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Sample records for active myofascial trigger

  1. Electrophysiological characteristics according to activity level of myofascial trigger points

    OpenAIRE

    Yu, Seong Hun; Kim, Hyun Jin

    2015-01-01

    [Purpose] This study compared the differences in electrophysiological characteristics of normal muscles versus muscles with latent or active myofascial trigger points, and identified the neuromuscular physiological characteristics of muscles with active myofascial trigger points, thereby providing a quantitative evaluation of myofascial pain syndrome and clinical foundational data for its diagnosis. [Subjects] Ninety adults in their 20s participated in this study. Subjects were equally divide...

  2. Electrophysiological characteristics according to activity level of myofascial trigger points.

    Science.gov (United States)

    Yu, Seong Hun; Kim, Hyun Jin

    2015-09-01

    [Purpose] This study compared the differences in electrophysiological characteristics of normal muscles versus muscles with latent or active myofascial trigger points, and identified the neuromuscular physiological characteristics of muscles with active myofascial trigger points, thereby providing a quantitative evaluation of myofascial pain syndrome and clinical foundational data for its diagnosis. [Subjects] Ninety adults in their 20s participated in this study. Subjects were equally divided into three groups: the active myofascial trigger point group, the latent myofascial trigger point group, and the control group. [Methods] Maximum voluntary isometric contraction (MVIC), endurance, median frequency (MDF), and muscle fatigue index were measured in all subjects. [Results] No significant differences in MVIC or endurance were revealed among the three groups. However, the active trigger point group had significantly different MDF and muscle fatigue index compared with the control group. [Conclusion] Given that muscles with active myofascial trigger points had an increased MDF and suffered muscle fatigue more easily, increased recruitment of motor unit action potential of type II fibers was evident. Therefore, electrophysiological analysis of these myofascial trigger points can be applied to evaluate the effect of physical therapy and provide a quantitative diagnosis of myofascial pain syndrome.

  3. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation.

    Science.gov (United States)

    Ge, Hong-You; Fernández-de-Las-Peñas, César; Yue, Shou-Wei

    2011-03-25

    Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy.

  4. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation

    Directory of Open Access Journals (Sweden)

    Fernández-de-las-Peñas César

    2011-03-01

    Full Text Available Abstract Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy.

  5. Latent myofascial trigger points.

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    Ge, Hong-You; Arendt-Nielsen, Lars

    2011-10-01

    A latent myofascial trigger point (MTP) is defined as a focus of hyperirritability in a muscle taut band that is clinically associated with local twitch response and tenderness and/or referred pain upon manual examination. Current evidence suggests that the temporal profile of the spontaneous electrical activity at an MTP is similar to focal muscle fiber contraction and/or muscle cramp potentials, which contribute significantly to the induction of local tenderness and pain and motor dysfunctions. This review highlights the potential mechanisms underlying the sensory-motor dysfunctions associated with latent MTPs and discusses the contribution of central sensitization associated with latent MTPs and the MTP network to the spatial propagation of pain and motor dysfunctions. Treating latent MTPs in patients with musculoskeletal pain may not only decrease pain sensitivity and improve motor functions, but also prevent latent MTPs from transforming into active MTPs, and hence, prevent the development of myofascial pain syndrome.

  6. Comparison between four treatment modalities for active myofascial triggers points

    Directory of Open Access Journals (Sweden)

    Atef Fouda

    2014-06-01

    Full Text Available Aim: The study aimed at the painful trigger points (TrPs for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction. Methods: We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction. Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain. We used mean and standard deviation values. The Mann-Whitney U-test was used to compare the two groups. The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores. The Student's t-test was used to compare maximum mouth opening (MMO groups. Then paired t-test was also used to study the changes of time in an MMO. Results: The results showed that pulsed electromagnetic field (PEMF therapy is the most effective treatment modality regarding for pain relief. Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods, and a statistically significant increase in mean MMO. Conclusion: The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.

  7. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome

    DEFF Research Database (Denmark)

    Ge, Hong-You; Nie, Hongling; Madeleine, Pascal

    2009-01-01

    The generalized hypersensitivity associated with fibromyalgia syndrome (FMS) may in part be driven by peripheral nociceptive sources. The aim of the study was to investigate whether local and referred pain from active myofascial trigger points (MTrPs) contributes to fibromyalgia pain. FMS patients...

  8. Etiology of myofascial trigger points

    NARCIS (Netherlands)

    Bron, C.; Dommerholt, J.D.

    2012-01-01

    Myofascial pain syndrome (MPS) is described as the sensory, motor, and autonomic symptoms caused by myofascial trigger points (TrPs). Knowing the potential causes of TrPs is important to prevent their development and recurrence, but also to inactivate and eliminate existing TrPs. There is general

  9. Etiology of myofascial trigger points

    NARCIS (Netherlands)

    Bron, C.; Dommerholt, J.D.

    2012-01-01

    Myofascial pain syndrome (MPS) is described as the sensory, motor, and autonomic symptoms caused by myofascial trigger points (TrPs). Knowing the potential causes of TrPs is important to prevent their development and recurrence, but also to inactivate and eliminate existing TrPs. There is general ag

  10. Understanding of myofascial trigger points

    Institute of Scientific and Technical Information of China (English)

    Zhuang Xiaoqiang; Tan Shusheng; Huang Qiangmin

    2014-01-01

    Objective To investigate the current practice of myofascial pain syndrome (MPS) including current epidemiology,pathology,diagnosis and treatment.Data sources The data analyzed in this review were mainly from relevant articles without restriction on the publication date reported in PubMed,MedSci,Google scholar.The terms "myofasial trigger points" and "myofacial pain syndrome" were used for the literature search.Study selection Original articles with no limitation of research design and critical reviews containing data relevant to myofascial trigger points (MTrPs) and MPS were retrieved,reviewed,analyzed and summarized.Results Myofascial pain syndrome (MPS) is characterized by painful taut band,referred pain,and local response twitch with a prevalence of 85% to 95% of incidence.Several factors link to the etiology of MTrPs,such as the chronic injury and overload of muscles.Other factors,such as certain nutrient and hormone insufficiency,comorbidities,and muscle imbalance may also maintain the MTrP in an active status and induce recurrent pain.The current pathology is that an extra leakage acetylcholine at the neuromuscular junction induces persistent contracture knots,relative to some hypotheses of integration,muscle spindle discharges,spinal segment sensitization,ect.MTrPs can be diagnosed and localized based on a few subjective criteria.Several approaches,including both direct and supplementary treatments,can inactivate MTrPs.Direct treatments are categorized into invasive and conservative.Conclusion This review provides a clear understanding of MTrP pain and introduces the most useful treatment approaches in China.

  11. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    DEFF Research Database (Denmark)

    Ge, Hong-You; Wang, Ying; Fernandez-de-las-Penas, Cesar

    2011-01-01

    It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern...

  12. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    DEFF Research Database (Denmark)

    Ge, Hong-You; Wang, Ying; Fernandez-de-las-Penas, Cesar

    2011-01-01

    It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern...

  13. Tensiomyography, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points

    Science.gov (United States)

    Calvo-Lobo, César; Diez-Vega, Ignacio; Martínez-Pascual, Beatriz; Fernández-Martínez, Silvia; de la Cueva-Reguera, Mónica; Garrosa-Martín, Gerson; Rodríguez-Sanz, David

    2017-01-01

    Abstract The myofascial pain syndrome (MPS) is considered the most common musculoskeletal condition. The lumbopelvic pain (LPP) is established as one of the most prevalent musculoskeletal disorders. Nevertheless, previous research has not yet studied the contractibility changes by tensiomyography between myofascial trigger point (MTrP) types and normal tissue. Therefore, the aim of this study was to determine the tensiomyography, sonoelastography, and pressure pain threshold (PPT) differences between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. A cross-sectional descriptive study was performed. A convenience sample of 60 points (20 active MTrPs, 20 latent MTrPs, and 20 control points) was registered bilaterally in the lumbar erector spinae muscles from subjects with nonspecific LPP. The palpation order of active MTrPs, latent MTrPs, or control points was randomized for each side. The outcome assessors were blinded to the order or point type. The outcome measurements order for each point was sonoelastography manual strain index, tensiomyography, and PPT, separated by 15 minutes. Five contractile objective parameters were: maximal radial displacement (Dm), contraction time (Tc), sustain time (Ts), delay time (Td), and half-relaxation time (Tr). Tensiomyography parameters did not show any statistically significant difference (P > 0.05) between active MTrPs, latent MTrPs, and control points. Nevertheless, PPT and sonoelastography showed statistically significant differences (P < 0.05) between all point types, except for active and latent MTrPs PPT comparison (P = 0.091). Regarding the active MTrPs, a moderate positive correlation was observed between PPT and Dm (P = 0.047; τB = 0.450). Considering the control points, a moderate positive correlation was shown between sonoelastography and Td (P = 0.044; τB = 0.328). The tensiomyography contractile

  14. Introduction to myofascial trigger points in dogs.

    Science.gov (United States)

    Wall, Rick

    2014-06-01

    In dogs, muscles make up 44%-57% of total body weight and can serve as source of both pain and dysfunction when myofascial trigger points are present. However, rarely is muscle mentioned as a generator of pain in dogs, and even less mentioned is muscle dysfunction. The veterinary practitioner with interest in pain management, rehabilitation, orthopedics, and sports medicine must be familiar with the characteristics, etiology, and precipitating factors of myofascial trigger points. Additionally, the development of examination and treatment skill is needed to effectively manage myofascial trigger points in dogs.

  15. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome.

    Science.gov (United States)

    Ge, Hong-You; Nie, Hongling; Madeleine, Pascal; Danneskiold-Samsøe, Bente; Graven-Nielsen, Thomas; Arendt-Nielsen, Lars

    2009-12-15

    The generalized hypersensitivity associated with fibromyalgia syndrome (FMS) may in part be driven by peripheral nociceptive sources. The aim of the study was to investigate whether local and referred pain from active myofascial trigger points (MTrPs) contributes to fibromyalgia pain. FMS patients and healthy controls (n=22 each, age- and gender-matched) were recruited. The surface area over the upper trapezius muscle on each side was divided into 13 sub-areas (points) of 1cm in diameter for each point. Pressure pain threshold (PPT) and the local and referred pain pattern induced by manual palpation at 13 points bilaterally in the upper trapezius were recorded. Results showed that PPT levels at all measured points were significantly lower in FMS than controls. Multiple active MTrPs (7.4+/-2.2) were identified bilaterally in the muscle in FMS patients, but no active MTrPs were found in controls. The mid-fiber region of the muscle had the lowest PPT level with the largest number of active MTrPs in FMS and with the largest number of latent MTrPs in controls. The local and referred pain pattern induced from active MTrPs bilaterally in the upper trapezius muscle were similar to the ongoing pain pattern in the neck and shoulder region in FMS. In conclusion, active MTrPs bilaterally in the upper trapezius muscle contribute to the neck and shoulder pain in FMS. Active MTrPs may serve as one of the sources of noxious input leading to the sensitization of spinal and supraspinal pain pathways in FMS.

  16. Activator instrument versus dry needling of active upper trapezius myofascial trigger points in those with neck pain

    OpenAIRE

    2013-01-01

    M.Tech. (Chiropractic) Neck pain is a common and costly complaint in society and many are made to believe that their neck pain is caused by pinched nerve, compressed disk, arthritis or displaced cervical vertebrae, when in reality the pain may be solely due to referral from myofascial trigger points in overworked or traumatized muscles of their upper back and shoulders. Travel and Simons (1999) demonstrated trapezius muscle of the neck, back and shoulder as the main cause of mechanical nec...

  17. Assessment of Myofascial Trigger Points Using Ultrasound.

    Science.gov (United States)

    Kumbhare, Dinesh A; Elzibak, Alyaa H; Noseworthy, Michael D

    2016-01-01

    Myofascial pain syndrome is a common musculoskeletal pain disorder characterized by the presence of myofascial trigger points (MTrPs). The diagnosis of myofascial pain syndrome is currently made on clinical grounds. Numerous diagnostic criteria are used to identify myofascial pain syndrome, including the localization of MTrPs. Identifying the presence of MTrPs currently requires the physician to palpate the symptomatic region. Because the interrater reliability of the palpation technique has been found to be poor, numerous groups have been interested in finding objective imaging measures to localize the MTrP. This comprehensive review focuses on summarizing ultrasound imaging techniques that have shown promise in visually localizing the trigger point. The authors' literature search identified three sonographic approaches that have been used in MTrP localization: conventional gray-scale imaging, Doppler imaging, and elastographic ultrasound imaging. This review article explains the basic physics behind the imaging methods and summarizes the characteristics of the MTrP as identified by the ultrasonic techniques.

  18. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    Science.gov (United States)

    2011-01-01

    Introduction It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern. The current study investigated whether the overall spontaneous FM pain pattern can be reproduced by local and referred pain from active MTPs located in different muscles. Methods A spontaneous pain pattern in FM was recorded in 30 FM patients and 30 healthy subjects served as controls. Local and referred pain patterns induced from active (patients) and latent (controls) MTPs were recorded following manual stimulation. The existence of MTPs was confirmed by intramuscular electromyographical registration of spontaneous electrical activity. Results Local and referred pain areas induced from key active MTPs in FM were larger than pain areas from latent MTPs in healthy controls (P 0.05). The induced pain area was positively associated with current spontaneous pain intensity in FM (P fibromyalgia pain is largely composed of pain arising from muscle pain and spasm. Targeting active MTPs and related perpetuating factors may be an important strategy in FM pain control. Trial registration ISRCTN ISRCTN43167547. PMID:21426569

  19. Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats

    Directory of Open Access Journals (Sweden)

    Fei Meng

    2015-01-01

    Full Text Available Myofascial trigger points (MTrPs are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P0.05. 30 min after the injection, MPTs at MTrSs were significantly lower than those of non-MTrSs (P<0.01. Therefore, we concluded that proliferated myelinated afferents existed at MTrSs, which were closely related to pathology of SEA and mechanical hyperalgesia of MTrSs.

  20. Referred pain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Ge, Hong-You; Alonso-Blanco, Cristina; González-Iglesias, Javier; Arendt-Nielsen, Lars

    2010-10-01

    Our aim was to analyze the differences in the referred pain patterns and size of the areas of those myofascial trigger points (TrPs) involved in chronic tension type headache (CTTH) including a number of muscles not investigated in previous studies. Thirteen right handed women with CTTH (mean age: 38 ± 6 years) were included. TrPs were bilaterally searched in upper trapezius, sternocleidomastoid, splenius capitis, masseter, levator scapulae, superior oblique (extra-ocular), and suboccipital muscles. TrPs were considered active when both local and referred pain evoked by manual palpation reproduced total or partial pattern similar to a headache attack. The size of the referred pain area of TrPs of each muscle was calculated. The mean number of active TrPs within each CTTH patient was 7 (95% CI 6.2-8.0). A greater number (T = 2.79; p = 0.016) of active TrPs was found at the right side (4.2 ± 1.5) when compared to the left side (2.9 ± 1.0). TrPs in the suboccipital muscles were most prevalent (n = 12; 92%), followed by the superior oblique muscle (n =11/n = 9 right/left side), the upper trapezius muscle (n = 11/n = 6) and the masseter muscle (n = 9/n=7). The ANOVA showed significant differences in the size of the referred pain area between muscles (F = 4.7, p = 0.001), but not between sides (F = 1.1; p = 0.3): as determined by a Bonferroni post hoc analysis the referred pain area elicited by levator scapulae TrPs was significantly greater than the area from the sternocleidomastoid (p = 0.02), masseter (p = 0.003) and superior oblique (p = 0.001) muscles. Multiple active TrPs exist in head, neck and shoulder muscles in women with CTTH. The referred pain areas of TrPs located in neck muscles were larger than the referred pain areas of head muscles. Spatial summation of nociceptive inputs from multiple active TrPs may contribute to clinical manifestations of CTTH. Copyright © 2009 Elsevier Ltd. All rights reserved.

  1. Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.

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    Moraska, Albert F; Schmiege, Sarah J; Mann, John D; Butryn, Nathan; Krutsch, Jason P

    2017-09-01

    This study aimed to assess the effects of single and multiple massage treatments on pressure-pain threshold (PPT) at myofascial trigger points (MTrPs) in people with myofascial pain syndrome expressed as tension-type headache. Individuals (n = 62) with episodic or chronic tension-type headache were randomized to receive 12 twice-weekly 45-min massage or sham ultrasound sessions or wait-list control. Massage focused on trigger point release (ischemic compression) of MTrPs in the bilateral upper trapezius and suboccipital muscles. PPT was measured at MTrPs with a pressure algometer pre and post the first and final (12th) treatments. PPT increased across the study timeframe in all four muscle sites tested for massage, but not sham ultrasound or wait-list groups (P myofascial trigger points to myofascial pain; (2) Describe an effective treatment for decreasing tenderness of a myofascial trigger point; and (3) Discuss the relative values of single vs. multiple massage sessions on increasing pressure-pain thresholds at myofascial trigger points. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

  2. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders.

    Science.gov (United States)

    Fernández-Carnero, Josué; La Touche, Roy; Ortega-Santiago, Ricardo; Galan-del-Rio, Fernando; Pesquera, Jorge; Ge, Hong-You; Fernández-de-Las-Peñas, César

    2010-01-01

    To investigate the effects of dry needling over active trigger points (TrPs) in the masseter muscle in patients with temporomandibular disorders (TMD). Twelve females, aged 20 to 41 years old (mean = 25, standard deviation +/- 6 years) diagnosed with myofascial TMD were recruited. Each patient attended two treatment sessions on two separate days and received one intervention assigned in a random fashion, at each visit: deep dry needling (experimental) or sham dry needling (placebo) at the most painful point on the masseter muscle TrP. Pressure pain threshold (PPT) over the masseter muscle TrP and the mandibular condyle and pain-free active jaw opening were assessed pre- and 5 minutes postintervention by an examiner blinded to the treatment allocation of the subject. A two-way repeated-measures analysis of variance (ANOVA) with intervention as the between-subjects variable and time as the within-subjects variable was used to examine the effects of the intervention. The ANOVA detected a significant interaction between intervention and time for PPT levels in the masseter muscle (F = 62.5; P dry needling compared to the sham dry needling (P dry needling into active TrPs in the masseter muscle induced significant increases in PPT levels and maximal jaw opening when compared to the sham dry needling in patients with myofascial TMD.

  3. Characteristics of referred muscle pain to the head from active trigger points in women with myofascial temporomandibular pain and fibromyalgia syndrome.

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    Alonso-Blanco, Cristina; Fernández-de-Las-Peñas, César; de-la-Llave-Rincón, Ana Isabel; Zarco-Moreno, Pedro; Galán-Del-Río, Fernando; Svensson, Peter

    2012-11-01

    Our aim was to compare the differences in the prevalence and the anatomical localization of referred pain areas of active trigger points (TrPs) between women with myofascial temporomandibular disorder (TMD) or fibromyalgia (FMS). Twenty women (age 46 ± 8 years) with TMD and 20 (age 48 ± 6 years) with FMS were recruited from specialized clinic. Bilateral temporalis, masseter, sternocleidomastoid, upper trapezius, and suboccipital muscles were examined for TrPs. TrPs were identified by palpation and considered active when the pain reproduced familiar pain symptom experienced by the patient. The referred pain areas were drawn on anatomical maps, digitalized and also measured. A new analysis technique based on a center of gravity (COG) method was used to quantitative estimate of the localization of the TrP referred pain areas. Women with FMS exhibited larger areas of usual pain symptoms than women with myofascial TMD (P pain on the frontal and posterior pain maps were located more superior in TMD than in FMS. The number of active TrPs was significantly higher in TMD (mean ± SD 6 ± 1) than in FMS (4 ± 1) (P = 0.002). Women with TMD exhibited more active TrPs in the temporalis and masseter muscles than FMS (P pain areas than those with TMD for sternocleidomastoid and suboccipital muscles (P pain areas were found in TMD, the referred pain was more pronounced in the orofacial region, whereas the referred pain in FMS was more pronounced in the cervical spine. This study showed that the referred pain elicited from active TrPs shared similar patterns as usual pain symptoms in women with TMD or FMS, but that distinct differences in TrP prevalence and location of the referred pain areas could be observed. Differences in location of referred pain areas may help clinicians to determine the most relevant TrPs for each pain syndrome in spite of overlaps in pain areas.

  4. Pathophysiology of Trigger Points in Myofascial Pain Syndrome.

    Science.gov (United States)

    Money, Sarah

    2017-06-01

    Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. Trigger point pathophysiology in myofascial pain syndrome, which involves muscle stiffness, tenderness, and pain that radiates to other areas of the body, is considered. The causes of trigger points and several theories about how they develop are reviewed, and treatment approaches, including stretching, physical therapy, dry needling, and injections, are offered.

  5. Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain.

    Science.gov (United States)

    Turo, Diego; Otto, Paul; Hossain, Murad; Gebreab, Tadesse; Armstrong, Katherine; Rosenberger, William F; Shao, Hui; Shah, Jay P; Gerber, Lynn H; Sikdar, Siddhartha

    2015-12-01

    To compare a mechanical heterogeneity index derived from ultrasound vibration elastography with physical findings before and after dry-needling treatment of spontaneously painful active myofascial trigger points in the upper trapezius muscle. Forty-eight patients with chronic myofascial pain enrolled in a prospective interventional trial of 3 weekly dry-needling treatments for active myofascial trigger points. Trigger points were evaluated at baseline and at treatment completion using palpation, the pressure-pain threshold, and the mechanical heterogeneity index. Thirty patients were reevaluated at 8 weeks. Trigger points that "responded" changed to tissue that was no longer spontaneously painful, with or without the presence of a palpable nodule. Trigger points that "resolved" changed to tissue without a palpable nodule. The mechanical heterogeneity index was defined as the proportion of the upper trapezius muscle that appeared mechanically stiffer on elastography. Statistical significance for comparisons was determined at P dry needle treatments, the mechanical heterogeneity index decreased significantly for the 38 myofascial trigger points (79% of 48) that responded to treatment. Among these, the baseline mechanical heterogeneity index was significantly lower for the 13 trigger points (27% of 38) that resolved, but the decrease after 3 dry needle treatments did not reach significance. The pressure-pain threshold improved significantly for both groups. At 8 weeks, the mechanical heterogeneity index decreased significantly for the 22 trigger points (73% of 30) that responded and for the 10 (45% of 22) that resolved. The pressure-pain threshold improvement was significant for trigger points that responded but did not reach significance for resolved trigger points. The mechanical heterogeneity index identifies changes in muscle tissue properties that correlate with changes in the myofascial trigger point status after dry needling. © 2015 by the American Institute

  6. Myofascial trigger points in cluster headache patients: a case series

    Directory of Open Access Journals (Sweden)

    Rico-Villademoros Fernando

    2008-12-01

    Full Text Available Abstract Active myofascial trigger points (MTrPs have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3% and in 6 (85.7% of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

  7. DRY NEEDLING FOR MYOFASCIAL TRIGGER POINT PAIN: A CLINICAL COMMENTARY.

    Science.gov (United States)

    Unverzagt, Casey; Berglund, Kathy; Thomas, J J

    2015-06-01

    Sports and orthopaedic physical therapists have long used a multitude of techniques in order to address pain and dysfunction associated with myofascial trigger points. One technique in particular has recently received overwhelming attention: trigger point dry needling (DN). Despite its efficacy and low risk, questions remain as to its effectiveness, safety, and whether the technique is within the scope of practice of physical therapists. Therefore, the purpose of this clinical commentary is to summarize the current literature related to the associated mechanisms of action of DN, the safety of DN, as well as to discuss relevant scope of practice concerns. 5.

