Abstract
The aim of the study is to test if sustained nociceptive mechanical stimulation (SNMS)
of latent myofascial trigger points (MTrPs) induces widespread mechanical hyperalgesia.
SNMS was obtained by inserting and retaining an intramuscular electromyographic (EMG)
needle within a latent MTrP or a nonMTrP in the finger extensor muscle for 8 minutes
in 12 healthy subjects. Pain intensity (VAS) and referred pain area induced by SNMS
were recorded. Pressure pain threshold (PPT) was measured immediately before and after,
and 10-, 20-, and 30-minutes after SNMS at the midpoint of the contralateral tibialis
anterior muscle. Surface and intramuscular EMG during SNMS were recorded. When compared
to nonMTrPs, maximal VAS and the area under VAS curve (VASauc) were significantly
higher and larger during SNMS of latent MTrPs (both, P < .05); there was a significant decrease in PPT 10 minutes, 20 minutes, and 30 minutes
postSNMS of latent MTrPs (all, P < .05). Muscle cramps following SNMS of latent MTrPs were positively associated with
VASauc (r = .72, P = .009) and referred pain area (r = .60, P = .03). Painful stimulation of latent MTrPs can initiate widespread central sensitization.
Muscle cramps contribute to the induction of local and referred pain.
Perspective
This study shows that MTrPs are one of the important peripheral pain generators and
initiators for central sensitization. Therapeutic methods for decreasing the sensitivity
and motor-unit excitability of MTrPs may prevent the development of muscle cramps
and thus decrease local and referred pain.
Key words
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Article info
Publication history
Published online: May 07, 2010
Accepted:
March 15,
2010
Received in revised form:
March 9,
2010
Received:
January 26,
2010
Footnotes
Supported by the Danish Working Environment Authority.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
