non–region-specific spinal manipulation (applied on an upper thoracic vertebra) in patients with chronic nonspecific low back pain for the outcome measures of pain intensity and pressure pain threshold at the time of the assessment. Design This was a 2-arm, prospectively registered, randomized controlled trial with a blinded assessor. Setting The study was conducted in an outpatient physical therapy clinic in Brazil. Patients The study participants were 148 patients with chronic nonspecific low back pain (with pain duration of at least 12 weeks). Randomization The randomization schedule was generated by an independent statistician and was concealed by using consecutively numbered, sealed, opaque envelopes. Interventions A single high-velocity manipulation was administered to the upper thoracic region of the participants allocated to the non–region-specific manipulation group and to the painful lumbar levels of the participants allocated to the region-specific manipulation group. Measurements Pain intensity was measured by a 0 to 10 numeric pain rating scale. Pressure pain threshold was measured using a pressure algometer. Limitations It was not possible to blind the therapist and participants. Results A total of 148 patients participated in the study (74 in each group). There was no loss to follow-up. Both groups improved in terms of immediate decrease of pain intensity; however, no between-group differences were observed. The between-group difference for pain intensity and pressure pain threshold were 0.50 points (95% confidence interval=−0.10 to 1.10) and −1.78 points (95% confidence interval=−6.40 to 2.82), respectively. No adverse reactions were observed. Conclusion The immediate changes in pain intensity and pressure pain threshold after a single high-velocity manipulation do not differ by region-specific versus non–region-specific manipulation techniques in patients with chronic low back pain.

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Correlation Between Severity of Temporomandibular Disorder, Pain Intensity, and Pressure Pain Threshold

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/j.jmpt.2017.08.001 ◽

2018 ◽

Vol 41 (1) ◽

pp. 47-51 ◽

Cited By ~ 9

Author(s):

Carolina Marciela Herpich ◽

Cid André Fidelis de Paula Gomes ◽

Almir Vieira Dibai-Filho ◽

Fabiano Politti ◽

Cesário da Silva Souza ◽

...

Keyword(s):

Pain Intensity ◽

Pain Threshold ◽

Temporomandibular Disorder ◽

Pressure Pain Threshold ◽

Pressure Pain

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Effectiveness of low-level laser therapy on pain intensity, pressure pain threshold, and SF-MPQ indexes of women with myofascial pain

Lasers in Medical Science ◽

10.1007/s10103-016-2138-x ◽

2017 ◽

Vol 32 (2) ◽

pp. 419-428 ◽

Cited By ~ 22

Author(s):

Laís Valencise Magri ◽

Vinícius Almeida Carvalho ◽

Flávia Cássia Cabral Rodrigues ◽

César Bataglion ◽

Christie Ramos Andrade Leite-Panissi

Keyword(s):

Pain Intensity ◽

Laser Therapy ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Low Level Laser Therapy ◽

Pressure Pain ◽

Low Level ◽

Low Level Laser ◽

Level Laser

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Preventative Taping in Futsal: An Exploratory Analysis of Low-Dye Taping on Planter Force Distribution and Pain Sensitivity

Applied Sciences ◽

10.3390/app10020540 ◽

2020 ◽

Vol 10 (2) ◽

pp. 540

Author(s):

Sebastian Klich ◽

Biye Wang ◽

Aiguo Chen ◽

Jun Yan ◽

Adam Kawczyński

Keyword(s):

Plantar Pressure ◽

Pain Sensitivity ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Force Distribution ◽

Pressure Pain ◽

Lower Extremity Injuries ◽

Foot Force ◽

Extremity Injuries ◽

The Right

The purpose of the present study was to investigate the changes in plantar foot force distribution (i.e., the percentage of force and force distribution under the rearfoot and forefoot) and plantar pressure pain sensitivity maps in professional futsal players after long-term low-dye taping (LDT). The subjects (n = 25) were male futsal players (age 23.03 ± 1.15 years). During the experiment, a nonelastic tape was applied on the plantar foot surface according to the standards of LDP. The experimental protocol consisted of a 3-day cycle during which the plantar foot force distribution (FFD) and plantar pressure pain threshold (PPT) were measured: (1) before the tape was applied, (2) 24 h after application, and (3) 72 h after application. The results revealed a significant decrease in the force distribution under the rearfoot (p ≤ 0.001) and forefoot (p ≤ 0.001) on the right and left sides. Moreover, the results showed an increase in the plantar pressure pain threshold in all regions of the foot (p ≤ 0.001). The results of this study suggest that plantar fascial taping can be an effective method for normalizing the force distribution on the foot and reducing the plantar pain threshold. The findings provide useful information regarding the prevention of and physical therapy of lower extremity injuries in soccer and futsal.

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Effects of Different Neck Manual Lymphatic Drainage Maneuvers on the Nervous, Cardiovascular, Respiratory and Musculoskeletal Systems in Healthy Students

Journal of Clinical Medicine ◽

10.3390/jcm9124062 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4062

Author(s):

Ángela Río-González ◽

Ester Cerezo-Téllez ◽

Cristina Gala-Guirao ◽

Laura González-Fernández ◽

Raquel Díaz-Meco Conde ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Respiratory Rate ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Control Group ◽

Pressure Pain ◽

Significant Difference ◽

Healthy Participants

The aim of this study is to describe the short-term effects of manual lymph drainage (MLD) isolated in supraclavicular area in healthy subjects. A 4-week cross-sectional, double-blinded randomized clinical trial was conducted. Participants: 24 healthy participants between 18 and 30 years old were recruited from Universidad Europea de Madrid from December 2018 to September 2019. A total of four groups were studied: control, placebo, Vodder, and Godoy. The order of the interventions was randomized. Resting Heart Rate and Oxygen Saturation, blood pressure, pressure pain threshold of trapezius muscle, respiratory rate, range of active cervical movements were measured before and after every intervention. All the participants fulfilled four different interventions with a one-week-wash-out period. No statistically significant differences were found between groups in descriptive data; neither in saturation of oxygen, diastolic blood pressure and cervical range of motion. Significant differences were found in favor of Vodder (p = 0.026) in heart rate diminution and in cardiac-rate-reduction. A significant difference in respiratory rate diminution is found in favor of the Godoy group in comparison with the control group (p = 0.020). A significant difference is found in favor of the Godoy group in systolic blood pressure decrease (p = 0.015) even in pressure pain threshold (p < 0.05). MLD decreases systolic blood pressure in healthy participants. However, it does not produce any changes in other physiologic outcomes maintaining physiologic values, which may suggest the safety of the technique in patients suffering from other pathologies.

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