  8. Myofascial trigger point therapy: laser therapy and dry needling.

    Science.gov (United States)

    Uemoto, Luciana; Nascimento de Azevedo, Rosany; Almeida Alfaya, Thays; Nunes Jardim Reis, Renata; Depes de Gouvêa, Cresus Vinicius; Cavalcanti Garcia, Marco Antonio

    2013-09-01

    The aim of the present review is to discuss two forms of treatment for myofascial pain: laser therapy and dry needling. Although studies have reported the deactivation of myofascial trigger points with these two methods, clinical trials demonstrating their efficacy are scarce. The literature reports greater efficacy with the use of laser over dry needling. It has been suggested that improvements in microcirculation through the administration of laser therapy may favor the supply of oxygen to the cells under conditions of hypoxia and help remove the waste products of cell metabolism, thereby breaking the vicious cycle of pain, muscle spasm and further pain. While laser therapy is the method of choice for patients with a fear of needles and healthcare professionals inexperienced with the dry needling technique, further controlled studies are still needed to prove the greater efficacy of this method.

  9. An update on botulinum toxin A injections of trigger points for myofascial pain.

    Science.gov (United States)

    Zhou, Jon Y; Wang, Dajie

    2014-01-01

    Myofascial pain syndrome (MPS) is a common chronic pain condition that is characterized by distinct "trigger points." Despite current treatments with physical therapy, analgesics, anti-depressants and trigger-point injections, myofascial pain remains a challenging chronic pain condition in clinical practice. Botulinum toxin A (BTX-A) can cause prolonged muscle relaxation through inhibition of acetylcholine release. It may offer some advantages over the current treatments for MPS by providing a longer sustained period of pain relief. Despite numerous clinical trials, the efficacy of BTX-A in alleviating MPS is not well-established due to mixed results from recent clinical trials. Active trigger points are associated with referred pain and greatly impact many aspects of activities of daily living, mood, and health status. This review is designed to analyze the clinical trials regarding the efficacy of BTX-A injection of active trigger points as a treatment for MPS. The literature referenced was obtained via a computer search with Google Scholar, Pubmed, Medline and EMbase. Our search terms included "Botulinum toxin," "myofascial pain," "trigger points," "myofascial trigger points," "chronic pain." Additional references were retrieved from the reference list of the reports found via this search. Studies were considered eligible for inclusion if they were double-blinded, randomized, controlled trials evaluating the efficacy of BTX-A injections into trigger points for pain reduction, and if the trigger point selection in the trial included referred pain and/or local twitch response. Open-label studies, case reports, and other non-randomized studies were excluded. Eight trials were found according to the above criteria and are summarized in Table 1. There are well-designed clinical trials to support the efficacy of trigger-point injections with BTX-A for MPS. However, further clinical trials with considerations of minimizing placebo effect, repeated dosing, adequate

  10. Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial.

    Science.gov (United States)

    Calvo-Lobo, César; Pacheco-da-Costa, Soraya; Martínez-Martínez, Jorge; Rodríguez-Sanz, David; Cuesta-Álvaro, Pedro; López-López, Daniel

    2016-01-15

    Shoulder pain is a prevalent condition in older adults. Some authors associate nonspecific shoulder pain with myofascial trigger points (MTrPs) in the infraspinatus muscle. Dry needling is recommended to relieve the MTrP pain of shoulders in the short term (dry needling improves shoulder pain and the irritability of the satellite MTrPs in the referred pain area. Nociceptive activity at a latent MTrP may influence motor activity and the sensitivity of MTrPs in distant muscles at a similar segmental level. Therefore, this study aimed to evaluate dry needling on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle of older adults with nonspecific shoulder pain. A single-center, randomized, single-blinded, controlled study (NCT02032602) was carried out. Sixty-six patients aged 65 years and older with trigger points in the ipsilateral infraspinatus of the painful shoulder were randomly assigned to (1) of (2) treatment groups. A session of dry needling on the infraspinatus was performed in (1) the most hyperalgesic active and latent MTrP or (2) only the most hyperalgesic active MTrP. The Numeric Rating Scale, the pressure pain threshold (primary outcome) on the anterior deltoid and extensor carpi radialis brevis latent MTrPs, and grip strength were assessed before, after, and 1 week after the intervention. Statistically significant differences in the reduction of pain intensity (P ≤ .001; η = 0.159-0.269; d = 1.017-1.219) and the increase of pressure pain threshold (P . 05; η = 0.006-0.033; d = 0.158-0.368). One dry needling intervention of the latent MTrP associated with the key active MTrP of the infraspinatus reduces pain intensity and the irritability of the satellite MTrPs located in the referred pain area in the short term in older adults with nonspecific shoulder pain.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is

  11. Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle.

    Science.gov (United States)

    Tsai, Chien-Tsung; Hsieh, Lin-Fen; Kuan, Ta-Shen; Kao, Mu-Jung; Chou, Li-Wei; Hong, Chang-Zern

    2010-02-01

    To investigate the remote effect of dry needling on the irritability of a myofascial trigger point in the upper trapezius muscle. Thirty-five patients with active myofascial trigger points in upper trapezius muscles were randomly divided into two groups: 18 patients in the control group received sham needling, and 17 patients in the dry-needling group received dry needling into the myofascial trigger point in the extensor carpi radialis longus muscle. The subjective pain intensity, pressure pain threshold, and range of motion of the neck were assessed before and immediately after the treatment. Immediately after dry needling in the experimental group, the mean pain intensity was significantly reduced, but the mean pressure threshold and the mean range of motion of cervical spine were significantly increased. There were significantly larger changes in all three parameters of measurement in the dry-needling group than that in the control group. This study demonstrated the remote effectiveness of dry needling. Dry needling of a distal myofascial trigger point can provide a remote effect to reduce the irritability of a proximal myofascial trigger point.

  12. [Differences between myofascial trigger points and tender points].

    Science.gov (United States)

    Mense, S

    2011-02-01

    The article describes and compares the characteristics of myofascial trigger points (MTrPs) of the myofascial pain syndrome and the tender points (TePs) of the fibromyalgia syndrome. Many statements are hypothetical, because not all aspects of the disorders have been clarified in solid studies. Signs and symptoms of MTrPs: (1) palpable nodule, often located close to the muscle belly, (2) often single, (3) allodynia and hyperalgesia at the MTrP, (4) referral of the MTrP pain, (5) normal pain sensitivity outside the MTrPs, (6) local twitch response, (7) local contracture in biopsy material, (8) peripheral mechanism probable. Signs and symptoms of TePs: (1) no palpable nodule, (2) location often close to the muscle attachments, (3) multiple by definition, (4) allodynia and hyperalgesia also outside the TePs, (5) enhanced pain under psychic stress, (6) unspecific histological changes in biopsy material, (7) central nervous mechanism probable. The multitude of differences speak against a common aetiology and pathophysiology.

  13. EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRAPEZIUS MYOFASCIAL TRIGGER POINTS IN NECK PAIN

    Directory of Open Access Journals (Sweden)

    Pragnya Ravichandran

    2016-04-01

    Full Text Available Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression on functional outcome in neck pain. Methods: A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis. Result: There was no statistical significance between groups (p≥0.05. But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01 in relation to all parameters. Conclusion: Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in pain pressure threshold and functional outcome in neck pain.

  14. Fibromyalgia, myofascial pain, tender points and trigger points: splitting or lumping?

    Science.gov (United States)

    Bennett, Robert M; Goldenberg, Don L

    2011-06-30

    Myofascial trigger points (MTPs) have long been a contentious issue in relation to fibromyalgia, and poorly defined pain complaints in general. Can MTPs be reproducibly identified? Do MTPs have valid objective findings, such as spontaneous electromyographic activity, muscle microdialysis evidence for an inflammatory milieu or visualization with newer ultrasound techniques? Is fibromyalgia a syndrome of multiple MTPs, or is focal muscle tenderness a manifestation of central sensitization? These issues are discussed with relevance to a recent paper reporting that manual palpation of active MTPs elicits the spontaneous pain experienced by fibromyalgia patients.

  15. Fibromyalgia, myofascial pain, tender points and trigger points: splitting or lumping?

    Science.gov (United States)

    2011-01-01

    Myofascial trigger points (MTPs) have long been a contentious issue in relation to fibromyalgia, and poorly defined pain complaints in general. Can MTPs be reproducibly identified? Do MTPs have valid objective findings, such as spontaneous electromyographic activity, muscle microdialysis evidence for an inflammatory milieu or visualization with newer ultrasound techniques? Is fibromyalgia a syndrome of multiple MTPs, or is focal muscle tenderness a manifestation of central sensitization? These issues are discussed with relevance to a recent paper reporting that manual palpation of active MTPs elicits the spontaneous pain experienced by fibromyalgia patients. PMID:21722339

  16. Traditional Chinese Medicine acupuncture and myofascial trigger needling: The same stimulation points?

    Science.gov (United States)

    Liu, Lizhou; Skinner, Margot A; McDonough, Suzanne M; Baxter, George David

    2016-06-01

    Acupuncture originates in China, and its effectiveness has been well documented in musculoskeletal pain disorders and other conditions. A widely accepted contemporary medical treatment option for myofascial pain is trigger point needling. Although there are many differences between Traditional Chinese Medicine acupuncture theory and the myofascial trigger point needling framework, it is argued that the stimulation sites for these two needling modalities are similar. In this paper we examined the correspondence between Traditional Chinese Medicine acupoints and myofascial trigger points. Based on this correspondence, we considered exploration of Ah-shi points from four aspects: pain recognition, distal Ah-shi points, Anti-Ah-shi points, and management approaches. The extent of correspondence is influenced by definitions of acupoints. Myofascial trigger points are significantly correlated to Traditional Chinese Medicine acupoints, including primary channel acupoints, extra acupoints, and Ah-shi points. Considering the correlation between MTrPs and acupoints and the rarely-studied research area of Ah-shi points, it may be reasonable to incorporate research findings of myofascial trigger points into further investigations into Ah-shi points. Correspondence between myofascial trigger points and acupoints enhances contemporary understanding of the mechanism of action of acupuncture, and may serve to facilitate increased integration of acupuncture into clinical management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. The importance of postural habits in perpetuating myofascial trigger point pain.

    Science.gov (United States)

    Edwards, Janet

    2005-06-01

    Various structural abnormalities that contribute to the perpetuation of myofascial trigger point activity and the pain arising from it, have previously been well documented. In addition, however, there are a number of postural habits that are important to recognise as they may also contribute, as shown in the five cases discussed. These postural habits, which are likely to be carried out both frequently and unconsciously, are adopted during the course of sitting, standing or sleeping. They are entirely independent of any structural abnormalities that may be present. Correcting them is a necessary contribution to treatment, as failure to do so is liable to lead to persistence of the pain.

  18. [Progress of research on acupuncture at trigger point for myofascial pain syndrome].

    Science.gov (United States)

    Ma, Yao; Bu, He; Jia, Ji-rong; Zhang, Xue

    2012-06-01

    To review the literature of acupuncture at trigger point for myofascial pain syndrome from the main selected points (trigger point), the mechanism of Chinese medicine and modern research and its clinical application. The results show that acupuncture at trigger point has significant effect on the myofascial pain syndrome, which could be influenced by the type of needle, manipulation, insertion angle and depth of the needles. However, the involved studies at present are still far from enough and lack of systematic study with multivariate analysis, it is needed to be improved that some problems about the clinical diagnosis and basic research.

  19. Neurophysiological and clinical effects of dry needling in patients with upper trapezius myofascial trigger points.

    Science.gov (United States)

    Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

    2017-01-01

    Dry needling (DN) is a widely used in treatment of myofascial trigger points (MTrPs). The purpose of this pretest-posttest clinical trial was to investigate the neurophysiological and clinical effects of DN in patients with MTrPs. A sample of 20 patients (3 man, 17 women; mean age 31.7 ± 10.8) with upper trapezius MTrPs received one session of deep DN. The outcomes of neuromuscular junction response (NMJR), sympathetic skin response (SSR), pain intensity (PI) and pressure pain threshold (PPT) were measured at baseline and immediately after DN. There were significant improvements in SSR latency and amplitude, pain, and PPT after DN. The NMJR decreased and returned to normal after DN. A single session of DN to the active upper trapezius MTrP was effective in improving pain, PPT, NMJR, and SSR in patients with myofascial trigger points. Further studies are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Treatment of myofascial trigger points in patients with chronic shoulder pain : a randomized, controlled trial

    NARCIS (Netherlands)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A. B.

    2011-01-01

    Background: Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the

  1. Incidence of trapezius myofascial trigger points in patients with the possible carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Hamid Azadeh

    2010-01-01

    Full Text Available Background: Patients with carpal tunnel syndrome (CTS often complain of prominent pain in shoulder and arm, also there are patients that have pain in their shoulder and arm which is due to myofascial trigger point (MTP located in their upper trapezius muscle. Despite the frequency of this observation, few studies have previously sought to establish possible relationship between the CTS and MTP in shoulder area. Methods: Samples were 160 patients (221 hands consist of 130 females and 30 males, with suspected diagnosis of CTS, from March 2008 to October 2008. In this study after performing electrodiagnosis searches, another evaluation was performed to find out if there was any sign of myofascial trigger point. The correlation between these two was sought. Results: It was found that all of 36 hands with normal electrodiagnostic findings had myofascial trigger points in their upper trapezius muscle. Out of 185 hands, 130 hands (70% with electrophysiological evidences of CTS showed myofascial trigger points in their trapezius muscles. Statistical analysis revealed significant (p < 0.001 reverse correlation between the severity of CTS and the presence of MTP. Conclusions: The findings of this study imply the significant correlation between occurrence of CTS and MTP. It is suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS.

  2. Incidence of trapezius myofascial trigger points in patients with the possible carpal tunnel syndrome

    Science.gov (United States)

    Azadeh, Hamid; Dehghani, Mohammad; Zarezadeh, Abolghasem

    2010-01-01

    BACKGROUND: Patients with carpal tunnel syndrome (CTS) often complain of prominent pain in shoulder and arm, also there are patients that have pain in their shoulder and arm which is due to myofascial trigger point (MTP) located in their upper trapezius muscle. Despite the frequency of this observation, few studies have previously sought to establish possible relationship between the CTS and MTP in shoulder area. METHODS: Samples were 160 patients (221 hands) consist of 130 females and 30 males, with suspected diagnosis of CTS, from March 2008 to October 2008. In this study after performing electrodiagnosis searches, another evaluation was performed to find out if there was any sign of myofascial trigger point. The correlation between these two was sought. RESULTS: It was found that all of 36 hands with normal electrodiagnostic findings had myofascial trigger points in their upper trapezius muscle. Out of 185 hands, 130 hands (70%) with electrophysiological evidences of CTS showed myofascial trigger points in their trapezius muscles. Statistical analysis revealed significant (p < 0.001) reverse correlation between the severity of CTS and the presence of MTP. CONCLUSIONS: The findings of this study imply the significant correlation between occurrence of CTS and MTP. It is suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS. PMID:21526092

  3. Treatment of myofascial trigger points in patients with chronic shoulder pain : a randomized, controlled trial

    NARCIS (Netherlands)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A. B.

    2011-01-01

    Background: Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effecti

  4. The Ultrasonographic Findings of Trigger Points of Myofascial Pain Syndrome in a Rabbit Model

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    Moon, Kyung Mi; Park, Seog Hee [Catholic University of Korea, Kangnam St. Mary' s Hospital, Seoul (Korea, Republic of); Lee, Sang Heon; Kim, Joo Hyun; Kim, Han Kyum [Korea University College of Medicine, Seoul (Korea, Republic of)

    2005-03-15

    Myofascial pain syndrome (MPS) is a common cause of musculoskeletal pain. Myofascial trigger points (MTrPs) have been repeatedly described by numerous authors. However, there have been few studies in which their existence and behavior was supported and their location confirmed. The purpose of this study was to determine whether diagnostic ultrasonography is an objective diagnostic tool which is able to significantly identify or detect the soft tissue changes in the region of clinically identified active MTrPs by using a rabbit experimental model. Ten MPS model rabbits were used in this study. We made an MPS animal model by causing the rabbits to overuse one leg for 3 weeks by cutting the contralateral L4 spinal nerve root. We compared the ultrasonographic findings of the taut band at pre-OP with those at post-OP during the consecutive three week period. To find the taut bands of the muscle, after skin exposure, the muscles were gently rubbed or pinched with the thumb and index finger on the two opposing surfaces of the muscle across the direction of the fibers. Then, the muscle was held in the same way, but with a 5-8 MHz stick probe being used in place of the thumb. After the palpation of various muscles, we selected the hardest and largest myofascial trigger nodule, in order to observe the ultrasonographic and power Doppler findings of the MPS. The size, shape, echogenecity and vascularity of the MTrPs were observed. The analysis of the results of the ultrasonography revealed that all MTrPs have a hyperechoic area. The mean thickness of the hyperechoic lesion in the biceps was 0.96{+-}0.14 cm in the MPS site (at pre-OP?), and 0.49{+-}0.12 cm at post-OP 3weeks (p < 0.01). The hyperechoic lesions in all of the studied biceps femoris of the rabbits were observed by high resolution ultrasonography. No definitively decreased vascularity was observed within the hyperechoic area by power Doppler imaging. Until now, there has been no objective method for the diagnosis of

  5. Trigger point dry needling versus strain-counterstrain technique for upper trapezius myofascial trigger points: a randomised controlled trial.

    Science.gov (United States)

    Segura-Ortí, E; Prades-Vergara, S; Manzaneda-Piña, L; Valero-Martínez, R; Polo-Traverso, J A

    2016-06-01

    Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS. Randomised controlled trial. 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured. The analysis of variance mixed model showed a significant time effect for pain (ppoints) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. NCT01290653. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Ovlivnění myofasciálního trigger pointu pomocí aplikace suché jehly

    OpenAIRE

    Halatová, Jana

    2016-01-01

    The historical roots of dry needling go back to the fist half of the 20th century. According to huge spread of issues connected with myofascial trigger points in society, dry needling is together with other therapeutic methods more and more on the front burner all around the world. This bachelor thesis is theoretical and introduces dry needling as possible treatment of myofascial pain and myofascial pain syndrome. The first part is focused on characteristic of myofascial trigger points, in th...

  7. Therapeutic effects of dry needling in patients with upper trapezius myofascial trigger points.

    Science.gov (United States)

    Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

    2017-04-01

    Active myofascial trigger points (MTrPs) are major pain generators in myofascial pain syndrome. Dry needling (DN) is an effective method for the treatment of MTrPs. To assess the immediate neurophysiological and clinical effects of DN in patients with upper trapezius MTrPs. This was a prospective, clinical trial study of 20 patients with upper trapezius MTrPs and 20 healthy volunteers (matched for height, weight, body mass index and age), all of whom received one session of DN. Primary outcome measures were neuromuscular junction response (NMJR) and sympathetic skin response (SSR). Secondary outcomes were pain intensity (PI) and pressure pain threshold (PPT). Data were collected at baseline and immediately post-intervention. At baseline, SSR amplitude was higher in patients versus healthy volunteers (p<0.003). With respect to NMJR, a clinically abnormal increment and normal reduction was observed in patients and healthy volunteers, respectively. Moreover, PPT of patients was less than healthy volunteers (p<0.0001). After DN, SSR amplitude decreased significantly in patients (p<0.01), but did not change in healthy volunteers. A clinically important reduction in the NMJR of patients and increment in healthy volunteers was demonstrated after DN. PPT increased after DN in patients, but decreased in healthy volunteers (p<0.0001). PI improved after DN in patients (p<0.001). The results of this study showed that one session of DN targeting active MTrPs appears to reduce hyperactivity of the sympathetic nervous system and irritability of the motor endplate. DN seems effective at improving symptoms and deactivating active MTrPs, although further research is needed. IRCT20130316128. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome.

    Science.gov (United States)

    Shah, Jay P; Gilliams, Elizabeth A

    2008-10-01

    This article discusses muscle pain concepts in the context of myofascial pain syndrome (MPS) and summarizes microdialysis studies that have surveyed the biochemical basis of this musculoskeletal pain condition. Though MPS is a common type of non-articular pain, its pathophysiology is only beginning to be understood due to its enormous complexity. MPS is characterized by the presence of myofascial trigger points (MTrPs), which are defined as hyperirritable nodules located within a taut band of skeletal muscle. MTrPs may be active (spontaneously painful and symptomatic) or latent (non-spontaneously painful). Painful MTrPs activate muscle nociceptors that, upon sustained noxious stimulation, initiate motor and sensory changes in the peripheral and central nervous systems. This process is called sensitization. In order to investigate the peripheral factors that influence the sensitization process, a microdialysis technique was developed to quantitatively measure the biochemical milieu of skeletal muscle. Biochemical differences were found between active and latent MTrPs, as well as in comparison with healthy muscle tissue. In this paper we relate the findings of elevated levels of sensitizing substances within painful muscle to the current theoretical framework of muscle pain and MTrP development.

  9. Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.

    Science.gov (United States)

    Shah, Jay P; Thaker, Nikki; Heimur, Juliana; Aredo, Jacqueline V; Sikdar, Siddhartha; Gerber, Lynn

    2015-07-01

    The intent of this article is to discuss the evolving role of the myofascial trigger point (MTrP) in myofascial pain syndrome (MPS) from both a historical and scientific perspective. MTrPs are hard, discrete, palpable nodules in a taut band of skeletal muscle that may be spontaneously painful (i.e., active) or painful only on compression (i.e., latent). MPS is a term used to describe a pain condition that can be acute or, more commonly, chronic and involves the muscle and its surrounding connective tissue (e.g. fascia). According to Travell and Simons, MTrPs are central to the syndrome-but are they necessary? Although the clinical study of muscle pain and MTrPs has proliferated over the past two centuries, the scientific literature often seems disjointed and confusing. Unfortunately, much of the terminology, theories, concepts, and diagnostic criteria are inconsistent, incomplete, or controversial. To address these deficiencies, investigators have recently applied clinical, imaging (of skeletal muscle and brain), and biochemical analyses to systematically and objectively study the MTrP and its role in MPS. Data suggest that the soft tissue milieu around the MTrP, neurogenic inflammation, sensitization, and limbic system dysfunction may all play a role in the initiation, amplification, and perpetuation of MPS. The authors chronicle the advances that have led to the current understanding of MTrP pathophysiology and its relationship to MPS, and review the contributions of clinicians and researchers who have influenced and expanded our contemporary level of clinical knowledge and practice.

  10. Multiple active myofascial trigger points and pressure pain sensitivity maps in the temporalis muscle are related in women with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Caminero, Ana B; Madeleine, Pascal; Guillem-Mesado, Amparo; Ge, Hong-You; Arendt-Nielsen, Lars; Pareja, Juan A

    2009-01-01

    To describe the common locations of active trigger points (TrPs) in the temporalis muscle and their referred pain patterns in chronic tension type headache (CTTH), and to determine if pressure sensitivity maps of this muscle can be used to describe the spatial distribution of active TrPs. Forty women with CTTH were included. An electronic pressure algometer was used to assess pressure pain thresholds (PPT) from 9 points over each temporalis muscle: 3 points in the anterior, medial and posterior part, respectively. Both muscles were examined for the presence of active TrPs over each of the 9 points. The referred pain pattern of each active TrP was assessed. Two-way analysis of variance detected significant differences in mean PPT levels between the measurement points (F=30.3; P<0.001), but not between sides (F=2.1; P=0.2). PPT scores decreased from the posterior to the anterior column (P<0.001). No differences were found in the number of active TrPs (F=0.3; P=0.9) between the dominant side the nondominant side. Significant differences were found in the distribution of the active TrPs (chi2=12.2; P<0.001): active TrPs were mostly found in the anterior column and in the middle of the muscle belly. The analysis of variance did not detect significant differences in the referred pain pattern between active TrPs (F=1.1, P=0.4). The topographical pressure pain sensitivity maps showed the distinct distribution of the TrPs indicated by locations with low PPTs. Multiple active TrPs in the temporalis muscle were found, particularly in the anterior column and in the middle of the muscle belly. Bilateral posterior to anterior decreased distribution of PPTs in the temporalis muscle in women with CTTH was found. The locations of active TrPs in the temporalis muscle corresponded well to the muscle areas with lower PPT, supporting the relationship between multiple active muscle TrPs and topographical pressure sensitivity maps in the temporalis muscle in women with CTTH.

  11. Prevalence of myofascial trigger points in fibromyalgia: the overlap of two common problems.

    Science.gov (United States)

    Ge, Hong-You

    2010-10-01

    With the objective evidence of their existence, myofascial trigger points (MTrPs) contribute to an increasing number of chronic regional and widespread pain conditions. The widespread spontaneous pain pattern in fibromyalgia (FM) is a summation of multiple regional pains due to active MTrPs. A regional pain in FM is from local active MTrPs and/or referred from remote active MTrPs. Positive tender points specified in FM are MTrPs, either active or latent. Manual stimulation of active MTrPs located in the muscles in different body regions completely reproduced overall spontaneous FM pain pattern. Active MTrPs as tonic peripheral nociceptive input contribute tremendously to the initiation and maintenance of central sensitization, to the impairment of descending inhibition, to the increased excitability of motor units, and to the induction of sympathetic hyperactivity observed in FM. The considerable overlap of MTrPs and FM in pain characteristics and pathophysiology suggests that FM pain is largely due to MTrPs.

  12. Dry needling versus cervical spine manipulation combined with dry needling of infraspinatus muscle myofascial trigger points

    OpenAIRE

    2013-01-01

    M.Tech. (Chiropractic) Objective: The purpose of this study was to compare dry needling with cervical spine manipulation combined with dry needling, in the treatment of infraspinatus muscle myofascial trigger points. Study Design: This was a randomized experimental study Setting: The participants were treated at the University of Johannesburg chiropractic day clinic Subjects: 30 participants volunteered for the study. The participants were divided into groups by randomly drawing thirty num...

  13. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    OpenAIRE

    Wensing Michel; Stegenga Boudewijn; Dommerholt Jan; Bron Carel; Oostendorp Rob AB

    2011-01-01

    Abstract Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs) are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment target...

  14. Dry needle stimulation of myofascial trigger points evokes segmental anti-nociceptive effects.

    Science.gov (United States)

    Srbely, John Z; Dickey, James P; Lee, David; Lowerison, Mark

    2010-05-01

    To test the hypothesis that dry needle stimulation of a myofascial trigger point (sensitive locus) evokes segmental anti-nociceptive effects. Double-blind randomized controlled trial. Forty subjects (21 males, 19 females). Test subjects received intramuscular dry needle puncture to a right supraspinatus trigger point (C4,5); controls received sham intramuscular dry needle puncture. Pain pressure threshold (PPT) readings were recorded from right infraspinatus (C5,6) and right gluteus medius (L4,5S1) trigger points at 0 (pre-needling baseline), 1, 3, 5, 10 and 15 min post-needling and normalized to baseline values. The supraspinatus and infraspinatus trigger points are neurologically linked at C5; the supraspinatus and gluteus medius are segmentally unrelated. The difference between the infraspinatus and gluteus medius PPT values (PPTseg) represents a direct measure of the segmental anti-nociceptive effects acting at the infraspinatus trigger point. Significant increases in PPTseg were observed in test subjects at 3 (p = 0.002) and 5 (p = 0.015) min post-needling, compared with controls. One intervention of dry needle stimulation to a single trigger point (sensitive locus) evokes short-term segmental anti-nociceptive effects. These results suggest that trigger point (sensitive locus) stimulation may evoke anti-nociceptive effects by modulating segmental mechanisms, which may be an important consideration in the management of myofascial pain.

  15. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine.

    Science.gov (United States)

    Fernández-de-Las-Peñas, C; Cuadrado, M L; Pareja, J A

    2006-09-01

    This paper describes the differences in the presence of myofascial trigger points (TrPs) in the upper trapezius, sternocleidomastoid, temporalis and suboccipital muscles between unilateral migraine subjects and healthy controls, and the differences in the presence of TrPs between the symptomatic side and the non-symptomatic side in migraine subjects. In addition, we assess the differences in the presence of both forward head posture (FHP) and active neck mobility between migraine subjects and healthy controls and the relationship between FHP and neck mobility. Twenty subjects with unilateral migraine without side-shift and 20 matched controls participated. TrPs were identified when there was a hypersensible tender spot in a palpable taut band, local twitch response elicited by the snapping palpation of the taut band and reproduction of the referred pain typical of each TrP. Side-view pictures were taken in both sitting and standing positions to measure the cranio-vertebral angle. A cervical goniometer was employed to measure neck mobility. Migraine subjects showed a significantly greater number of active TrPs (Pangle than controls (Pangle and neck mobility. Nociceptive inputs from TrPs in head and neck muscles may produce continuous afferent bombardment of the trigeminal nerve nucleus caudalis and, thence, activation of the trigeminovascular system. Active TrPs located ipsilateral to migraine headaches might be a contributing factor in the initiation or perpetuation of migraine.

  16. Mechanical pain sensitivity of deep tissues in children - possible development of myofascial trigger points in children

    Directory of Open Access Journals (Sweden)

    Han Ting-I

    2012-02-01

    Full Text Available Abstract Background It is still unclear when latent myofascial trigger points (MTrPs develop during early life. This study is designed to investigate the mechanical pain sensitivity of deep tissues in children in order to see the possible timing of the development of latent MTrPs and attachment trigger points (A-TrPs in school children. Methods Five hundreds and five healthy school children (age 4- 11 years were investigated. A pressure algometer was used to measure the pressure pain threshold (PPT at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site, the mid-point of the muscle belly (site B, assumed to be the MTrP site, and the muscle-tendon junction as a control site (site C. Results The results showed that, for all children in this study, the mean PPT values was significantly lower (p p Conclusions It is concluded that a child had increased sensitivity at the tendon attachment site and the muscle belly (endplate zone after age of 4 years. Therefore, it is likely that a child may develop an A-Trp and a latent MTrP at the brachioradialis muscle after the age of 4 years. The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years. Further investigation is still required to indentify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

  17. Myofascial syndrome

    Directory of Open Access Journals (Sweden)

    Giancarlo Carli

    2008-12-01

    Full Text Available Myofascial pain syndrome is common cause one of musculoskeletal pain and it is characterized by trigger points (TP, limited range of motion in joints and local twitch response (LTR during mechanical stimulation of the TP. Trigger point is a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is tender when pressed and can give rise to characteristic referred pain, motor dysfunction and autonomic phenomena. Palpation is reliable diagnostic criterion for locating TP in patients. Treatment is based on anesthetise TP, stretch and spray, local pression and physical activity.

  18. Dry Needling at Myofascial Trigger Spots of Rabbit Skeletal Muscles Modulates the Biochemicals Associated with Pain, Inflammation, and Hypoxia

    Directory of Open Access Journals (Sweden)

    Yueh-Ling Hsieh

    2012-01-01

    Full Text Available Background and Purpose. Dry needling is an effective therapy for the treatment of pain associated with myofascial trigger point (MTrP. However, the biochemical effects of dry needling that are associated with pain, inflammation, and hypoxia are unclear. This study investigated the activities of β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF after different dosages of dry needling at the myofascial trigger spots (MTrSs of a skeletal muscle in rabbit. Materials and Methods. Dry needling was performed either with one dosage (1D or five dosages (5D into the biceps femoris with MTrSs in New Zealand rabbits. Biceps femoris, serum, and dorsal root ganglion (DRG were sampled immediately and 5 d after dry needling for β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF immunoassays. Results. The 1D treatment enhanced the β-endorphin levels in the biceps femoris and serum and reduced substance P in the biceps femoris and DRG. The 5D treatment reversed these effects and was accompanied by increase of TNF-α, COX-2, HIF-1α, iNOS, and VEGF production in the biceps femoris. Moreover, the higher levels of these biochemicals were still maintained 5 d after treatment. Conclusion. Dry needling at the MTrSs modulates various biochemicals associated with pain, inflammation, and hypoxia in a dose-dependent manner.

  19. Dry Needling at Myofascial Trigger Spots of Rabbit Skeletal Muscles Modulates the Biochemicals Associated with Pain, Inflammation, and Hypoxia

    Science.gov (United States)

    Hsieh, Yueh-Ling; Yang, Shun-An; Yang, Chen-Chia; Chou, Li-Wei

    2012-01-01

    Background and Purpose. Dry needling is an effective therapy for the treatment of pain associated with myofascial trigger point (MTrP). However, the biochemical effects of dry needling that are associated with pain, inflammation, and hypoxia are unclear. This study investigated the activities of β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF after different dosages of dry needling at the myofascial trigger spots (MTrSs) of a skeletal muscle in rabbit. Materials and Methods. Dry needling was performed either with one dosage (1D) or five dosages (5D) into the biceps femoris with MTrSs in New Zealand rabbits. Biceps femoris, serum, and dorsal root ganglion (DRG) were sampled immediately and 5 d after dry needling for β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF immunoassays. Results. The 1D treatment enhanced the β-endorphin levels in the biceps femoris and serum and reduced substance P in the biceps femoris and DRG. The 5D treatment reversed these effects and was accompanied by increase of TNF-α, COX-2, HIF-1α, iNOS, and VEGF production in the biceps femoris. Moreover, the higher levels of these biochemicals were still maintained 5 d after treatment. Conclusion. Dry needling at the MTrSs modulates various biochemicals associated with pain, inflammation, and hypoxia in a dose-dependent manner. PMID:23346198

  20. Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain.

    Science.gov (United States)

    Gerber, Lynn H; Shah, Jay; Rosenberger, William; Armstrong, Kathryn; Turo, Diego; Otto, Paul; Heimur, Juliana; Thaker, Nikki; Sikdar, Siddhartha

    2015-07-01

    To determine whether dry needling of an active myofascial trigger point (MTrP) reduces pain and alters the status of the trigger point to either a non-spontaneously tender nodule or its resolution. A prospective, nonrandomized, controlled, interventional clinical study. University campus. A total of 56 subjects with neck or shoulder girdle pain of more than 3 months duration and active MTrPs were recruited from a campus-wide volunteer sample. Of these, 52 completed the study (23 male and 33 female). Their mean age was 35.8 years. Three weekly dry needling treatments of a single active MTrP. Baseline and posttreatment evaluations of pain using a verbal analogue scale, the Brief Pain Inventory, and the status of the MTrP as determined by digital palpation. Trigger points were rated as active (spontaneously painful), latent (requiring palpation to reproduce the characteristic pain), or resolved (no palpable nodule). Profile of Mood States, Oswestry Disability Index, and Short Form 36 scores, and cervical range of motion. A total of 41 subjects had a change in trigger point status from active to latent or resolved, and 11 subjects had no change (P Dry needling reduces pain and changes MTrP status. Change in trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction of pain is associated with improved mood, function, and level of disability. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  1. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points

    DEFF Research Database (Denmark)

    Ge, Hongyou; Wang, Ying; Danneskiold-Samsøe, Bente;

    2010-01-01

    The aim of this present study is to test the hypotheses that the 18 predetermined sites of examination for tender points (TP sites) in fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs), and that the induced pain from active MTrPs at TP sites may mimic fibromyalgia pain. Each TP site......), but not latent MTrPs (r = -.001, P = .99), was positively correlated with spontaneous pain intensity in FMS. The current study provides first evidence that pain from active MTrPs at TP sites mimics fibromyalgia pain. MTrPs may relate to generalized increased sensitivity in FMS due to central sensitization....... PERSPECTIVE: This article underlies the importance of active MTrPs in FMS patients. Most of the TP sites in FMS are MTrPs. Active MTrPs may serve as a peripheral generator of fibromyalgia pain and inactivation of active MTrPs may thus be an alternative for the treatment of FMS....

  2. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points

    DEFF Research Database (Denmark)

    Ge, Hong You; Wang, Ying; Danneskiold-Samsøe, Bente;

    2010-01-01

    The aim of this present study is to test the hypotheses that the 18 predetermined sites of examination for tender points (TP sites) in fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs), and that the induced pain from active MTrPs at TP sites may mimic fibromyalgia pain. Each TP site...... was evaluated with manual palpation followed by intramuscular electromyographic (EMG) registration of spontaneous electrical activity to confirm or refute the existence of an MTrP in 30 FMS patients. Overall spontaneous pain intensity and pain pattern were recorded before manual identification of MTrPs. Local...... and referred pain pattern from active MTrPs were drawn following manual palpation at TP sites. RESULTS: Showed that most of the TP sites are MTrPs. Local and referred pain from active MTrPs reproduced partly the overall spontaneous pain pattern. The total number of active MTrPs (r = .78, P

  3. Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points.

    Science.gov (United States)

    Ge, Hong-You; Zhang, Yang; Boudreau, Shellie; Yue, Shou-Wei; Arendt-Nielsen, Lars

    2008-06-01

    The aim of this present study is to test the hypothesis that nociceptive stimulation of latent myofascial trigger points (MTrPs) increases the occurrence of local muscle cramps. Nociceptive muscle stimulation was obtained by a bolus injection of glutamate (0.1 ml, 0.5 M) into a latent MTrP and a control point (a non-MTrP) located in the right or left gastrocnemius medialis muscles in 14 healthy subjects. A bolus of isotonic saline (0.9%, 0.1 ml) injection served as a control. The injections were guided by intramuscular electromyography (EMG) showing resting spontaneous electrical activity at a latent MTrP and no such activity at a non-MTrP. Intramuscular and surface EMG activities in the gastrocnemius medialis muscle were recorded pre-, during-, and post-injection for a period of 8 min to monitor the occurrence of muscle cramps, which are characterized by a brief episodic burst of high levels of EMG activity. The results showed that glutamate and isotonic saline injections into the latent MTrPs induced higher peak pain intensity than into the non-MTrPs (both P < 0.05). Glutamate injection induced higher peak pain intensity than isotonic saline injection into either latent MTrPs or non-MTrPs (both P < 0.05). Muscle camps were observed in 92.86% of the subjects following glutamate injection into the latent MTrPs, but not into the non-MTrPs (P < 0.001). No muscle cramps were recorded following isotonic saline injection into either the latent MTrPs or the non-MTrPs. These results suggest that latent MTrPs could be involved in the genesis of muscle cramps. Focal increase in nociceptive sensitivity at MTrPs constitutes one of the mechanisms underlying muscle cramps.

  4. Effect of bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points on upper back myofascial pain syndrome: a randomized controlled trial.

    Science.gov (United States)

    Jiang, Guimei; Jia, Chao; Lin, Mode

    2016-02-01

    To observe the clinical efficacy of bloodletting therapy and acupuncture at Jiaji points for treating upper back myofascial pain syndrome (MPS), and compare this with lidocaine block therapy. A total of 66 upper back MPS patients were randomly assigned to either the treatment group or the control group in a 1: 1 ratio. The treatment group (n = 33) were treated with bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points; one treatment course consisted of five, single 20-min-treatments with a 2-day break between each treatment. The control group (n = 33) were treated with a lidocaine block at trigger points; one treatment course consisted of five sessions of lidocaine block therapy with a 2-day break between each session. The simplified McGill Scale (SF-MPQ) and tenderness threshold determination were used to assess pain before and after a course of treatment. After the third and fifth treatment, the SF-MPQ values were significantly decreased (P 0.05). There were five cases with minor adverse reactions reported in the control patients, while no adverse reactions were reported in the treatment group. Bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji points was effective in treating upper back MPS. Clinically, bloodletting and acupuncture therapy had the same efficacy as the lidocaine block therapy, with fewer adverse reactions.

  5. The effectiveness of myofascial deep dry needling versus superficial dry needling in the treatment of Trapezius Myofascial Pain Syndrome

    OpenAIRE

    2012-01-01

    M.Tech. Purpose: The purpose of this study is to investigate whether needling active trigger points in the upper fibres of the trapezius muscle, using myofascial deep dry needling versus superficial dry needling is effective in the treatment of Trapezius Myofascial Pain Syndrome. Method: Forty participants underwent a general screening to determine whether they have active myofascial trigger points in the upper fibres of the Trapezius muscle. The general screening was done by using a pince...

  6. Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle.

    Science.gov (United States)

    Ziaeifar, Maryam; Arab, Amir Massoud; Nourbakhsh, Mohammad Reza

    2016-12-01

    The purpose of this study was to investigate the effect of dry needling (DN) on pain intensity and pressure pain threshold (PPT) compared with ischemic compression (IC) immediately and 48 hours after each treatment session in individuals with myofascial trigger points in the upper trapezius muscle. Thirty-one patients with myofascial trigger points in the upper trapezius muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 14). The treatment protocol for the standard group consisted of IC, whereas the patients in the experimental group received DN. The results indicated that the effect size of the DN methods for pain intensity and PPT was considerably greater after 2 days compared with immediately after the treatment session. In contrast, the effect of the IC for PPT was greater immediately after treatment compared with the measures after 2 days. There was also no noticeable difference in the effect size for IC on pain intensity between the scores obtained immediately and 2 days after treatment. However, our data also revealed a greater effect size for DN on PPT after 2 days compared with the IC technique. In this study, DN improved the pain intensity and PPT after 2 days. However, it had no clinical improvement immediately after application because of muscle soreness. Thus, assessment of the effect of DN immediately after application can be criticized, and the results should be interpreted with caution.

  7. Effects of myofascial trigger point dry needling in patients with sleep bruxism and temporomandibular disorders: a prospective case series.

    Science.gov (United States)

    Blasco-Bonora, Paloma María; Martín-Pintado-Zugasti, Aitor

    2017-03-01

    To investigate the effects of deep dry needling (DN) of myofascial trigger points (MTrPs) of the masseter and temporalis on pain, pressure pain threshold (PPT), pain-free maximal jaw opening and temporomandibular disorder (TMD)-related disability in patients with sleep bruxism (SB) and myofascial TMD. Seventeen subjects (11 women, 6 men) aged 39±13 years (range 23-66) diagnosed with SB and myofascial TMD were invited to participate in this prospective case series study. Each subject received a deep DN intervention in the masseter and temporalis MTrPs. Pain intensity, PPT, pain-free maximal jaw opening and TMD-related disability were assessed before treatment, immediately after treatment and at 1-week follow-up. Jaw disability was assessed using the jaw disability checklist (JDC) at baseline and 1 week post-treatment only. One-way analyses of variance showed significant improvements in pain intensity, PPT and jaw opening (ppoints in pain (immediate: Cohen's d=1.72, p<0.001; 1 week: d=3.24, p<0.001), jaw opening (immediate: d=0.77, p<0.001; 1 week: d=1.02, p<0.001) and PPT in the masseter (immediate: d=1.02, p<0.001; 1 week: d=1.64, p<0.001) and temporalis (immediate: d=0.91, p=0.006; 1 week: d=1.8, p<0.001). A dependent t-test showed a significant improvement in jaw functioning, reflected by a large reduction in 1-week JDC scores relative to baseline (d=3.15, p<0.001). Deep DN of active MTrPs in the masseter and temporalis in patients with myofascial TMD and SB was associated with immediate and 1-week improvements in pain, sensitivity, jaw opening and TMD-related disability. NCT02587182; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Quantification of dry needling on myofascial trigger points using a novel ultrasound method: A study protocol.

    Science.gov (United States)

    Taheri, Navid; Rezasoltani, Asghar; Okhovatian, Farshad; Karami, Mehdi; Hosseini, Sayed Mohsen; Kouhzad Mohammadi, Hosein

    2016-07-01

    Myofascial pain syndrome (MPS) is a neuromuscular dysfunction consisting of both motor and sensory abnormalities. Considering the high prevalence of MPS and its related disabilities and costs, this study was designed to determine the reliability of new ultrasonographic indexes of the upper trapezius muscle as well as the sensitivity and specificity of 2D ultrasound imaging for diagnostic purposes. Furthermore, we sought to evaluate the effectiveness of dry needling (DN) on studied ultrasonographic indexes. This study will be performed in two steps with two different designs. The first is a pilot study and was designed as a semi-experimental study to determine the sensitivity and specificity of ultrasonography for the diagnosis of MPS and the reliability of ultrasonographic measurements like muscle thickness, area of myofascial trigger points (MTrPs) in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and pennation angle of upper trapezius muscle. The second study is an interventional study which was designed to investigate the effectiveness of DN on ultrasonographic measurements, for which the reliability was determined in the first study. we will quantify the effectiveness of DN on MTrPs and muscle tissue by using novel ultrasonographic indexes. The results of the current study will provide baseline information to design more interventional studies to improve the evaluation of other treatments of MPS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Treatment of myofascial trigger points in female patients with chronic tension-type headache - A randomized controlled trial

    DEFF Research Database (Denmark)

    Berggreen, S.; Wiik, E.; Lund, Hans

    2012-01-01

    The aim of this study was to evaluate the efficacy of myofascial trigger point massage in the muscles of the head, neck and shoulders regarding pain in the treatment of females with chronic tension-type headache. They were randomized into either a treatment group (n = 20) (one session of trigger...... point massage per week for 10 weeks) or a control group receiving no treatment (n = 19). The patients kept a diary to record their pain on a visual analogue scale (VAS), and the daily intake of drugs (mg) during the 4 weeks before and after the treatment period. The McGill Pain Questionnaire......: 8.8 (95% CI 0.1117.4), p = 0.047). Furthermore, a significant decrease in the number of trigger points was observed in the treatment group compared with the control group. Myofascial trigger point massage has a beneficial effect on pain in female patients with chronic tension-type headache....

  10. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    Science.gov (United States)

    2011-01-01

    Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs) are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72) for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ) was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active MTrPs) and 4 (latent MTr

  11. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    Directory of Open Access Journals (Sweden)

    Wensing Michel

    2011-06-01

    Full Text Available Abstract Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72 for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active

  12. Effects of treatment of myofascial trigger points on the pain of fibromyalgia.

    Science.gov (United States)

    Giamberardino, Maria Adele; Affaitati, Giannapia; Fabrizio, Alessandra; Costantini, Raffaele

    2011-10-01

    Myofascial pain syndromes (MPSs) from trigger points (TrPs) and fibromyalgia syndrome (FMS) are common musculoskeletal pain conditions that frequently coexist in the same patients. In recent decades, it has become evident that these entities greatly influence each other's clinical expression. FMS is mainly rooted in the central nervous system, while TrPs have a peripheral origin. However, the nociceptive impulses from TrPs may have significant impact on symptoms of FMS, probably by enhancing the level of central sensitization typical of this condition. Several attempts have been made to assess the effects of treatment of co-occurring TrPs in FMS. We report the outcomes of these studies showing that local extinction of TrPs in patients with fibromyalgia produces significant relief of FMS pain. Though further studies are needed, these findings suggest that assessment and treatment of concurrent TrPs in FMS should be systematically performed before any specific fibromyalgia therapy is undertaken.

  13. [Myofascial pain syndrome treated with sparrow-pecking moxibustion at trigger points: a randomized controlled trial].

    Science.gov (United States)

    Ma, Yao; Bu, He; Jia, Ji-rong; Liu, Zheng

    2014-11-01

    To compare the efficacy difference in treatment of myofasical pain syndrome between sparrow-pecking moxibustion and acupuncture at trigger points so as to provide the reference of the effective therapeutic method for myofascial pain syndrome. Ninety patients were randomized into a sparrow-pecking moxibustion group and an acupuncture group, 45 cases in each one. The trigger points were selected in pain areas in the two groups. In the sparrow-pecking moxibustion group, the sparrow-pecking moxibustion was applied, 30 min in each time. In the acupuncture group, the filiform needles were inserted obliquely at 45 degrees and retained for 40 min in each treatment. The treatment was given once a day and 10 treatments made one session in the two groups. The short-form McGill pain questionnaire was used as the observation index, and the changes in pain rating index (PRI), present pain intensity (PPI) and visual analogue scale (VAS) before and after treatment were used for efficacy assessment. The results of PRI, PPI and VAS after treatment were reduced apparently as compared with those before treatment in the sparrow-pecking moxibustion group and the acupuncture group (all P0.05). The curative and remarkably effective rate was 80.0% (36/45) in the sparrow-pecking moxibustion group, which was better than 40.0% (18/45, Pmyofascial pain syndrome as compared with acupuncture at trigger points. This therapy is simpler in operation additionally.

  14. A RANDOMIZED TRIAL TO STUDY THE COMPARISON OF TRIGGER POINT DRY NEEDLING VERSUS KINESIO TAPING TECHNIQUE IN MYOFASCIAL PAIN SYNDROME DURING A 3-MONTH FOLLOW UP

    OpenAIRE

    Emrullah Hayta; Nur Mine Umdu

    2016-01-01

    Background: Managemen of myofascial pain syndrome (MPS) is a current research subject since there is a small number of randomized studies comparing different management techniques. Multiple studies attempted to assess various treatment options including trigger point dry needling and kinesiotaping. We compared the effects of trigger point dry needling and kinesiotaping in the management of myofascial pain syndome during a 3-month follow-up period. Methods: In this prospective randomized st...

  15. Chronic pain in a patient with Ehlers-Danlos syndrome (hypermobility type): The role of myofascial trigger point injections.

    Science.gov (United States)

    Tewari, Saipriya; Madabushi, Rajashree; Agarwal, Anil; Gautam, Sujeet K; Khuba, Sandeep

    2017-01-01

    Chronic widespread musculoskeletal pain is a cardinal symptom in hypermobility type of Ehler Danlos Syndrome (EDS type III). The management of pain in EDS, however, has not been studied in depth. A 30 year old female, known case of EDS, presented to the pain clinic with complaints of severe upper back pain for 6 months. Physical examination of the back revealed two myofascial trigger points over the left rhomboids and the left erector spinae. Local anaesthetic trigger point injections were given at these points, followed by stretching exercises under analgesic cover for the first week. After 1 week the patient reported 60-80% pain relief. This case highlights that we must keep a high index of suspicion for the more treatable causes of pain like myofascial pain syndrome in patients suffering from EDS, and should address it promptly and appropriately in order to maximise patient comfort. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. The Effect of Monochromatic Infrared Photo Energy on the Irritability of Myofascial Trigger Spot of Rabbit Skeletal Muscle

    Directory of Open Access Journals (Sweden)

    Ta-Shen Kuan

    2015-01-01

    Full Text Available Objective. To determine whether the vasodilatation effect of monochromatic infrared photo energy (MIRE had the potential for the treatment of myofascial trigger spot (MTrS in rabbits. Design. A randomized-controlled animal study. Subjects. Twelve adult New Zealand rabbits. Methods. For each rabbit, a MTrS (equivalent to a myofascial trigger point in humans in one side of the biceps femoris muscle was randomly selected for MIRE treatment (experimental side, while another MTrS in the other side (control side received a sham treatment. The intervention consisted of a daily 40 minutes treatment, three times per week for 2 weeks. The prevalence of endplate noise (EPN loci in the MTrS was assessed before, immediately after, and one week after the completion of the 2-week treatment. Results. MIRE could suppress the prevalence of EPN in the MTrS. The degree of reduction in EPN prevalence in the MTrS between the experimental side and the control side was significantly different immediately after MIRE treatment, but not significantly different one week after MIRE treatment. Conclusion. Our study suggests that MIRE may be a useful therapeutic option for the management of the myofascial trigger point in humans.

  17. SPECIFIC SEQUENTIAL MYOFASCIAL TRIGGER POINT THERAPY IN THE TREATMENT OF A PATIENT WITH MYOFASCIAL PAIN SYNDROME ASSOCIATED WITH REFLEX SYMPATHETIC DYSTROPHY

    Science.gov (United States)

    Hong, Chang-Zern

    2000-01-01

    A patient with traumatic rotator cuff tear of the left shoulder developed severe myofascial pain syndrome with reflex sympathetic dystrophy (RSD) involving the left upper extremity. He was unable to tolerate any type of manual therapy or needle treatment due to severe allodynia in the whole left upper limb. This patient presented for treatment approximately 6 months after the onset of trauma. Treatment consisting of specific myofascial trigger point (MTrP) therapy, beginning with desensitization and gentle massage on the MTrP of the first dorsal interosseous muscle, followed by treatment of MTrPs of the wrist-finger extensors and anterior deltoid muscles was commenced. Allodynia was remarkably reduced and further physical therapy with modalities was administered. After 2 weeks of daily MTrP therapy, he received local steroid injection to the left shoulder and continued MTrP therapy 2-3 times per week. Approximately 2 months after the injection the patient was almost pain free with nearly full range of motion in his left shoulder. The mechanism of MTrPs and their association with RSD is discussed in this paper. PMID:17987165

  18. The use of trigger point "dry" needling under ultrasound guidance for the treatment of myofascial pain (technological innovation and literature review).

    Science.gov (United States)

    Bubnov, Rostyslav V

    2010-01-01

    The aim of the study was to examine the use of trigger point dry needling under ultrasound guidance and myofascial release for the treatment of myofascial pain and to increase the provability of the puncture treatment by visual verification. A review of modern and traditional approaches to myofascial pain treatment is presented in the article. For the first time the trigger point was visualized by ultrasound (US) in this study and ultrasound guided needling therapy of muscles was performed as well. The group of 91 patients, suffered from myofascial pain of different location was included in the study. The patients were treated during last year by patented method (UA patent A 2010 06283). The pain relief effect was registered in 93.3% patients.

  19. Myofascial trigger points:the common cause of clinical tissue pain%肌筋膜疼痛触发点

    Institute of Scientific and Technical Information of China (English)

    刘琳; 黄强民; 汤莉

    2014-01-01

    BACKGROUND:Myofascial trigger points have been widely applied in clinical rehabilitation and tissue pain field in the United States and Europe countries, and they have been recognized as the common cause of clinical musculoskeletal pain, joint function limitation, tissue injuries and muscle fatigue by many physiotherapists abroad. However, in China, many experts stil have some mistaken ideas and limitations to understand the pathological mechanism and to diagnosis and treat myofascial trigger points. OBJECTIVE:From the aspects of the etiology, pathological mechanism, diagnosis and positioning, treatments, to elaborate the method issues and the clinical experience of treatments of myofascial trigger points. METHODS:PubMed, ScienceDirect, EBSCO and CNKI databases were searched by the keywords of “myofascial trigger points, myofascial pain syndrome” in Chinese and English, respectively, in the titles and abstract to retrieve relevant articles published from the time of database construction to August 2014. RESULTS AND CONCLUSION:It is concluded that a child has myofascial trigger points in some skeletal muscles after age of 4 years. The main causes of myofascial trigger points include issue trauma, the wrong posture, bone and joint degeneration, nutrition deficiency, mental stress, chronic infection and so on. The pathological mechanism of myofascial trigger points remains unknown, but what has been widely accepted is the integrated trigger point hypothesis introduced by Simons. And how to find and position myofascial trigger points is the key point to treat this disease successfuly. The application of myofascial trigger points techniques is important for the rehabilitation of clinical tissue pain and the occurrence and spread of bone and joint injuries, myofascitis, muscle pain, muscle fatigue and so on.%背景:肌筋膜疼痛触发点技术在欧美国家临床康复和组织疼痛领域已得到广泛性应用,国内相关专家对其病理机制认识,

  20. Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Espejo-Antúnez, Luis; Tejeda, Jaime Fernández-Huertas; Albornoz-Cabello, Manuel; Rodríguez-Mansilla, Juan; de la Cruz-Torres, Blanca; Ribeiro, Fernando; Silva, Anabela G

    2017-08-01

    This systematic review of randomized controlled trials aimed to examine the effectiveness of dry needling in the treatment of myofascial trigger points and to explore the impact of specific aspects of the technique on its effectiveness. Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus, The Cochrane Library and Physiotherapy Evidence Database. Studies identified by electronic searches were screened against a set of pre-defined inclusion criteria. Fifteen studies were included in this systematic review. The main outcomes that were measured were pain, range of motion, disability, depression and quality of life. The results suggest that dry needling is effective in the short term for pain relief, increase range of motion and improve quality of life when compared to no intervention/sham/placebo. There is insufficient evidence on its effect on disability, analgesic medication intake and sleep quality. Despite some evidence for a positive effect in the short term, further randomized clinical trials of high methodological quality, using standardized procedures for the application of dry needling are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Remote Subcutaneous Needling to Suppress the Irritability of Myofascial Trigger Spots: An Experimental Study in Rabbits

    Directory of Open Access Journals (Sweden)

    Zhonghua Fu

    2012-01-01

    Full Text Available Objective. To obtain electrophysiological effects of Fu’s subcutaneous needling (FSN on needling distance by assessment of endplate noise (EPN recorded from the myofascial trigger spots (MTrSs in rabbit skeletal muscle. Method. Eighteen New Zealand rabbits weighing 2.5–3.0 kg were randomly divided into two groups as follows: proximal needling (PN group and distal needling (DN group. The needling procedure followed the instructions described by the inventor of FSN, including needling insertion and swaying movement. The amplitudes of EPN on the MTrS region of BF muscle were recorded as an index of MTrS irritability. Random sampling of EPN tracings were taken for further analyses before, during, and after FSN treatment. Results. In PN and DN groups, the trends of EPN amplitude alterations were similar at conditions before, during, and after FSN treatment. The degree of reduction in the EPN amplitude in PN group was significantly higher than that in DN group. There were no significant changes in EPN amplitudes in the MTrS of contralateral BF without FSN intervention either in DN or PN group. Conclusion. The irritability of proximal MTrSs could be modulated after ipsilateral FSNs. The placement of FSN may affect the effectiveness of suppression of irritability of MTrSs.

  2. Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy.

    Science.gov (United States)

    Moldwin, Robert M; Fariello, Jennifer Yonaitis

    2013-10-01

    Myofascial trigger points (MTrP), or muscle "contraction knots," of the pelvic floor may be identified in as many as 85 % of patients suffering from urological, colorectal and gynecological pelvic pain syndromes; and can be responsible for some, if not all, symptoms related to these syndromes. Identification and conservative treatment of MTrPs in these populations has often been associated with impressive clinical improvements. In refractory cases, more "aggressive" therapy with varied trigger point needling techniques, including dry needling, anesthetic injections, or onabotulinumtoxinA injections, may be used, in combination with conservative therapies.

  3. Effects of postural and visual stressors on myofascial trigger point development and motor unit rotation during computer work.

    Science.gov (United States)

    Hoyle, Jeffrey A; Marras, William S; Sheedy, James E; Hart, Dennis E

    2011-02-01

    Musculoskeletal complaint rates are high among those performing low-level static exertions (LLSEs), such as computer users. However, our understanding of the causal mechanisms is lacking. It was hypothesized that myofascial trigger point (MTrP) development might be one causal mechanism to help explain these complaints and that static postural and visual demands may be contributing factors. Therefore, the purpose of this experiment was to examine MTrP development and the behavior of multiple parts of the trapezius muscle under postural and mental stress (represented by visual stress) conditions during computer work. Twelve subjects (six male and six female) were monitored for MTrP development via expert opinion, subject self-report, and cyclic changes in EMG median frequency across fourteen spatial locations. Results showed that MTrPs developed after one hour of continuous typing, despite the stress condition. Interestingly, both the high postural and high visual stress conditions resulted in significantly fewer median frequency cycles (3.76 and 5.35 cycles, respectively), compared to the baseline low stress condition (6.26 cycles). Lastly, the MTrP location as well as locations more medial to the spine showed significantly fewer cycles than other locations. Findings suggest that MTrPs may be one causal pathway for pain during LLSEs and both postural and visual demands may play a role in muscle activation patterns, perhaps attributing to MTrP development and resultant discomfort. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Remote Dose-Dependent Effects of Dry Needling at Distant Myofascial Trigger Spots of Rabbit Skeletal Muscles on Reduction of Substance P Levels of Proximal Muscle and Spinal Cords

    OpenAIRE

    Yueh-Ling Hsieh; Chen-Chia Yang; Szu-Yu Liu; Li-Wei Chou; Chang-Zern Hong

    2014-01-01

    Background. Dry needling at distant myofascial trigger points is an effective pain management in patients with myofascial pain. However, the biochemical effects of remote dry needling are not well understood. This study evaluates the remote effects of dry needling with different dosages on the expressions of substance P (SP) in the proximal muscle, spinal dorsal horns of rabbits. Methods. Male New Zealand rabbits (2.5–3.0 kg) received dry needling at myofascial trigger spots of a gastrocnemiu...

  5. Does myofascial and trigger point treatment reduce pain and analgesic intake in patients undergoing OnabotulinumtoxinA injection due to chronic intractable migraine? A pilot, single-blind randomized controlled trial.

    Science.gov (United States)

    Gandolfi, Marialuisa; Geroin, Christian; Valè, Nicola; Marchioretto, Fabio; Turrina, Andrea; Dimitrova, Eleonora; Tamburin, Stefano; Serina, Anna; Castellazzi, Paola; Meschieri, Andrea; Ricard, François; Saltuari, Leopold; Picelli, Alessandro; Smania, Nicola

    2017-07-27

    Chronic migraine is a disabling disorder associated with myofascial and trigger point disorders in the neck. Pharmacological management is the first line of treatment; however, rehabilitation procedures aimed at lessening symptoms of myofascial and trigger point disorders may add value in the management of headache symptoms. To evaluate the feasibility of myofascial and trigger point treatment in chronic migraine patients receiving prophylactic treatment with onabotulinumtoxinA. To evaluate the treatment effects on headache frequency and intensity, analgesic consumption, cervical range of motion, trigger point pressure pain threshold, quality of life, and disability. Pilot, single-blind randomized controlled trial with two parallel groups. Neurorehabilitation unit. 22 outpatients with chronic migraine. Patients were randomly assigned to receive either cervicothoracic manipulative treatment (n=12) or transcutaneous electrical nerve stimulation (TENS) in the upper trapezius (n=10). Treatment consisted of 4 sessions (30 min/session, 1 session/week for 4 weeks). A rater blinded to treatment allocation evaluated outcomes before treatment, during treatment, and 1 month after the end of treatment. Consistent with the pilot nature of the study, feasibility was considered the primary outcome and efficacy the secondary outcome. All patients completed the study. No adverse events were reported. No significant between-group differences in pain intensity were observed during the study period. At post-treatment evaluation, the total consumption of analgesics (p=.02) and non-steroidal anti-inflammatory (p=.02) drugs was significantly lower in the manipulative treatment group than in the TENS group. These effects paralleled significant improvements in trigger point sensitivity and cervical active range of motion. Manipulative techniques aimed at reducing peripheral nociceptive triggers might add value in the management of chronic migraine symptoms and lower acute medication use

  6. Extracorporeal Shock Wave Therapy Versus Trigger Point Injection in the Treatment of Myofascial Pain Syndrome in the Quadratus Lumborum.

    Science.gov (United States)

    Hong, Jin Oh; Park, Joon Sang; Jeon, Dae Geun; Yoon, Wang Hyeon; Park, Jung Hyun

    2017-08-01

    To compare the effectiveness of extracorporeal shock wave therapy (ESWT) and trigger point injection (TPI) for the treatment of myofascial pain syndrome in the quadratus lumborum. In a retrospective study at our institute, 30 patients with myofascial pain syndrome in the quadratus lumborum were assigned to ESWT or TPI groups. We assessed ESWT and TPI treatment according to their affects on pain relief and disability improvement. The outcome measures for the pain assessment were a visual analogue scale score and pain pressure threshold. The outcome measures for the disability assessment were Oswestry Disability Index, Roles and Maudsley, and Quebec Back Pain Disability Scale scores. Both groups demonstrated statistically significant improvements in pain and disability measures after treatment. However, in comparing the treatments, we found ESWT to be more effective than TPI for pain relief. There were no statistically significant differences between the groups with respect to disability. Compared to TPI, ESWT showed superior results for pain relief. Thus, we consider ESWT as an effective treatment for myofascial pain syndrome in the quadratus lumborum.

  7. Dry needling of trigger points with and without paraspinal needling in myofascial pain syndromes in elderly patients.

    Science.gov (United States)

    Ga, Hyuk; Choi, Ji-Ho; Park, Chang-Hae; Yoon, Hyun-Jung

    2007-01-01

    To compare the efficacies of dry needling of trigger points (TrPs) with and without paraspinal needling in myofascial pain syndrome of elderly patients. Single-blinded, randomized controlled trial. Forty (40) subjects, between the ages of 63 and 90 with myofascial pain syndrome of the upper trapezius muscle. Eighteen (18) subjects were treated with dry needling of all the TrPs only and another 22 with additional paraspinal needling on days 0, 7, and 14. At 4-week follow-up the results were as follows: (1) TrP and paraspinal dry needling resulted in more continuous subjective pain reduction than TrP dry needling only; (2) TrP and paraspinal dry needling resulted in significant improvements on the geriatric depression scale but TrP dry needling only did not; (3) TrP and paraspinal dry needling resulted in improvements of all the cervical range of motions but TrP dry needling only did not in extensional cervical range of motion; and (4) no cases of gross hemorrhage were noted. TrP and paraspinal dry needling is suggested to be a better method than TrP dry needling only for treating myofascial pain syndrome in elderly patients.

  8. Effect of Hyaluronidase Addition to Lidocaine for Trigger Point Injection in Myofascial Pain Syndrome.

    Science.gov (United States)

    Choi, Ji Won; Lee, Chul Joong; Lee, Sangmin M; Shin, Byung Seop; Jun, Byunghui; Sim, Woo Seog

    2015-10-07

    This randomized, double-blind study compared the efficacy of hyaluronidase co-injection with that of local anesthesia alone on the degree of pain and quality of life in patients with myofascial pain syndrome (MPS). Sixty-one adults, aged 25 to 75 years, with MPS affecting both trapezius muscles were randomly assigned to one of the 2 treatment groups: lidocaine (group L: n = 31) or hyaluronidase (group H: n = 30). All patients received Trigger point injection (TPI). Group L received 3.2 mL 0.5% lidocaine alone. Group H received the same solution of lidocaine mixed with hyaluronidase (600 iu/mL). Patients were followed for 14 days (pre- and post-TPI days 0, 1, 4, 7, and 14) with the verbal numerical rating scale (VNRS), and the primary outcome was VNRS on day 7. Also, we evaluated the neck disability index (NDI) and the short form of brief pain inventory (BPI-SF) on pre- and post-TPI day 14. In both groups, VNRS decreased on days 4, 7, and 14 compared to the pre-TPI. However, in group H, VNRS decreased on day 1 also. There were no significant differences of VNRS between the 2 groups during 14 days. NDI and BPI-SF scores also significantly decreased after TPI in both groups. There were no significant differences between groups in terms of VNRS, NDI, or BPI-SF scores. However, TPI consisting of lidocaine mixed with hyaluronidase worked more effectively than lidocaine alone on post-TPI day 1. Further, hyaluronidase showed a tendency to reduce TPI-related soreness. © 2015 World Institute of Pain.

  9. Evaluation of dry needling and 0.5% lidocaine injection therapies in myofascial pain trigger points in masticatory muscles

    Directory of Open Access Journals (Sweden)

    Renato Oliveira Ferreira da Silva

    2012-04-01

    Full Text Available OBJECTIVE: The purpose of this study was to compare the effectiveness of trigger points injections using lidocaine 0.5% and dry needling without any kind of home-based rehabilitation program. METHODS: Sixteen patients with myofascial pain and trigger points in masticatory muscles were randomly assigned to two groups and received only one application session. The pressure pain threshold (PPT was recorded before and after the injection: Ten minutes, 24 hours later, 7, 15, 21 and 30 days after the treatment. Visual analogue scale (VAS was used to in all evaluation periods. RESULTS: There were no difference between groups for PPT, but for all groups the PPT during the time significantly increased when compared the before treatment. VAS showed differences between groups and during the time. The 0.5% lidocaine had the lowest VAS values when compared to dry needling, but at 30 days there were no differences among them. CONCLUSIONS: Despite the differences in VAS and considering there were no differences in PPT increases, we concluded that, in this study, both groups were able to disrupt the mechanisms of trigger point and relieve the myofascial pain symptoms.

  10. Chronic whiplash and central sensitization; an evaluation of the role of a myofascial trigger points in pain modulation

    Directory of Open Access Journals (Sweden)

    Freeman Michael D

    2009-04-01

    Full Text Available Abstract Objective it has been established that chronic neck pain following whiplash is associated with the phenomenon of central sensitization, in which injured and uninjured parts of the body exhibit lowered pain thresholds due to an alteration in central pain processing. it has furthermore been hypothesized that peripheral sources of nociception in the muscles may perpetuate central sensitization in chronic whiplash. the hypothesis explored in the present study was whether myofascial trigger points serve as a modulator of central sensitization in subjects with chronic neck pain. Design controlled case series. Setting outpatient chronic pain clinic. Subjects seventeen patients with chronic and intractable neck pain and 10 healthy controls without complaints of neck pain. Intervention symptomatic subjects received anesthetic infiltration of myofascial trigger points in the upper trapezius muscles and controls received the anesthetic in the thigh. Outcome measures: pre and post injection cervical range of motion, pressure pain thresholds (ppt over the infraspinatus, wrist extensor, and tibialis anterior muscles. sensitivity to light (photophobia and subjects' perception of pain using a visual analog scale (vas were also evaluated before and after injections. only the ppt was evaluated in the asymptomatic controls. Results immediate (within 1 minute alterations in cervical range of motion and pressure pain thresholds were observed following an average of 3.8 injections with 1–2 cc of 1% lidocaine into carefully identified trigger points. cervical range of motion increased by an average of 49% (p = 0.000 in flexion and 44% (p = 0.001 in extension, 47% (p = 0.000 and 28% (p Conclusion the present data suggest that myofascial trigger points serve to perpetuate lowered pain thresholds in uninjured tissues. additionally, it appears that lowered pain thresholds associated with central sensitization can be immediately reversed, even when associated

  11. Myofascial pain syndromes and their evaluation.

    Science.gov (United States)

    Giamberardino, Maria Adele; Affaitati, Giannapia; Fabrizio, Alessandra; Costantini, Raffaele

    2011-04-01

    This article reviews the available published knowledge about the diagnosis, pathophysiology and treatment of myofascial pain syndromes from trigger points. Furthermore, epidemiologic data and clinical characteristics of these syndromes are described, including a detailed account of sensory changes that occur at both painful and nonpainful sites and their utility for diagnosis and differential diagnosis; the identification/diagnostic criteria available so far are critically reviewed. The key role played by myofascial trigger points as activating factors of pain symptoms in other algogenic conditions--headache, fibromyalgia and visceral disease--is also addressed. Current hypotheses on the pathophysiology of myofascial pain syndromes are presented, including mechanisms of formation and persistence of primary and secondary trigger points as well as mechanisms beyond referred pain and hyperalgesia from trigger points. Conventional and most recent therapeutic options for these syndromes are described, and their validity is discussed on the basis of results from clinical controlled studies.

  12. Myofascial pain syndrome treatments.

    Science.gov (United States)

    Borg-Stein, Joanne; Iaccarino, Mary Alexis

    2014-05-01

    Myofascial pain syndrome (MPS) is a regional pain disorder caused by taut bands of muscle fibers in skeletal muscles called myofascial trigger points. MPS is a common disorder, often diagnosed and treated by physiatrists. Treatment strategies for MPS include exercises, patient education, and trigger point injection. Pharmacologic interventions are also common, and a variety of analgesics, antiinflammatories, antidepressants, and other medications are used in clinical practice. This review explores the various treatment options for MPS, including those therapies that target myofascial trigger points and common secondary symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders H

    2011-01-01

    A diagnosis of Myofascial Pain Syndrome (MPS) requires palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies currently exist from which to draw firm conclusions regarding the robustness of TP examination. An inter...

  14. A narrative review of new trends in the diagnosis of myofascial trigger points: diagnostic ultrasound imaging and biomarkers

    Science.gov (United States)

    Srbely, John Z; Kumbhare, Dinesh; Grosman-Rimon, Liza

    2016-01-01

    Myofascial pain syndrome (MPS) is one of the most common conditions of chronic musculoskeletal pain encountered by primary healthcare practitioners on a daily basis. It is generally accepted amongst the broad profile of healthcare practitioners treating MPS that the presence of discrete, palpable and tender nodules within the muscle, known as myofascial trigger points (MTrP), is necessary to confirm the diagnosis of MPS. Manual palpation is currently the most common technique used to detect MTrP, however, previous research has shown that the reliability of manual palpation for detecting MTrP is poor, and in our opinion unacceptably poor, leading to inconsistent diagnosis of MPS and poor patient outcomes. There are currently no objective accepted diagnostic criteria for the clinical detection of MTrP, nor are there standardized diagnostic criteria for MPS. Two promising areas of research with potential for enhancing the diagnosis of MPS include the use of diagnostic ultrasound and biomarkers. Further research is needed to advance the development of composite diagnostic criteria employing ultrasound imaging, biomarker assessments and physical assessment to enhance the accuracy and objectivity of MTrP detection and diagnosis of chronic MPS disorder. PMID:27713577

  15. Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kai-Hua Chen

    2013-01-01

    Full Text Available Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40 and Yanglingquan (GB34 points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side versus sham needling on the contralateral lower limb (control side in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P=0.03 in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P=0.036. Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle.

  16. [Clinical observation on therapeutic effect of cupping combined with acupuncture stimulation at trigger points for lumbar myofascial pain syndrome].

    Science.gov (United States)

    Zhao, Hong

    2014-08-01

    To observe the clinical effect of cupping combined with acupuncture stimulation of trigger points on lumbar myofascial pain syndrome (MPS). Sixty MPS patients were randomly divided into acupuncture + TDP group (n = 30), and cupping + acupuncture group (n = 30). Patients in the acupuncture + TDP group were treated by acupuncture stimulation of trigger points and local TDP irradiation, and patients of the cupping + acupuncture group treated by intensive cupping applied to the myofascial band and acupuncture stimulation of the locus according to the position of muscular tension band. The therapeutic effects were assessed according to the score of the McGill pain questionnaire composing of pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI) before, immediately and 1 month after the treatment. After the treatment, the total effective rates of the acupuncture+ TDP and cupping + acupuncture groups were 83.3% (25/30) and 96.6% (29/30), respectively, without significant difference between the two groups (P > 0.05). One month's follow-up showed that the total effective rates of the acupuncture + TDP and cupping + acupuncture groups were 40.0% and 90.0% respectively, and the latter group was significantly better than the acupuncture + TDP group in the therapeutic effect (P < 0.05). The scores of PRI, VAS, PPI after the treatment were markedly decreased in both groups (P < 0.05). One month later, the scores of PRI, VAS and PPI in the cupping + acupuncture group were obviously lower than those of the acupuncture group (P < 0.05). Both acupuncture stimulation of trigger points plus TDP and cupping plus acupuncture can effectively relieve pain in MPS patients, while the therapeutic effect of cupping plus acupuncture treatment lasts longer analgesic effect.

  17. Evolution of the methodological quality of controlled clinical trials for myofascial trigger point treatments for the period 1978-2015: A systematic review.

    Science.gov (United States)

    Stoop, Rahel; Clijsen, Ron; Leoni, Diego; Soldini, Emiliano; Castellini, Greta; Redaelli, Valentina; Barbero, Marco

    2017-08-01

    The methodological quality of controlled clinical trials (CCTs) of physiotherapeutic treatment modalities for myofascial trigger points (MTrP) has not been investigated yet. To detect the methodological quality of CCTs for physiotherapy treatments of MTrPs and demonstrating the possible increase over time. Systematic review. A systematic search was conducted in two databases, Physiotherapy Evidence Database (PEDro) and Medicine Medical Literature Analysis and Retrieval System online (MEDLINE), using the same keywords and selection procedure corresponding to pre-defined inclusion criteria. The methodological quality, assessed by the 11-item PEDro scale, served as outcome measure. The CCTs had to compare at least two interventions, where one intervention had to lay within the scope of physiotherapy. Participants had to be diagnosed with myofascial pain syndrome or trigger points (active or latent). A total of n = 230 studies was analysed. The cervico-thoracic region was the most frequently treated body part (n = 143). Electrophysical agent applications was the most frequent intervention. The average methodological quality reached 5.5 on the PEDro scale. A total of n = 6 studies scored the value of 9. The average PEDro score increased by 0.7 points per decade between 1978 and 2015. The average PEDro score of CCTs for MTrP treatments does not reach the cut-off of 6 proposed for moderate to high methodological quality. Nevertheless, a promising trend towards an increase of the average methodological quality of CCTs for MTrPs was recorded. More high-quality CCT studies with thorough research procedures are recommended to enhance methodological quality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  18. PENURUNAN NYERI DAN DISABILITAS DENGAN INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUES (INIT DAN MASSAGE EFFLEURAGE PADA MYOFASCIAL TRIGGER POINT SYNDROME OTOT TRAPESIUS BAGIAN ATAS

    Directory of Open Access Journals (Sweden)

    Veni Fatmawati

    2013-07-01

    Full Text Available Myofascia Trigger Point Syndrome (MTrPs is trigger point muscle happens in musculoskeletal. Factors which strengthen and trigger the emerge of MTrPs are the muscle contraction which happens continuously, poor body position, wrong body position or movement, poor occupation activity and unsuitable workplace arrangement that affect the unergonomic work behavior. The objective of this reseacrh is to reveal the effectivity of  integrated neuromuscular  inhibition techniques (init and massage efflurage in decreasing pain and disability in myofasial trigger point of upper trapesius muscle. The subjects this research are 34 people which are taken randomly in Puskesmas 2 Kartosuro, Surakarta with 17 samples of each group. Group 1 is integrated neuromuscular inhibition techniques (init and group 2 is massage efflurage. The data used in this research is NDI scale taken before and after therapy. The data collected is processed by using differential test through computer base of SPSS 15.0 version. The data analysis by using paired sample t-test, in group 1 the data resulted before therapy is 48,35±6,68 and the data resulted after therapy is 25,94±5,87 with p = 0,000 (p < 0,05. Whereas in group 2, the  resulted before therapy is 47,53±5,17 and the data resulted before therapy is 28,00±8,91 with p = 0,000 (p < 0,05. To conclude, based on the data resulted in this research, integrated neuromuscular  inhibition techniques (init and massage effleurage are there is no difference decrease pain and disability in myofascial trigger point of upper trapezius muscle.

  19. Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.

    Science.gov (United States)

    Anderson, Rodney U; Harvey, Richard H; Wise, David; Nevin Smith, J; Nathanson, Brian H; Sawyer, Tim

    2015-03-01

    This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).

  20. Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Tough, Elizabeth A; White, Adrian R; Cummings, T Michael; Richards, Suzanne H; Campbell, John L

    2009-01-01

    Pain from myofascial trigger points is often treated by needling, with or without injection, although evidence is inconclusive on whether this is effective. We aimed to review the current evidence on needling without injection, by conducting a systematic literature review. We searched electronic databases to identify relevant randomised controlled trials, and included studies where at least one group were treated by needling directly into the myofascial trigger points, and where the control was either no treatment, or usual care; indirect local dry needling or some form of placebo intervention. We extracted data on pain, using VAS scores as the standard. Seven studies were included. One study concluded that direct dry needling was superior to no intervention. Two studies, comparing direct dry needling to needling elsewhere in the muscle, produced contradictory results. Four studies used a placebo control and were included in a meta-analysis. Combining these studies (n=134), needling was not found to be significantly superior to placebo (standardised mean difference, 14.9 [95%CI, -5.81 to 33.99]), however marked statistical heterogeneity was present (I(2)=88%). In conclusion, there is limited evidence deriving from one study that deep needling directly into myofascial trigger points has an overall treatment effect when compared with standardised care. Whilst the result of the meta-analysis of needling compared with placebo controls does not attain statistically significant, the overall direction could be compatible with a treatment effect of dry needling on myofascial trigger point pain. However, the limited sample size and poor quality of these studies highlights and supports the need for large scale, good quality placebo controlled trials in this area.

  1. A systematic, critical review of manual palpation for identifying myofascial trigger points

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Larsen, Anders Holsgaard; Hartvigsen, Jan

    2008-01-01

    To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature.......To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature....

  2. Myofascial low back pain.

    Science.gov (United States)

    Ramsook, Ryan R; Malanga, Gerard A

    2012-10-01

    Low back pain is a common condition that is encountered by both primary care physicians as well as various specialists, which include: orthopedic surgeons, physical medicine and rehabilitation specialists, neurologists, rheumatologists, and pain management specialists. Associated muscular pain is very common and often a reactive response from nociception from other structures. Myofascial pain may arise, which is characterized by the presence of myofascial trigger points (MTrPs) that are located in fascia, tendons, and/or muscle. This article reviews the current evidence regarding the pathophysiology, assessment, and recommended treatment options for myofascial low back pain.

  3. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger

  4. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger p

  5. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger p

  6. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: A randomized controlled trial [ISRCTN75722066

    Directory of Open Access Journals (Sweden)

    Franssen Jo LM

    2007-11-01

    Full Text Available Abstract Background Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior over others. Systematic reviews provide some evidence that certain physical therapy interventions (i.e. supervised exercises and mobilisation are effective in particular shoulder disorders (i.e. rotator cuff disorders, mixed shoulder disorders and adhesive capsulitis, but there is an ongoing need for high quality trials of physical therapy interventions. Usually, physical therapy consists of active exercises intended to strengthen the shoulder muscles as stabilizers of the glenohumeral joint or perform mobilisations to improve restricted mobility of the glenohumeral or adjacent joints (shoulder girdle. It is generally accepted that a-traumatic shoulder problems are the result of impingement of the subacromial structures, such as the bursa or rotator cuff tendons. Myofascial trigger points (MTrPs in shoulder muscles may also lead to a complex of symptoms that are often seen in patients diagnosed with subacromial impingement or rotator cuff tendinopathy. Little is known about the treatment of MTrPs in patients with shoulder disorders. The primary aim of this study is to investigate whether physical therapy modalities to inactivate MTrPs can reduce symptoms and improve shoulder function in daily activities in a population of chronic a-traumatic shoulder patients when compared to a wait-and-see strategy. In addition we investigate the recurrence rate during a one-year-follow-up period. Methods/Design This paper presents the design for a randomized controlled trial to be conducted between September 2007 – September 2008, evaluating the effectiveness of a physical therapy treatment for non-traumatic shoulder complaints. One hundred subjects are included in this study. All subjects

  7. Effect of Latent Myofascial Trigger Points on Strength Measurements of the Upper Trapezius: A Case-Controlled Trial

    Science.gov (United States)

    Anshul

    2011-01-01

    ABSTRACT Purpose: The purpose of this article was to determine whether strength is altered in the upper trapezius in the presence of latent myofascial trigger points (MTrP). Methods: This study was case controlled and used convenience sampling. The sample recruited was homogeneous with respect to age, sex, height, and body mass. Participants were assessed for the presence of latent MTrP in the upper trapezius and placed into two groups: an experimental group that had latent MTrP in the upper trapezius and a control group that did not. Eighteen women (mean age 21.4 y, SD 1.89; mean height 156.9 cm, SD 4.03; and mean body mass 51.7 kg, SD 5.84) made up the experimental group, and 19 women (mean age 20.3 y, SD 1.86; mean height 158.6 cm, SD 3.14; and mean body mass 53.2 kg, SD 5.17) made up the control group. We obtained strength measurements of the non-dominant arm using a handheld dynamometer and compared them between the two groups. Results: The difference in the strength measurements between the two groups was not statistically significant (p=0.59). Conclusions: The presence of latent MTrPs may not affect the strength of the upper trapezius. PMID:22942517

  8. Glimpse of Views in Ashi and Myofascial Trigger Point%阿是穴与激痛点浅议

    Institute of Scientific and Technical Information of China (English)

    王列; 马铁明; 曹锐; 王颖; 马帅; 王建华; 王莹; 陈玲

    2016-01-01

    阿是穴与激痛点虽于不同时代提出,但二者之间有诸多相似之处,本文从二者的起源、定位、病理机制、临床应用及干预方法等多方面进行分析阐述,揭示二者之间的联系与区别,希望从一个全新的视角出发,对二者的理论及实践的发展提供借鉴.%Ashi and myofascial trigger point,although proposed at different times,but there are many similarities between them,due to its unique efficacy and widespread concern in Western medical community.From the origin,location,pathological mechanisms,clinical application and intervention aspects of both methods were analyzed and discussed,reveals links and differences between them.We hope from a new perspective on the development of both the theory and practice for reference.

  9. Myofascial Pain Syndrome: A Treatment Review

    OpenAIRE

    Desai, Mehul J.; Saini, Vikramjeet; Saini, Shawnjeet

    2013-01-01

    Myofascial pain syndrome (MPS) is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation, and regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the treatment modalities for myofascial trigge...

  10. Myofascial pain syndrome: a treatment review.

    Science.gov (United States)

    Desai, Mehul J; Saini, Vikramjeet; Saini, Shawnjeet

    2013-06-01

    Myofascial pain syndrome (MPS) is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation, and regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the treatment modalities for myofascial trigger points and muscle pain. Through a critical evidence-based review of the pharmacologic and nonpharmacologic treatments, the authors aim to provide clinicians with a more comprehensive knowledge of the interventions for myofascial pain.

  11. The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Simons, David; Cuadrado, Maria Luz; Pareja, Juan

    2007-10-01

    Neck and head pain syndromes are common problems seen in clinical practice. Pain features of commonly designated idiopathic neck pain and some primary headaches (ie, tension-type headache or migraine) fit the descriptions of referred pain originating in muscle trigger points (TrPs). This article discusses the scientific evidence supporting the role of muscle TrPs in chronic musculo-skeletal disorders of the neck and head. The relevance of referred pain elicited by muscle TrPs in patients with neck pain has been investigated in few studies. Some authors found that both muscle TrPs in neck-shoulder muscles and cervical joint dysfunctions contribute at the same time to neck pain perception. Furthermore, it seems that referred pain originated in muscle TrPs could also contribute to neck symptoms perceived by subjects after a rear-end crash. In addition, several recent studies reported that both TTH and migraine are associated with referred pain from TrPs in the suboccipital, upper trapezius, sternocleidomastoid, temporalis, or superior oblique muscles. Referred pain elicited by active TrPs mimics the pain areas observed during head pain attacks in these primary headaches. Based on available data, it seems that the pain profile of neck and head syndromes may be provoked referred pain from TrPs in the posterior cervical, head, and shoulder muscles. Additional studies are needed to delineate more information on the relation between muscle TrPs and musculoskeletal pain syndromes of the head and neck.

  12. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Cotchett Matthew P

    2010-09-01

    Full Text Available Abstract Background Plantar heel pain (plantar fasciitis is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. Methods We searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool. Results Three quasi-experimental trials matched the inclusion criteria: two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials. Conclusions There is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the

  13. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review.

    Science.gov (United States)

    Cotchett, Matthew P; Landorf, Karl B; Munteanu, Shannon E

    2010-09-01

    Plantar heel pain (plantar fasciitis) is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs) however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. We searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI) in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline) alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool. Three quasi-experimental trials matched the inclusion criteria: two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials. There is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the Standards for Reporting Interventions in Controlled Trials of

  14. Mechanisms of Myofascial Pain

    Science.gov (United States)

    Jafri, M. Saleet

    2014-01-01

    Myofascial pain syndrome is an important health problem. It affects a majority of the general population, impairs mobility, causes pain, and reduces the overall sense of well-being. Underlying this syndrome is the existence of painful taut bands of muscle that contain discrete, hypersensitive foci called myofascial trigger points. In spite of the significant impact on public health, a clear mechanistic understanding of the disorder does not exist. This is likely due to the complex nature of the disorder which involves the integration of cellular signaling, excitation-contraction coupling, neuromuscular inputs, local circulation, and energy metabolism. The difficulties are further exacerbated by the lack of an animal model for myofascial pain to test mechanistic hypothesis. In this review, current theories for myofascial pain are presented and their relative strengths and weaknesses are discussed. Based on new findings linking mechanoactivation of reactive oxygen species signaling to destabilized calcium signaling, we put forth a novel mechanistic hypothesis for the initiation and maintenance of myofascial trigger points. It is hoped that this lays a new foundation for understanding myofascial pain syndrome and how current therapies work, and gives key insights that will lead to the improvement of therapies for its treatment. PMID:25574501

  15. Treatment of myofascial pain.

    Science.gov (United States)

    Desai, Mehul J; Bean, Matthew C; Heckman, Thomas W; Jayaseelan, Dhinu; Moats, Nick; Nava, Andrew

    2013-01-01

    SUMMARY The objective of this article was to perform a narrative review regarding the treatment of myofascial pain syndrome and to provide clinicians with treatment recommendations. This paper reviews the efficacy of various myofascial pain syndrome treatment modalities, including pharmacological therapy, injection-based therapies and physical therapy interventions. Outcomes evaluated included pain (visual analog scale), pain pressure threshold and range of motion. The evidence found significant benefit with multiple treatments, including diclofenac patch, thiocolchicoside and lidocaine patches. Trigger point injections, ischemic compression therapy, transcutaneous electrical nerve stimulation, spray and stretch, and myofascial release were also efficacious. The authors recommend focusing on treating underlying pathologies, including spinal conditions, postural abnormalities and underlying behavioral issues. To achieve maximum pain reduction and improve function, we recommend physicians approach myofascial pain syndrome with a multimodal plan, which includes a combination of pharmacologic therapies, various physical therapeutic modalities and injection therapies.

  16. 肌筋膜“扳机点”动物模型的构建及针灸干预机制%Myofascial Trigger Points:Construction of Animal Models and Mechanism of Acupuncture Intervention

    Institute of Scientific and Technical Information of China (English)

    邵开超; 查和萍; 范志勇; 吴世芳; 李珊珊

    2013-01-01

    肌筋膜炎是临床常见病之一,从肌筋膜“扳机点”入手治疗具有较好的疗效。本文分别从中医学和现代医学的角度,进一步深入了解肌筋膜“扳机点”,并对目前肌筋膜“扳机点”动物模型的构建进行阐述,阐明针灸干预肌筋膜“扳机点”的机制,对肌筋膜“扳机点”的进一步研究具有积极的意义。%Myofascitis is one of clinical common diseases ,and myofascial trigger point therapy usually plays a good curative effect .Respectively from the angle of medicine and modern medicine , in order to further under-stand myofascial trigger points , and myofascial trigger point elaborates the construction of animal models , to clarify the mechanism of acupuncture intervention myofascial trigger point .The further study of myofascial trigger points has a positive significance .

  17. Quantification of dry needling and posture effects on myofascial trigger points using ultrasound shear-wave elastography.

    Science.gov (United States)

    Maher, Ruth M; Hayes, Dawn M; Shinohara, Minoru

    2013-11-01

    To determine (1) whether the shear modulus in upper trapezius muscle myofascial trigger points (MTrPs) reduces acutely after dry needling (DN), and (2) whether a change in posture from sitting to prone affects the shear modulus. Ultrasound images were acquired in B mode with a linear transducer oriented in the transverse plane, followed by performance of shear-wave elastography (SWE) before and after DN and while sitting and prone. University. Women (N=7; mean age ± SD, 46±17y) with palpable MTrPs were recruited. All participants were dry needled in the prone position using solid filament needles that were inserted and manipulated inside the MTrPs. SWE was performed before and after DN in the sitting and prone positions. MTrPs were evaluated by shear modulus using SWE. Palpable reductions in stiffness were noted after DN and in the prone position. These changes were apparent in the shear modulus map obtained with ultrasound SWE. With significant main effects, the shear modulus reduced from before to after DN (P<.01) and from the sitting to the prone position (P<.05). No significant interaction effect between time and posture was observed. The shear modulus measured with ultrasound SWE reduced after DN and in the prone position compared with sitting, in agreement with reductions in palpable stiffness. These findings suggest that DN and posture have significant effects on the shear modulus of MTrPs, and that shear modulus measurement with ultrasound SWE may be sensitive enough to detect these effects. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Difference in effect between ischemic compression and muscle energy technique on upper trepezius myofascial trigger points: Comparative study

    Directory of Open Access Journals (Sweden)

    Gopal S Nambi

    2013-01-01

    Full Text Available Background: Myofascial trigger point (MTrP is a hyperirritable point or spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression and can give rise to characteristic-referred pain and motor dysfunction. Studies suggest that various types of massage forms are available for treating MTrPs. Aims: To find the difference in effect of two forms of massage techniques: Ischemic compression and muscle energy technique (MET on upper trepezius MTrPs. Settings and Design: Quasi experimental design was conducted with convenient sampling method. Materials and Methods: Patients ( n = 30 who fulfil the screening criteria were randomly assigned to Group A ( n = 15 treated with ischemic compression and ultrasound and Group B ( n = 15 treated with MET and ultrasound for 4 weeks and they were assessed at baseline and after 4 weeks. Outcome measures included pain intensity by visual analog scale (VAS and range of motion by universal goniometer. Statistical Analysis Used: Intergroup analysis was done with Mann-Whitney test and intragroup analysis was done with Wilcoxon signed-rank test. Results: Statistically, no significant ( P > 0.05 changes in the scores were found in the Groups A and B for VAS, and statistically significant ( P < 0.05 changes in the scores were found in the Groups A and B for Range of Motion (ROM with greater change scores in the Group B compared with Group A. Conclusion: Treatment program consisting of MET with ultrasound may be more effective in reducing pain and improve ROM in patients in upper trepezius MTrPs.

  19. A case study utilizing myofascial release, acupressure and trigger point therapy to treat bilateral "Stringhalt" in a 12 year old Akhal-Teke horse.

    Science.gov (United States)

    Brockman, Tammy

    2017-07-01

    "Stringhalt" is a horse condition that causes one or both hind legs to spasm when walking, trotting or backing. The condition is thought to be related to a neurological cause from either plant toxicity or peripheral nerve injury. The prognosis is poor and the horse's performance and quality of life can be affected. Treatment has included surgically cutting the digital extensors with varied results. The objective of the study is to utilize soft tissue release via acupressure, trigger point and myofascial release to decrease symptoms of stringhalt. The case study is a 12 year old Akhal-Teke horse of excellent pedigree. In 2011, she was caught in barbed wire overnight and sustained lacerations to the bone in her hindlimbs. Shortly after the injury the horse was placed in a stall for several months and was unable to walk or run, developing stringhalt. Currently, her condition is aggravated by stress and alleviated by certain types of massage (myofascial, acupressure, and trigger point release). The incidence of stringhalt occurs every 3-5 min, with more frequent and severe symptoms on the right hindlimb. The horse is unable to run or back up. Six 1 to 1½ hour bi-weekly treatments were performed. The treatments consisted of myofascial release at the cervical, sacrum and iliums, acupressure of the bladder meridian (including c-spine, t-spine, l-spine, and hamstring), and trigger point release of the iliacus. The stringhalt symptoms were monitored for 30 min prior to each of the 6 treatment sessions. After 6 treatments, the horse was observed running and standing in a position that promotes hip extension. She has not been able to do either since the injury. The frequency and severity of the spasms have decreased to every 10-20 min. The horse's owners report that her disposition, stress and quality of life are much improved. The results suggest that myofascial release, acupressure and trigger point therapy may be utilized to provide a positive treatment outcome in the

  20. A RANDOMIZED TRIAL TO STUDY THE COMPARISON OF TRIGGER POINT DRY NEEDLING VERSUS KINESIO TAPING TECHNIQUE IN MYOFASCIAL PAIN SYNDROME DURING A 3-MONTH FOLLOW UP

    Directory of Open Access Journals (Sweden)

    Emrullah Hayta

    2016-10-01

    Full Text Available Background: Managemen of myofascial pain syndrome (MPS is a current research subject since there is a small number of randomized studies comparing different management techniques. Multiple studies attempted to assess various treatment options including trigger point dry needling and kinesiotaping. We compared the effects of trigger point dry needling and kinesiotaping in the management of myofascial pain syndome during a 3-month follow-up period. Methods: In this prospective randomized studyin MPS patients with upper trapezius muscle trigger points, the effects of dry needling (n=28 and kinesiotaping (n=27 was compared with regard to the visual analog scale (VAS, neck disability index (NDI, and Nottingham health profile (NHP scores measured at the weeks 0, 4, and 12. Results: Both dry needling and kinesiotaping comparably reduced VAS scores measured at the weeks 4 and 12 and their efficacies were more remarkable at the week 12 (p<0.05. These interventions significantly reduced the NDI and NHP score and their effects were also more remarkable at the week 12; however, dry needling was found more effective (p<0.05. Conclusion: Overall, in current clinical settings, during the management of MPS, pain can be reduced comparably by both dry needling and kinesiotaping; however, restriction in the range of motionin neck region and quality of life are more remarkably reduced by dry needling. Both dry needling and kinesiotaping can provide an increasing effectiveness up to 12 weeks.

  1. Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome.

    Science.gov (United States)

    Kamanli, A; Kaya, A; Ardicoglu, O; Ozgocmen, S; Zengin, F Ozkurt; Bayik, Y

    2005-10-01

    Myofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. Several methods have been recommended for the inactivation of trigger points (TrP). This prospective, single-blind study was proposed to compare TrP injection with botulinum toxin type A (BTX-A) to dry needling and lidocaine injection in MPS. Eighty-seven trigger points (cervical and/or periscapular regions) in 23 female and six male patients with MPS were treated and randomly assigned to three groups: lidocaine injection (n=10, 32 TrP), dry needling (n=10, 33 TrP), and BTX-A injection (n=9, 22 TrP). Clinical assessment including cervical range of motion, TrP pain pressure threshold (PPT), pain scores (PS), and visual analog scales for pain, fatigue, and work disability were evaluated at entry and the end of the 4th week. Additionally, depression and anxiety were evaluated with the Hamilton depression and anxiety rating scales, and quality of life was assessed using the Nottingham health profile (NHP). The subjects were also asked to describe side effects. INJECTION PROCEDURE: One milliliter of 0.5% lidocaine was administered to each TrP in the lidocaine injection group, 10-20 IU of BTX-A to each TrP in the BTX-A group, and dry needling to each TrP in the last group, followed by stretching of the muscle groups involved. The patients were instructed to continue their home exercise programs. Pain pressure thresholds and PS significantly improved in all three groups. In the lidocaine group, PPT values were significantly higher than in the dry needle group, and PS were significantly lower than in both the BTX-A and dry needle groups. In all, visual analog scores significantly decreased in the lidocaine injection and BTX-A groups and did not significantly change in the dry needle group. Disturbance during the injection procedure was lowest in the lidocaine injection group. Quality of life scores assessed by NHP significantly improved in the lidocaine and BTX-A groups but not

  2. Diagnosis of myofascial pain syndrome.

    Science.gov (United States)

    Gerwin, Robert D

    2014-05-01

    Myofascial pain is one of the most common causes of pain. The diagnosis of myofascial pain syndrome (MPS) is made by muscle palpation. The source of the pain in MPS is the myofascial trigger point, a very localized region of tender, contracted muscle that is readily identified by palpation. The trigger point has well-described electrophysiologic properties and is associated with a derangement of the local biochemical milieu of the muscle. A proper diagnosis of MPS includes evaluation of muscle as a cause of pain, and assessment of associated conditions that have an impact on MPS. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Fluence-dependent effects of low-level laser therapy in myofascial trigger spots on modulation of biochemicals associated with pain in a rabbit model.

    Science.gov (United States)

    Hsieh, Yueh-Ling; Hong, Chang-Zern; Chou, Li-Wei; Yang, Shun-An; Yang, Chen-Chia

    2015-01-01

    Evidence strongly supports that low-level laser therapy (LLLT) is an effective physical modality for the treatment of pain associated with myofascial trigger points (MTrP). However, the effect of laser fluence (energy intensity in J/cm(2)) on biochemical regulation related to pain is unclear. To better understand the biochemical mechanisms modulated by high- and low-fluence LLLT at myofascial trigger spots (MTrSs; similar to human MTrPs) in skeletal muscles of rabbits, the levels of β-endorphin (β-ep), substance P (SP), tumor necrosis factor-α (TNF-α), and cyclooxygenase-2 (COX-2) were investigated in this study. New Zealand rabbits (2.5-3.0 kg in weight) were used in this study. High-fluence LLLT (27 J/cm(2)), low-fluence LLLT (4.5 J/cm(2)), or sham operations were applied on MTrSs of biceps femoris of rabbits for five sessions (one session per day). Effects of LLLT at two different fluences on biceps femoris, dorsal root ganglion (DRG), and serum were determined by β-ep, SP, TNF-α, and COX-2 immunoassays. LLLT irradiation with fluences of 4.5 and 27 J/cm(2) at MTrSs can significantly reduce SP level in DRG. LLLT with lower fluence of 4.5 J/cm(2) exerted lower levels of TNF-α and COX-2 expression in laser-treated muscle, but LLLT with higher fluence of 27 J/cm(2) elevated the levels of β-ep in serum, DRG, and muscle. This study demonstrated fluence-dependent biochemical effects of LLLT in an animal model on management of myofascial pain. The findings can contribute to the development of dosage guideline for LLLT for treating MTrP-induced pain.

  4. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    OpenAIRE

    Njoo, Khing Hua; Does, Emiel

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger point symptoms. Using the symptoms and signs as described by Simons' 1990 definition and two other former sets of criteria, 61 non-specific low back pain patients and 63 controls were examined in ge...

  5. Masticatory Muscle Sleep Background EMG Activity is Elevated in Myofascial TMD Patients

    Science.gov (United States)

    Raphael, Karen G.; Janal, Malvin N.; Sirois, David A.; Dubrovsky, Boris; Wigren, Pia E.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2013-01-01

    Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n=124) with a demographically matched control group without TMD (n=46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artifacts were removed. Results indicated that median background EMG during these non SB-event periods was significantly higher (p<.01) for women with myofascial TMD (median=3.31 μV and mean=4.98 μV) than for control women (median=2.83 μV and mean=3.88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0–10 numerical scale) on post sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance. PMID:24237356

  6. Masticatory muscle sleep background electromyographic activity is elevated in myofascial temporomandibular disorder patients.

    Science.gov (United States)

    Raphael, K G; Janal, M N; Sirois, D A; Dubrovsky, B; Wigren, P E; Klausner, J J; Krieger, A C; Lavigne, G J

    2013-12-01

    Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P myofascial TMD (median = 3·31 μV and mean = 4·98 μV) than for control women (median = 2·83 μV and mean = 3·88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance.

  7. Botulinum type A toxin complex for the relief of upper back myofascial pain syndrome: how do fixed-location injections compare with trigger point-focused injections?

    Science.gov (United States)

    Benecke, Reiner; Heinze, Axel; Reichel, Gerhard; Hefter, Harald; Göbel, Hartmut

    2011-11-01

    This was a prospective, randomized, double-blind, placebo-controlled, 12-week, multicenter study to evaluate the efficacy and tolerability of fixed location injections of botulinum type A toxin (BoNT-A, Dysport) in predetermined injection sites in patients with myofascial pain syndrome of the upper back. Patients with moderate-to-severe myofascial pain syndrome affecting cervical and/or shoulder muscles (10 trigger points, disease duration 6-24 months) and moderate-to-severe pain intensity were randomized to BoNT-A (N = 81) or saline (N = 72). Patients received treatment into 10 predetermined fixed injection sites in the head, neck, and shoulder (40 units of BoNT-A per site or saline, a total of 400 units of BoNT-A). The primary efficacy outcome was the proportion of patients with mild or no pain at week 5 (responders). Secondary outcomes included changes in pain intensity and the number of pain-free days per week. At week 5, 49% (37/76) of BoNT-A patients and 38% (27/72) of placebo patients had responded to treatment (P = 0.1873). Duration of daily pain was reduced in the BoNT-A group compared with the placebo group from week 5, with statistically significant differences at weeks 9 and 10 (P = 0.04 for both). Treatment was well tolerated. Fixed-location treatment with BoNT-A of patients with upper back myofascial pain syndrome did not lead to a significant improvement of the main target parameter in week 5 after treatment. Only in week 8 were significant differences found. Several secondary parameters, such as physicians' global assessment and patients' global assessment, significantly favored BoNT-A over placebo at weeks 8 and 12. Wiley Periodicals, Inc.

  8. 腰背部肌筋膜疼痛综合征激痛点的剪切波弹性模量研究%Study on the elastic modulus of shear wave for myofascial trigger points of lumber and back myofascial pain syndrome

    Institute of Scientific and Technical Information of China (English)

    李真; 吕恒勇; 任泽阳; 梁晓宁; 贾晓霞; 李硕; 牛雅莉; 李迎新; 郭瑞君

    2016-01-01

    Objective To investigate the clinical diagnostic value of elastography in myofascial pain syndrome by measuring the elastic properties of myofascial trigger points.Methods The elastic modulus of 30 myofascial trigger points from 15 female patients with myofascial pain syndrome and 8 normal points from 8 female healthy volunteers were measured by shear wave elastography.The mean,min,max,and standard deviation (SD) of elastic modulus in lesions,surrounding tissue of myofascial trigger point and normal points were recorded and compared,and the correlation between elasticity of myofascial trigger points and age,location were analyzed.Results The mean,min,max,and standard deviation of elastic modulus in lesion area of myofascial trigger point were significantly higher than that in surrounding tissue and normal points (P<0.05).There were no significant differences between lesion area of myofascial trigger point and normal points (P>0.05),and elastic modulus of myofascial trigger points bore no relation to age and location (P>0.05).Conclusions Shear wave elastic modulus can be used to differentiate lesion area and its adjacent area of trigger points and normal points,which will provide a new way to identify myofascial trigger point and new basis for palpation,thus has higher application value in clinical and research prospect.%目的 通过剪切波弹性成像(SWE)技术研究肌筋膜疼痛综合征激痛点的弹性特征,探索弹性超声技术在肌筋膜疼痛综合征临床诊断中的应用价值.方法 对8例女性健康志愿者的8个正常点和15例女性肌筋膜疼痛综合征患者腰背部30个激痛点行弹性超声检查,分别获得正常点、激痛点病灶区及邻近区定量分析取样框(Q-box)内弹性模量的均值(Mean)、最小值(Min)、最大值(Max)及标准差(SD);比较正常点、激痛点病灶区及临近区的弹性模量差异,探索激痛点弹性模量与患者年龄、所在部位的关系.结果 激痛点病灶区弹

  9. Experienced versus Inexperienced Interexaminer Reliability on Location and Classification of Myofascial Trigger Point Palpation to Diagnose Lateral Epicondylalgia: An Observational Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Raquel Mora-Relucio

    2016-01-01

    Full Text Available The purpose was to evaluate the interexaminer reliability of experienced and inexperienced examiners on location and classification of myofascial trigger points (MTrPs in two epicondylar muscles and the association between the MTrP found and the diagnosis of lateral epicondylalgia (LE. Fifty-two pianists (some suffered LE voluntarily participated in the study. Three physiotherapists (one inexperienced in myofascial pain examined, located, and marked MTrPs in the extensor carpi radialis brevis (ECRB and extensor digitorum communis (EDC muscles. Forearms were photographed and analyzed to establish the degree of agreement on MTrPs diagnosis. Data showed 81.73% and 77.88% of agreement on MTrP classification and 85.58% and 72.12% on MTrP location between the expert evaluators for ECRB and EDC, respectively. The agreement on MTrP classification between experienced and inexperienced examiners was 54.81% and 51.92% for ECRB and 50.00% and 55.77% for EDC. Also, agreement on MTrP location was 54.81% and 60.58% for ECRB and 48.08% and 48.08% for EDC. A strong association was found between presence of relevant MTrPs, LE diagnosis, and forearm pain when the examiners were experts. The analysis of location and classification of MTrPs in the epicondylar muscles through physical examination by experienced evaluators is reliable, reproducible, and suitable for diagnosing LE.

  10. Short-term effects of acupuncture and stretching on myofascial trigger point pain of the neck: a blinded, placebo-controlled RCT.

    Science.gov (United States)

    Wilke, J; Vogt, L; Niederer, D; Hübscher, M; Rothmayr, J; Ivkovic, D; Rickert, M; Banzer, W

    2014-10-01

    This trial aimed to evaluate the short-term effectiveness of acupuncture plus stretching to reduce pain and improve range of motion in patients afflicted by cervical myofascial pain syndrome. Randomized, blinded, placebo-controlled crossover study. Nineteen patients (11 females, eight males, 33 ± 14 years) with myofascial neck pain in randomized order received the following treatments with one week washout between: acupuncture, acupuncture plus stretching, and placebo laser acupuncture. Mechanical pain threshold (MPT, measured with a pressure algometer) represented the primary outcome. Secondary outcomes were motion-related pain (Visual Analogue Scale, VAS) and cervical range of motion (ROM, recorded by means of an ultrasonic 3D movement analysis system). Outcomes were assessed immediately prior as well as 5, 15 and 30 min post treatment. Friedman tests with post hoc Bonferroni-Holm correction were applied to compare differences between treatments. Both acupuncture as well as acupuncture plus stretching increased MPT by five, respectively, 11 percent post treatment. However, only acupuncture in combination with stretching was superior to placebo (pstretching, ROM was significantly increased in the frontal and the transversal plane compared to placebo (pstretching could represent a suitable treatment option to improve cervical movement behavior and reduce trigger point pain in the short-term. However, additional studies further discriminating the placebo effects are still warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Change and role of biochemical milieu in the site near to myofascial trigger points%肌筋膜疼痛触发点内理化环境的改变及其作用

    Institute of Scientific and Technical Information of China (English)

    黄丹婧; 吕娇娇; 黄强民; 吴小丽

    2011-01-01

    背景:以往研究对肌筋膜疼痛触发点的研究主要集中在发病特点和临床治疗方面,有关肌筋膜疼痛触发点局部组织的理化环境变化及其作用的研究较少.目的:总结并讨论肌筋膜疼痛触发点局部组织的理化环境变化及各种理化因子在肌筋膜疼痛中的作用.方法:由第一作者用计算机检索中国期刊全文数据库(CNKI:2000/2010)和Medline数据库(2000/2010),检索词分别为"肌筋膜疼痛触发点、致痛因子、神经系统致敏、伤害性感受器"和"myofascial trigger points,algogenic substance,nervous system sensitization,nociceptors".共检索到159篇文章,按纳入和排除标准对文献进行筛选,共纳入30篇文章.从肌筋膜疼痛触发点局部理化环境变化及各种理化因子的作用两方面进行总结,对理化环境在肌筋膜疼痛触发点发病中的重要作用进行介绍.结果与结论:肌筋膜疼痛触发点局部肌肉组织各种理化因子发生显著性变化,表现为各神经血管反应物质增多,炎症递质和致痛因子浓度明显升高.但是国内外对肌筋膜疼痛触发点理化环境变化及其作用的相关研究较少,了解仍不深入.%BACKGROUND: Most previous studies of sites near to myofascial trigger points focus on pathological characteristics and clinical treatments. The biochemical milieu and role in the sites near to myofascial trigger points are poorly understood.OBJECTIVE: To summarize the biochemical milieu in the sites near to myofascial trigger points and the role of various biochemical factors in myofascial pains.METHODS: A computer-based retrieval was performed by the first author using the key words“myofascial trigger points, algogenic substance, nervous system sensitization, nociceptors” in English and Chinese to search papers published between 2000 and 2010 in CNKI and Medline databases. A total of 159 papers were retrieved. According to inclusion and exclusion criteria, 30 papers were incl

  12. Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study

    Science.gov (United States)

    Pacheco-da-Costa, Soraya; Hita-Herranz, Edgar

    2017-01-01

    Background: Nonspecific shoulder pain has a high prevalence in older adults and causes functional alterations. Furthermore, there are difficulties in establishing a clinical diagnosis, effective treatments are lacking, and little evidence has been found regarding the use of invasive physical therapy techniques in this age group. Purpose: To determine the efficacy of a single physical therapy intervention with deep dry needling (DDN) on latent and active myofascial trigger points (MTrPs) in older adults with nonspecific shoulder pain. Methods: This pilot study is a single-blind, randomized, controlled clinical trial that included 20 participants, aged 65 years and older, who were diagnosed with nonspecific shoulder pain. The study was approved by the Clinical Research Ethics Committee of the area. Participants were recruited at their homes or at a care center and were randomly assigned into either an experimental group (n = 10), which received a session of DDN on 1 active and 1 latent MTrP of the infraspinatus muscle, or a control group (n = 10), which received a session of DDN on only 1 active MTrP. A blind examiner assessed the pain intensity, pain pressure threshold on the anterior deltoid, and extensor carpi radialis brevis muscles and grip strength before, immediately after, and 1 week after the intervention. Results: Statistically significant differences (P < .05) in the pressure pain thresholds (PPTs) of the extensor carpi radialis brevis were found in the experimental group in both posttreatment assessments. Moreover, the effect size values (d Cohen) varied from small for grip strength (0.017-0.36) to moderate for the pain intensity (0.46-0.78) and PPT in the anterior deltoid (0.49-0.66) and to large for the PPT in the extensor carpi radialis brevis (1.06-1.58). Conclusions: A single physical therapy intervention with DDN on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle may increase the PPT of the extensor carpi radialis

  13. Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study.

    Science.gov (United States)

    Calvo-Lobo, César; Pacheco-da-Costa, Soraya; Hita-Herranz, Edgar

    Nonspecific shoulder pain has a high prevalence in older adults and causes functional alterations. Furthermore, there are difficulties in establishing a clinical diagnosis, effective treatments are lacking, and little evidence has been found regarding the use of invasive physical therapy techniques in this age group. To determine the efficacy of a single physical therapy intervention with deep dry needling (DDN) on latent and active myofascial trigger points (MTrPs) in older adults with nonspecific shoulder pain. This pilot study is a single-blind, randomized, controlled clinical trial that included 20 participants, aged 65 years and older, who were diagnosed with nonspecific shoulder pain. The study was approved by the Clinical Research Ethics Committee of the area. Participants were recruited at their homes or at a care center and were randomly assigned into either an experimental group (n = 10), which received a session of DDN on 1 active and 1 latent MTrP of the infraspinatus muscle, or a control group (n = 10), which received a session of DDN on only 1 active MTrP. A blind examiner assessed the pain intensity, pain pressure threshold on the anterior deltoid, and extensor carpi radialis brevis muscles and grip strength before, immediately after, and 1 week after the intervention. Statistically significant differences (P < .05) in the pressure pain thresholds (PPTs) of the extensor carpi radialis brevis were found in the experimental group in both posttreatment assessments. Moreover, the effect size values (d Cohen) varied from small for grip strength (0.017-0.36) to moderate for the pain intensity (0.46-0.78) and PPT in the anterior deltoid (0.49-0.66) and to large for the PPT in the extensor carpi radialis brevis (1.06-1.58). A single physical therapy intervention with DDN on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle may increase the PPT of the extensor carpi radialis brevis muscle area immediately following and 1 week after

  14. The efficacy of progressive muscle relaxation in combination with spinal manipulative therapy on active trigger points of the trapezius muscle

    OpenAIRE

    2013-01-01

    M.Tech. (Chiropractic) Purpose: The trapezius muscle is thought to be the muscle most commonly associated with the presence of active myofascial trigger points (MFTP’s). Studies of the trapezius muscle clearly show that muscular activity significantly increases in response to psychological stress. Cervical spine manipulation has been proven to be highly effective in the treatment of active MFTP’s and muscular tension. Progressive muscle relaxation (PMR) therapy is frequently utilized as a ...

  15. Range of motion and cervical myofascial pain.

    Science.gov (United States)

    Wilke, J; Niederer, D; Fleckenstein, J; Vogt, L; Banzer, W

    2016-01-01

    Several studies investigating myofascial pain syndrome include assessments of range of motion (ROM) as a diagnostic criterion. However, the value of ROM in this context has not yet been evaluated in controlled clinical studies. We aimed to examine whether patients with myofascial pain syndrome display alterations of ROM when compared to healthy subjects. Twenty-two individuals (13 females, 9 males; aged 33.4 ± 13.9 yrs) afflicted with active myofascial trigger points in the upper trapezius muscle as well as 22 age and sex matched healthy controls were included. All subjects underwent an examination of maximal active cervical ROM in flexion/extension assessed by means of a 3D ultrasonic movement analysis system (30 Hz; Zebris CMS 70). In the patients group, pressure pain threshold (PPT) of the trigger points was determined using a pressure algometer. Maximum range of motion in the sagittal plane did not differ between individuals with MTrP (125.9 ± 23.2°, 95% CI: 116.2-135.6°) and asymptomatic subjects (128.2 ± 20.4°, 95% CI: 119.7-136.7°; p > .05). In patients, PPT (1.7 ± .6, 95% CI: 1.5-1.9) was not correlated with cervical mobility (r = -.13; p > .05). Based on these pilot data, range of motion in flexion/extension is not a valid criterion for the detection of myofascial trigger points. Additional research incorporating movement amplitudes in other anatomical planes and additional afflicted muscles should be conducted in order to further delineate the relative impact of MTrP on range of motion.

  16. The neurophysiological effects of dry needling in patients with upper trapezius myofascial trigger points: study protocol of a controlled clinical trial.

    Science.gov (United States)

    Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

    2013-05-28

    Dry needling (DN) is an effective method for the treatment of myofascial trigger points (MTrPs). There is no report on the neurophysiological effects of DN in patients with MTrPs. The aim of the present study will be to assess the immediate neurophysiological efficacy of deep DN in patients with upper trapezius MTrPs. A prospective, controlled clinical trial was designed to include patients with upper trapezius MTrPs and volunteered healthy participants to receive one session of DN. The primary outcome measures are neuromuscular junction response and sympathetic skin response. The secondary outcomes are pain intensity and pressure pain threshold. Data will be collected at baseline and immediately after intervention. This study protocol has been approved by the Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences. The results of the study will be disseminated in a peer-reviewed journal and presented at international congresses.

  17. Cisplatin triggers platelet activation.

    Science.gov (United States)

    Togna, G I; Togna, A R; Franconi, M; Caprino, L

    2000-09-01

    Clinical observations suggest that anticancer drugs could contribute to the thrombotic complications of malignancy in treated patients. Thrombotic microangiopathy, myocardial infarction, and cerebrovascular thrombotic events have been reported for cisplatin, a drug widely used in the treatment of many solid tumours. The aim of this study is to explore in vitro cisplatin effect on human platelet reactivity in order to define the potentially active role of platelets in the pathogenesis of cisplatin-induced thrombotic complications. Our results demonstrate that cisplatin increases human platelet reactivity (onset of platelet aggregation wave and thromboxane production) to non-aggregating concentrations of the agonists involving arachidonic acid metabolism. Direct or indirect activation of platelet phospholipase A(2) appears to be implicated. This finding contributes to a better understanding of the pathogenesis of thrombotic complications occurring during cisplatin-based chemotherapy.

  18. A afferent fibers are involved in the pathology of central changes in the spinal dorsal horn associated with myofascial trigger spots in rats.

    Science.gov (United States)

    Meng, Fei; Ge, Hong-You; Wang, Yong-Hui; Yue, Shou-Wei

    2015-11-01

    A afferent fibers have been reported to participate in the development of the central sensitization induced by inflammation and injuries. Current evidence suggests that myofascial trigger points (MTrPs) induce central sensitization in the related spinal dorsal horn, and clinical studies indicate that A fibers are associated with pain behavior. Because most of these clinical studies applied behavioral indexes, objective evidence is needed. Additionally, MTrP-related neurons in dorsal root ganglia and the spinal ventral horn have been reported to be smaller than normal, and these neurons were considered to be related to A fibers. To confirm the role of A fibers in MTrP-related central changes in the spinal dorsal horn, we studied central sensitization as well as the size of neurons associated with myofascial trigger spots (MTrSs, equivalent to MTrPs in humans) in the biceps femoris muscle of rats and provided some objective morphological evidence. Cholera toxin B subunit-conjugated horseradish peroxidase was applied to label the MTrS-related neurons, and tetrodotoxin was used to block A fibers specifically. The results showed that in the spinal dorsal horn associated with MTrS, the expression of glutamate receptor (mGluR1α/mGluR5/NMDAR1) increased, while the mean size of MTrS-related neurons was smaller than normal. After blocking A fibers, these changes reversed to some extent. Therefore, we concluded that A fibers participated in the development and maintenance of the central sensitization induced by MTrPs and were related to the mean size of neurons associated with MTrPs in the spinal dorsal horn.

  19. A Comparative Pilot Study to Evaluate the Adjunctive Role of Levosulpride with Trigger Point Injection Therapy in the Management of Myofascial Pain Syndrome of Orofacial Region.

    Science.gov (United States)

    Gupta, Pranav; Singh, Virendra; Sethi, Sujata; Kumar, Arun

    2014-12-01

    To evaluate the effect of therapy with levosulpride combined with conventional trigger point injection therapy in terms of pain and depression in the chronic myofascial pain syndrome patients. This was a comparative prospective study in which subjects with at least one trigger point and symptom duration of at least 3 months were recruited and randomized into two groups. Group A subjects received trigger point injections with 0.5 % bupivacaine and tablet levosulpride and group B received trigger point injections and a placebo. Subjects were assessed for pain with visual analog scale (VAS) and depression with Beck's depression inventory (BDI) at the follow-up periods of 1, 4, 6 and 12 weeks. The treatment effect was measured in terms of mean difference of BDI and VAS scores at various studied intervals from the baseline values. The sample was composed of 15 subjects with 8 in group A (6 females and 2 males, with a mean age of 41.88 ± 15.13 years, disease duration of 12.37 ± 16.11 months) and 7 in group B (6 females and 1 male, with a mean age of 43.86 ± 12.34 years, disease duration of 9.64 ± 9.34 months). The mean baseline VAS score and BDI score was 6.75 ± 1.03 in group A and 6.86 ± 1.06 in group B and 24.25 ± 10.20 in group A and 24.43 ± 11.16 in group B respectively. The mean difference of VAS scores at 12th week interval from the baseline values was highly significant. Although the mean difference of VAS scores at all the other intervals and mean difference of BDI scores at all the intervals was statistically nonsignificant, there was improvement in the mean differences at all the follow-up intervals in terms of both pain as well as depression. The combined therapy with conventional trigger point injection and levosulpride as antidepressant significantly reduce pain and depression in the study subjects suffering from chronic myofascial pain with moderate to severe depression in the orofacial region.

  20. Fascial components of the myofascial pain syndrome.

    Science.gov (United States)

    Stecco, Antonio; Gesi, Marco; Stecco, Carla; Stern, Robert

    2013-08-01

    Myofascial pain syndrome (MPS) is described as the muscle, sensory, motor, and autonomic nervous system symptoms caused by stimulation of myofascial trigger points (MTP). The participation of fascia in this syndrome has often been neglected. Several manual and physical approaches have been proposed to improve myofascial function after traumatic injuries, but the processes that induce pathological modifications of myofascial tissue after trauma remain unclear. Alterations in collagen fiber composition, in fibroblasts or in extracellular matrix composition have been postulated. We summarize here recent developments in the biology of fascia, and in particular, its associated hyaluronan (HA)-rich matrix that address the issue of MPS.

  1. Remote Dose-Dependent Effects of Dry Needling at Distant Myofascial Trigger Spots of Rabbit Skeletal Muscles on Reduction of Substance P Levels of Proximal Muscle and Spinal Cords

    Directory of Open Access Journals (Sweden)

    Yueh-Ling Hsieh

    2014-01-01

    Full Text Available Background. Dry needling at distant myofascial trigger points is an effective pain management in patients with myofascial pain. However, the biochemical effects of remote dry needling are not well understood. This study evaluates the remote effects of dry needling with different dosages on the expressions of substance P (SP in the proximal muscle, spinal dorsal horns of rabbits. Methods. Male New Zealand rabbits (2.5–3.0 kg received dry needling at myofascial trigger spots of a gastrocnemius (distant muscle in one (1D or five sessions (5D. Bilateral biceps femoris (proximal muscles and superficial laminaes of L5-S2, T2-T5, and C2-C5 were sampled immediately and 5 days after dry needling to determine the levels of SP using immunohistochemistry and western blot. Results. Immediately after dry needling for 1D and 5D, the expressions of SP were significantly decreased in ipsilateral biceps femoris and bilateral spinal superficial laminaes (P<.05. Five days after dry needling, these reduced immunoactivities of SP were found only in animals receiving 5D dry needling (P<.05. Conclusions. This remote effect of dry needling involves the reduction of SP levels in proximal muscle and spinal superficial laminaes, which may be closely associated with the control of myofascial pain.

  2. Remote dose-dependent effects of dry needling at distant myofascial trigger spots of rabbit skeletal muscles on reduction of substance P levels of proximal muscle and spinal cords.

    Science.gov (United States)

    Hsieh, Yueh-Ling; Yang, Chen-Chia; Liu, Szu-Yu; Chou, Li-Wei; Hong, Chang-Zern

    2014-01-01

    Dry needling at distant myofascial trigger points is an effective pain management in patients with myofascial pain. However, the biochemical effects of remote dry needling are not well understood. This study evaluates the remote effects of dry needling with different dosages on the expressions of substance P (SP) in the proximal muscle, spinal dorsal horns of rabbits. Male New Zealand rabbits (2.5-3.0 kg) received dry needling at myofascial trigger spots of a gastrocnemius (distant muscle) in one (1D) or five sessions (5D). Bilateral biceps femoris (proximal muscles) and superficial laminaes of L5-S2, T2-T5, and C2-C5 were sampled immediately and 5 days after dry needling to determine the levels of SP using immunohistochemistry and western blot. Immediately after dry needling for 1D and 5D, the expressions of SP were significantly decreased in ipsilateral biceps femoris and bilateral spinal superficial laminaes (P dry needling, these reduced immunoactivities of SP were found only in animals receiving 5D dry needling (P dry needling involves the reduction of SP levels in proximal muscle and spinal superficial laminaes, which may be closely associated with the control of myofascial pain.

  3. Eficácia da desativação dos pontos-gatilho miofasciais para o controle do zumbido Efficacy of myofascial trigger point deactivation for tinnitus control

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    Carina Bezerra Rocha

    2012-12-01

    Full Text Available Dor crônica nas imediações do ouvido pode influenciar o zumbido. OBJETIVO: Investigar a eficácia da desativação de pontos-gatilho miofasciais na melhora do zumbido. MÉTODO: Ensaio clínico randomizado com 71 pacientes com zumbido e síndrome dolorosa miofascial. O Grupo Experimental (n = 37 foi submetido a 10 sessões de desativação dos pontos-gatilho miofasciais e o Grupo Controle (n = 34, a 10 sessões de desativação placebo. RESULTADOS: O tratamento do Grupo Experimental foi eficaz para o controle do zumbido (p Chronic pain in areas surrounding the ear may influence tinnitus. OBJECTIVE: To investigate the efficacy of myofascial trigger point deactivation for the relief of tinnitus. METHOD: A double-blind randomized clinical trial enrolled 71 patients with tinnitus and myofascial pain syndrome. The experimental group (n = 37 underwent 10 sessions of myofascial trigger point deactivation and the control group (n = 34, 10 sessions with sham deactivation. RESULTS: Treatment of the experimental group was effective for tinnitus relief (p < 0.001. Pain and tinnitus relieves were associated (p = 0.013, so were the ear with worst tinnitus and the side of the body with more pain (p < 0.001. The presence of temporary tinnitus modulation (increase or decrease upon initial muscle palpation was frequent in both groups, but its temporary decrease was related to the persistent relief at the end of treatment (p = 0.002. CONCLUSION: Besides medical and audiological investigation, patients with tinnitus should also be checked for: 1 presence of myofascial pain surrounding the ear; 2 laterality between both symptoms; 3 initial decrease of tinnitus during muscle palpation. Treating this specific subgroup of tinnitus patients with myofascial trigger point release may provide better results than others described so far.

  4. Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study.

    Science.gov (United States)

    Müller, Cristina Emöke Erika; Aranha, Maria Fernanda Montans; Gavião, Maria Beatriz Duarte

    2015-04-01

    Chronic pain has been often associated with myofascial pain syndrome (MPS), which is determined by myofascial trigger points (MTrP). New features have been tested for MTrP diagnosis. The aim of this study was to evaluate two-dimensional ultrasonography (2D US) and ultrasound elastography (UE) images and elastograms of upper trapezius MTrP during electroacupuncture (EA) and acupuncture (AC) treatment. 24 women participated, aged between 20 and 40 years (M ± SD = 27.33 ± 5.05) with a body mass index ranging from 18.03 to 27.59 kg/m2 (22.59 ± 3.11), a regular menstrual cycle, at least one active MTrP at both right (RTPz) and left trapezius (LTPz) and local or referred pain for up to six months. Subjects were randomized into EA and AC treatment groups and the control sham AC (SHAM) group. Intensity of pain was assessed by visual analogue scale; MTrP mean area and strain ratio (SR) by 2D US and UE. A significant decrease of intensity in general, RTPz, and LTPz pain was observed in the EA group (p = 0.027; p < 0.001; p = 0.005, respectively) and in general pain in the AC group (p < 0.001). Decreased MTrP area in RTPz and LTPz were observed in AC (p < 0.001) and EA groups (RTPz, p = 0.003; LTPz, p = 0.005). Post-treatment SR in RTPz and LTPz was lower than pre-treatment in both treatment groups. 2D US and UE effectively characterized MTrP and surrounding tissue, pointing to the possibility of objective confirmation of subjective EA and AC treatment effects. © The Author(s) 2014.

  5. A Comparative Study of Trigger Point Therapy with Local Anaesthetic (0.5 % Bupivacaine) Versus Combined Trigger Point Injection Therapy and Levosulpiride in the Management of Myofascial Pain Syndrome in the Orofacial Region.

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    Gupta, Pranav; Singh, Virendra; Sethi, Sujata; Kumar, Arun

    2016-09-01

    To compare the efficacy of combined local anesthetic injection with 0.5 % bupivacaine and levosulpiride versus local anesthetic injection alone on outcome measures including levels of pain intensity and depression in the management of myofascial pain syndrome in orofacial region. This was a prospective, randomized, controlled and open-label comparative clinical study. Seventy-four patients diagnosed to have myofascial pain syndrome and fulfilling the inclusion criteria were enrolled for the study. Patients were randomly assigned into 2 groups. Group A received local anesthetic injection (0.5 % bupivacaine) on trigger points and Group B received combined trigger point injection therapy and 50 mg of tablet Levosulpiride orally B.I.D. They were assessed for pain intensity and depression at baseline and at follow-up of 1, 4, 6 and 12 week intervals. The mean age of patients was 44.54 + 15.977 years in group A and 39.97 + 14.107 years in group B (P value = 0.2). Group A comprised of 25 females (67.567 %) and 12 males (32.432 %) while group B had 27 females (75 %) and 9 males (25 %). 70.27 % were diagnosed with moderate depression in group A and 75 % in group B. 18.91 % in group A and 19.44 % in group B were diagnosed with severe depression. When the VAS score and BDI score was compared at the follow-up intervals with the baseline scores in both treatment groups, the mean difference was highly significant at all the follow-up intervals. However when the relative efficacies of two interventions were compared between the two groups, improvement in pain was significant at all the follow-up intervals except the 1st week follow-up whereas the improvement in depression was non-significant at 1st and 4th week interval while it was highly significant at 6th and 12th week intervals. The combined therapy with trigger point injection and levosulpiride as antidepressant significantly reduces pain and depression in the study subjects suffering from chronic

  6. COMPARISON OF ACTIVE RELEASE TECHNIQUE AND MYOFASCIAL RELEASE TECHNIQUE ON PAIN, GRIP STRENGTH & FUNCTIONAL PERFORMANCE IN PATIENTS WITH CHRONIC LATERAL EPICONDYLITIS

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    Parth Trivedi

    2014-06-01

    Full Text Available Background & Purpose: Lateral epicondylitis is the most common lesion of the elbow. Tennis elbow or lateral epicondylitis is defined as a syndrome of pain in the wrist extensor muscles at or near their lateral epicondyle origin or pain directly over the lateral epicondyle. So, the aim of this study was to compare the effectiveness of Active Release Technique (ART and Myofascial Release Technique (MFR in the treatment of Chronic Lateral Epicondylitis (CLE. Methodology: The study included thirty-six patients with Chronic Lateral Epicondylitis of age group range between 30 to 45 years. Patients were randomly divided into three groups: Control Group (A, Active Release Technique Group (B and Myofascial Release Technique Group (C. The patients were treated for 4 weeks and three outcome measures: 0-10 NPRS, Hand Dynamometer and PRTEE were taken for assessment and analysis at baseline and after 4th weeks was done. Result: In this study the result showed that Active Release Technique and Myofascial Release Technique were effective in all three outcome measures when compared to Control Group. Myofascial Release Technique was more effective in improving grip strength & reducing pain & disability when compared to Active Release Technique.(p<0.05 Conclusion: Active Release Technique and Myofascial Release Technique are effective in patients with Chronic Lateral Epicondylitis. Myofascial Release Technique demonstrated better outcomes than Active Release Technique in the management of Chronic Lateral Epicondylitis.

  7. Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration.

    Science.gov (United States)

    Martín-Pintado-Zugasti, Aitor; Pecos-Martin, Daniel; Rodríguez-Fernández, Ángel Luis; Alguacil-Diego, Isabel María; Portillo-Aceituno, Alicia; Gallego-Izquierdo, Tomás; Fernandez-Carnero, Josue

    2015-10-01

    To investigate the effect of ischemic compression (IC) versus placebo and control on reducing postneedling soreness of 1 latent myofascial trigger point and on improving cervical range of motion (CROM) in asymptomatic subjects. A randomized, double-blind, placebo-controlled trial with 72-hour follow-up. A university community. Asymptomatic volunteers (N = 90: 40 men and 50 women) aged 18 to 39 years (mean ± standard deviation [SD]: 22 ± 3 years). All subjects received a dry needling application over the upper trapezius muscle. Participants were then randomly divided into 3 groups: a treatment group who received IC over the needled trapezius muscle, a placebo group who received sham IC, and a control group who did not receive any treatment after needling. Visual analog scale (VAS; during needling, at posttreatment and 6, 12, 24, 48, and 72 hours) and CROM (at preneedling, postneedling, and 24 and 72 hours). Subjects in the IC group showed significantly lower postneedling soreness than the placebo and the control group subjects immediately after treatment (mean ± standard deviation [SD]: IC, 20.1 ± 4.8; placebo, 36.7 ± 4.8; control, 34.8 ± 3.6) and at 48 hours (mean ± SD: IC, 0.6 ± 1; placebo, 4.8 ± 1; control, 3.8 ± 0.7). In addition, subjects in the dry needling+IC group showed significantly lower postneedling soreness duration (P = .026). All subjects significantly improved CROM in contralateral lateroflexion and both homolateral and contralateral rotations, but only the improvements found in the IC group reached the minimal detectable change. IC can potentially be added immediately after dry needling of myofascial trigger point in the upper trapezius muscle because it has the effect of reducing postneedling soreness intensity and duration. The combination of dry needling and IC seems to improve CROM in homolateral and contralateral cervical rotation movements. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by

  8. Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

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    Pavlos Bobos

    2016-01-01

    Full Text Available Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs. Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67 completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05. However, no differences were found within and between the therapeutic groups (p<0.05 in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

  9. Efficacy of myofascial trigger point dry needling in the prevention of pain after total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial.

    Science.gov (United States)

    Mayoral, Orlando; Salvat, Isabel; Martín, María Teresa; Martín, Stella; Santiago, Jesús; Cotarelo, José; Rodríguez, Constantino

    2013-01-01

    The aim of this study was to determine whether the dry needling of myofascial trigger points (MTrPs) is superior to placebo in the prevention of pain after total knee arthroplasty. Forty subjects were randomised to a true dry needling group (T) or to a sham group (S). All were examined for MTrPs by an experienced physical therapist 4-5 hours before surgery. Immediately following anesthesiology and before surgery started, subjects in the T group were dry needled in all previously diagnosed MTrPs, while the S group received no treatment in their MTrPs. Subjects were blinded to group allocation as well as the examiner in presurgical and follow-up examinations performed 1, 3, and 6 months after arthroplasty. Subjects in the T group had less pain after intervention, with statistically significant differences in the variation rate of the visual analogue scale (VAS) measurements 1 month after intervention and in the need for immediate postsurgery analgesics. Differences were not significant at 3- and 6-month follow-up examinations. In conclusion, a single dry needling treatment of MTrP under anaesthesia reduced pain in the first month after knee arthroplasty, when pain was the most severe. Results show a superiority of dry needling versus placebo. An interesting novel placebo methodology for dry needling, with a real blinding procedure, is presented.

  10. Postneedling soreness after deep dry needling of a latent myofascial trigger point in the upper trapezius muscle: Characteristics, sex differences and associated factors.

    Science.gov (United States)

    Martín-Pintado-Zugasti, Aitor; Rodríguez-Fernández, Ángel Luis; Fernandez-Carnero, Josue

    2016-04-27

    Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent myofascial trigger point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.

  11. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility.

    Science.gov (United States)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders H; Hartvigsen, Jan

    2011-04-01

    A diagnosis of Myofascial Pain Syndrome (MPS) requires palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies currently exist from which to draw firm conclusions regarding the robustness of TP examination. An inter-observer agreement study was conducted using two experienced and two inexperienced clinicians. All performed standardized palpation of the upper Trapezius musculature, judging the clinical relevance of TP(s) using clinician global assessment (GA). A random case mix of 81 female participants was examined, 14 asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor skills training and video feedback analysis to improve protocol standardization. Kappa co-efficient calculations indicated good agreement between the experienced pairing (κ = 0.63), moderate agreement between the mixed pairings (κ = 0.35 and 0.47) and poor agreement between the inexperienced pairing (κ = 0.22). Inter-observer agreement was not stable with the experienced pairing exhibiting a sharp decline in agreement during the latter portion of the study. Identification of clinically relevant TPs of the upper Trapezius musculature is reproducible when performed by two experienced clinicians, however, a mixed observer pairing can yield acceptable agreement. A protracted period of data collection may be detrimental to inter-observer agreement; more investigation is needed in this regard.

  12. The effect of dry needling on pain, pressure pain threshold and disability in patients with a myofascial trigger point in the upper trapezius muscle.

    Science.gov (United States)

    Ziaeifar, Maryam; Arab, Amir Massoud; Karimi, Noureddin; Nourbakhsh, Mohammad Reza

    2014-04-01

    Dry needling (DN) has been used recently by physical therapists as a therapy of choice for patients with myofascial trigger points (TrP). The purpose of this randomized controlled trial was to investigate the effect of DN in the treatment of TrPs in the upper trapezius (UT) muscle. A sample of convenience of 33 patients with TrP in the UT muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 16). The treatment protocol for the standard group consisted of trigger point compression technique (TCT) on MTP, while the patients in the experimental group received DN. Pain intensity and pressure pain thresholds were assessed for both groups before and after the treatment sessions. In addition, the Disability of Arm, Hand, and Shoulder (DASH) was administered. Statistical analysis (paired t-test) revealed a significant improvement in pain, PPT and DASH scores after treatment in the experimental (DN) and standard (TCT) group compared with before treatment (P < 0.05). The ANCOVA revealed significant differences between the DN and TCT groups on the post-measurement VAS score (P = 0.01). There was, however, no significant difference between the two groups on the post-measurement score of the PPT (P = 0.08) and DASH (P = 0.34). DN produces an improvement in pain intensity, PPT and DASH and may be prescribed for subjects with TrP in UT muscles especially when pain relief is the goal of the treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Paraspinal stimulation combined with trigger point needling and needle rotation for the treatment of myofascial pain: a randomized sham-controlled clinical trial.

    Science.gov (United States)

    Couto, Cláudio; de Souza, Izabel Cristina C; Torres, Iraci L S; Fregni, Felipe; Caumo, Wolnei

    2014-03-01

    There are different types and parameters of dry needling (DN) that can affect its efficacy in the treatment of pain that have not been assessed properly. To test the hypothesis that either multiple deep intramuscular stimulation therapy multiple deep intramuscular stimulation therapy (MDIMST) or TrP lidocaine injection (LTrP-I) is more effective than a placebo-sham for the treatment of myofascial pain syndrome (MPS) and that MDIMST is more effective than LTrP-I for improving pain relief, sleep quality, and the physical and mental state of the patient. Seventy-eight females aged 20 to 40 who were limited in their ability to perform active and routine activities due to MPS in the previous 3 months were recruited. The participants were randomized into 1 of the 3 groups as follows: placebo-sham, LTrP-I, or MDIMST. The treatments were provided twice weekly over 4 weeks using standardized MDIMST and LTrP-I protocols. There was a significant interaction (time vs. group) for the main outcomes. Compared with the sham-treated group, MDIMST and LTrP-I administration improved pain scores based on a visual analog scale, the pain pressure threshold (Pphysical and mental health scores. This study highlighted the greater efficacy of MDIMST over the placebo-sham and LTrP-I and indicated that both active treatments are more effective than placebo-sham for MPS associated with limitations in active and routine activities.

  14. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Liu, Lin; Huang, Qiang-Min; Liu, Qing-Guang; Thitham, Nguyen; Li, Li-Hui; Ma, Yan-Tao; Zhao, Jia-Min

    2017-07-08

    To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP). PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017. Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included. Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up. A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], -1.06; 95% confidence interval [CI], -1.77 to -0.36; P=.003) and functional disability (SMD, -0.76; 95% CI, -1.46 to -0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55-1.11; Pdry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Deep dry needling of trigger points located in the lateral pterygoid muscle: Efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction.

    Science.gov (United States)

    Gonzalez-Perez, Luis-Miguel; Infante-Cossio, Pedro; Granados-Nunez, Mercedes; Urresti-Lopez, Francisco-Javier; Lopez-Martos, Ricardo; Ruiz-Canela-Mendez, Pablo

    2015-05-01

    To determine whether deep dry needling (DDN) of trigger points (TPs) in the lateral pterygoid muscle (LPM) would significantly reduce pain and improve function, compared with methocarbamol/paracetamol medication. Forty-eight patients with chronic myofascial pain located in the LPM were selected and randomly assigned to one of two groups (DDN test group, n=24; drug-treated control group, n=24). The test group received three applications of needling of the LPM once per week for three weeks, while control group patients were given two tablets of a methocarbamol/paracetamol combination every six hours for three weeks. Assessments were carried out pre-treatment, 2 and 8 weeks after finishing the treatment. A statistically significant difference (p<0.05) was detected for both groups with respect to pain reduction at rest and with mastication, but the DDN test group had significantly better levels of pain reduction. Moreover, statistically significant differences (p<0.05) up to day 70 in the test group were seen with respect to maximum mouth opening, laterality and protrusion movements compared with pre-treatment values. Pain reduction in the test group was greater as a function of pain intensity at baseline. The evaluation of efficacy as assessed both by patients/investigators was better for the test group. 41% of the patients receiving the combination drug treatment described unpleasant side effects (mostly drowsiness). DDN of TPs in the LPM showed better efficacy in reducing pain and improving maximum mouth opening, laterality, and protrusion movements compared with methocarbamol/paracetamol treatment. No adverse events were observed with respect to DDN.

  16. [Features of autonomic dysfunction in myofascial pain syndromes cervicobrachial localization].

    Science.gov (United States)

    Морозова, О Г; Ярошевский, А А; Липинская, Я В

    2015-01-01

    The relevance of this study is due to the prevalence of autonomic disorders and musculoskeletal pain, especially among the young people of working age. In recent years, many authors in scientific works have been highlighted aspects of mutual development myofascial and autonomic dysfunction, which is caused by neurophysiological preconditions and anatomical and topographical relationships that need to be considered in the diagnostic and therapeutic approaches. To study the characteristics of the formation and flow of autonomic dysfunction syndrome with paroxysmal and permanent types of flow in patients with myofascial pain syndromes cervicobrachial localization. Using clinical neurological, vertebral neurological, neuropsychological methods of studying the severity of pain (visual analogue scale and Pain questionnaire of Mac Gill) examined 84 patients suffering from autonomic dysfunction on the background of myofascial pain syndromes cervicobrachial localization. To identify the features of vegetative regulation of patients were divided into two groups: group 1 (51 people) - with a permanent type of course; group 2 (33 patients) - a type of paroxysmal of course of autonomic dysfunction. It was found more pronounced disturbances in patients with paroxysmal type of course of autonomic dysfunction. The frequency and severity of autonomic paroxysms associated with the severity of musculo-tonic syndrome and location of active trigger points in the muscles of the neck and shoulder girdle, due to anatomic and topographic features of these muscles, namely the proximity of their location to the sympathetic formations neck. The formation and development of emotional and affective disorders in both groups played a significant role of pain and musculo-tonic syndrome. The syndrome of autonomic dysfunction, in particular its paroxysmal type of flow, on the one hand is a response to the development of myofascial pain syndromes cervicobrachial localization, with another - a factor

  17. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice.

    Science.gov (United States)

    Njoo, K H; Van der Does, E

    1994-09-01

    The presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger point symptoms. Using the symptoms and signs as described by Simons' 1990 definition and two other former sets of criteria, 61 non-specific low back pain patients and 63 controls were examined in general practice by 5 observers, working in pairs. From the two major criteria of Simons' 1990 definition only 'localized tenderness' has good discriminative ability and inter-rater reliability (kappa > 0.5). This study does not find proof for the clinical usefulness of 'referred pain', which has neither of these two abilities. The criteria 'jump sign' and 'recognition', on the condition that localized tenderness is present, also have good discriminative ability and inter-rater reliability. Trigger points defined by the criteria found eligible in this study allow significant distinction between non-specific low back pain patients and controls. This is not the case with trigger points defined by Simons' 1990 criteria. Concerning reliability there is also a significant difference between the two different criteria sets. This study suggests that the clinical usefulness of trigger points is increased when localized tenderness and the presence of either jump sign or patient's recognition of his pain complaint are used as criteria for the presence of trigger points in the M. quadratus lumborum and the M. gluteus medius.

  18. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Lin; Huang, Qiang-Min; Liu, Qing-Guang; Ye, Gang; Bo, Cheng-Zhi; Chen, Meng-Jin; Li, Ping

    2015-05-01

    To evaluate current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with neck and shoulder pain. PubMed, EBSCO, Physiotherapy Evidence Database, ScienceDirect, The Cochrane Library, ClinicalKey, Wanfang Data Chinese database, China Knowledge Resource Integrated Database, Chinese Chongqing VIP Information, and SpringerLink databases were searched from database inception to January 2014. Randomized controlled trials were performed to determine whether dry needling was used as the main treatment and whether pain intensity was included as an outcome. Participants were diagnosed with MTrPs associated with neck and shoulder pain. Two reviewers independently screened the articles, scored methodological quality, and extracted data. The results of the study of pain intensity were extracted in the form of mean and SD data. Twenty randomized controlled trials involving 839 patients were identified for meta-analysis. Meta-analyses were performed using RevMan version 5.2 and Stata version 12.0. The results suggested that compared with control/sham, dry needling of MTrPs was effective in the short term (immediately to 3 days) (standardized mean difference [SMD]=-1.91; 95% confidence interval [CI], -3.10 to -.73; P=.002) and medium term (SMD=-1.07; 95% CI, -1.87 to -.27; P=.009); however, wet needling (including lidocaine) was superior to dry needling in relieving MTrP pain in the medium term (SMD=1.69; 95% CI, .40-2.98; P=.01). Other therapies (including physiotherapy) were more effective than dry needling in treating MTrP pain in the medium term (9-28d) (SMD=.62; 95% CI, .02-1.21; P=.04). Dry needling can be recommended for relieving MTrP pain in neck and shoulders in the short and medium term, but wet needling is found to be more effective than dry needling in relieving MTrP pain in neck and shoulders in the medium term. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Myofascial low back pain: a review.

    Science.gov (United States)

    Malanga, Gerard A; Cruz Colon, Eduardo J

    2010-11-01

    Myofascial pain syndrome is a common nonarticular local musculoskeletal pain syndrome caused by myofascial trigger points located at muscle, fascia, or tendinous insertions, affecting up to 95% of people with chronic pain disorders. Clinically, myofascial pain syndrome can present as painful restricted range of motion, stiffness, referred pain patterns, and autonomic dysfunction. The underlying cause is often related to muscular imbalances, and following a thorough physical examination the condition should be treated with a comprehensive rehabilitation program. Additional treatment options include pharmacologic, needling with or without anesthetic agents or nerve stimulation, and alternative medicine treatments such as massage or herbal medicines. Repeated trigger point injections should be avoided, and corticosteroids should not be injected into trigger points. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Effect of Trigger Point of Myofascial Pain for Treatment of Low Back Myofascial Pain Syndrome%肌筋膜疼痛触发点治疗技术治疗腰背肌筋膜疼痛综合征疗效分析

    Institute of Scientific and Technical Information of China (English)

    龙佳佳; 庄小强; 谭树生

    2011-01-01

    Objective:To evaluate the superiority effect of trigger point of myofascial pain for treatment of low back myofas-cial pain syndrome. Methods: All 500 patients met the diagnostic criteria were randomly divided into treatment group and control group, with 250 cases in each group. The patients of treatment group were treated with trigger point of myofascial pain technology (acupuncture and massage therapy), while the control group were treated with tizanidine, all the patients were treated every other day, for 7 days was a course of treatment. The two groups were compared each other before and 8 courses after treatment. Results: The index of pain, functional status, and induration cords were decreased after treatment in both groups (P<0. 05). There were 100 cases cured (accounting for 40. 00%), 78 cases effective (accounting for 31. 20%), 61 cases improved (accounting for 24. 40%), and 11 cases ineffective (accounting for 4. 40%), with the total efficiency of 95. 60% in the treatment group. While, there were 80 cases cured (accounting for 32. 00%), 92 cases effective (accounting for 36. 80%), 41 cases improved (accounting for 16. 40%), and 37 cases ineffective (accounting for 14. 80%), with the total efficiency of 85. 20% in the control group. The therapeutic effects was significant difference between two groups (P<0. 05). Conclusion: It is effective for using trigger point of myofascial pain for treatment of low back myofascial pain syndrome, and which is superior to tizanidine therapeutic, so it is worthy for further research and extension.%目的:评价利用肌筋膜疼痛触发点治疗腰背肌筋膜疼痛综合征临床疗效的优越性.方法:将500例符合诊断标准的患者随机分为治疗组和对照组,每组250例,治疗组采用肌筋膜疼痛触发点治疗技术(针刺和推拿疗法)进行治疗,对照组采用替扎尼定进行治疗;2组治疗均隔日1次,7d为1个疗程;治疗8个疗程后,进行2组自身治疗前后对照,以及2

  1. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction.

    Science.gov (United States)

    Aredo, Jacqueline V; Heyrana, Katrina J; Karp, Barbara I; Shah, Jay P; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections.

  2. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction

    Science.gov (United States)

    Aredo, Jacqueline V.; Heyrana, Katrina J.; Karp, Barbara I.; Shah, Jay P.; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections. PMID:28049214

  3. TRIGGER

    CERN Multimedia

    by Wesley Smith

    2010-01-01

    Level-1 Trigger Hardware and Software The overall status of the L1 trigger has been excellent and the running efficiency has been high during physics fills. The timing is good to about 1%. The fine-tuning of the time synchronization of muon triggers is ongoing and will be completed after more than 10 nb-1 of data have been recorded. The CSC trigger primitive and RPC trigger timing have been refined. A new configuration for the CSC Track Finder featured modified beam halo cuts and improved ghost cancellation logic. More direct control was provided for the DT opto-receivers. New RPC Cosmic Trigger (RBC/TTU) trigger algorithms were enabled for collision runs. There is further work planned during the next technical stop to investigate a few of the links from the ECAL to the Regional Calorimeter Trigger (RCT). New firmware and a new configuration to handle trigger rate spikes in the ECAL barrel are also being tested. A board newly developed by the tracker group (ReTRI) has been installed and activated to block re...

  4. Progress of research on acupuncture at trigger point for myofascial pain syndrome%针刺激痛点治疗肌筋膜疼痛综合征研究进展

    Institute of Scientific and Technical Information of China (English)

    马尧; 布赫; 贾纪荣; 张雪

    2012-01-01

    To review the literature of acupuncture at trigger point for myofascial pain syndrome from the main selected points (trigger point), the mechanism of Chinese medicine and modern research and its clinical application. The results show that acupuncture at trigger point has significant effect on the myofascial pain syndrome, which could be influenced by the type of needle, manipulation, insertion angle and depth of the needles. However, the involved studies at present are still far from enough and lack of systematic study with multivariate analysis, it is needed to be improved that some problems about the clinical diagnosis and basic research.%从针刺治疗肌筋膜疼痛综合征的主要选穴(激痛点)、针刺激痛点治疗本痛的中医和现代研究机制及治疗该病时针刺激痛点的临床应用几个方面,对针刺激痛点治疗肌筋膜疼痛综合征的相关文献进行综述.结果表明针刺激痛点在治疗肌筋膜疼痛综合征中具有十分显著的疗效,且针刺激痛点时选择的针具、针刺的手法、角度、深度等各项参数对治疗肌筋膜疼痛综合征临床疗效有重要影响,但目前对此研究非常薄弱,缺乏多因素分析的系统性研究,且在临床诊断及基础性研究等方面有待改进.

  5. Comparing Trigger Point Dry Needling and Manual Pressure Technique for the Management of Myofascial Neck/Shoulder Pain: A Randomized Clinical Trial.

    Science.gov (United States)

    De Meulemeester, Kayleigh E; Castelein, Birgit; Coppieters, Iris; Barbe, Tom; Cools, Ann; Cagnie, Barbara

    2017-01-01

    The aim of this study was to investigate short-term and long-term treatment effects of dry needling (DN) and manual pressure (MP) technique with the primary goal of determining if DN has better effects on disability, pain, and muscle characteristics in treating myofascial neck/shoulder pain in women. In this randomized clinical trial, 42 female office workers with myofascial neck/shoulder pain were randomly allocated to either a DN or MP group and received 4 treatments. They were evaluated with the Neck Disability Index, general numeric rating scale, pressure pain threshold, and muscle characteristics before and after treatment. For each outcome parameter, a linear mixed-model analysis was applied to reveal group-by-time interaction effects or main effects for the factor "time." No significant differences were found between DN and MP. In both groups, significant improvement in the Neck Disability Index was observed after 4 treatments and 3 months (P Dry needling was found to be no more effective than MP in the treatment of myofascial neck/shoulder pain. Copyright © 2016. Published by Elsevier Inc.

  6. Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain.

    Science.gov (United States)

    Pastore, Elizabeth A; Katzman, Wendy B

    2012-01-01

    Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by health care providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, biofeedback, and electrical stimulation. An interdisciplinary team is essential for identifying and successfully treating MFPP.

  7. TRIGGER

    CERN Multimedia

    W. Smith from contributions of C. Leonidopoulos

    2010-01-01

    Level-1 Trigger Hardware and Software Since nearly all of the Level-1 (L1) Trigger hardware at Point 5 has been commissioned, activities during the past months focused on the fine-tuning of synchronization, particularly for the ECAL and the CSC systems, on firmware upgrades and on improving trigger operation and monitoring. Periodic resynchronizations or hard resets and a shortened luminosity section interval of 23 seconds were implemented. For the DT sector collectors, an automatic power-off was installed in case of high temperatures, and the monitoring capabilities of the opto-receivers and the mini-crates were enhanced. The DTTF and the CSCTF now have improved memory lookup tables. The HCAL trigger primitive logic implemented a new algorithm providing better stability of the energy measurement in the presence of any phase misalignment. For the Global Calorimeter Trigger, additional Source Cards have been manufactured and tested. Testing of the new tau, missing ET and missing HT algorithms is underw...

  8. Occurrence of myofascial pain in patients with possible carpal tunnel syndrome - a single-blinded study

    DEFF Research Database (Denmark)

    Qerama, Erisela; Kasch, Helge; Fuglsang-Frederiksen, Anders

    2009-01-01

    There exits some similarity between symptoms of carpal tunnel syndrome (CTS) and myofascial pain related to trigger points (TPs) in the infraspinatus muscle.......There exits some similarity between symptoms of carpal tunnel syndrome (CTS) and myofascial pain related to trigger points (TPs) in the infraspinatus muscle....

  9. Expression of the endocannabinoid system in fibroblasts and myofascial tissues.

    Science.gov (United States)

    McPartland, John M

    2008-04-01

    The endocannabinoid (eCB) system, like the better-known endorphin system, consists of cell membrane receptors, endogenous ligands and ligand-metabolizing enzymes. Two cannabinoid receptors are known: CB(1) is principally located in the nervous system, whereas CB(2) is primarily associated with the immune system. Two eCB ligands, anandamide (AEA) and 2-arachidonoylglycerol (2-AG), are mimicked by cannabis plant compounds. The first purpose of this paper was to review the eCB system in detail, highlighting aspects of interest to bodyworkers, especially eCB modulation of pain and inflammation. Evidence suggests the eCB system may help resolve myofascial trigger points and relieve symptoms of fibromyalgia. However, expression of the eCB system in myofascial tissues has not been established. The second purpose of this paper was to investigate the eCB system in fibroblasts and other fascia-related cells. The investigation used a bioinformatics approach, obtaining microarray data via the GEO database (www.ncbi.nlm.nih.gov/geo/). GEO data mining revealed that fibroblasts, myofibroblasts, chondrocytes and synoviocytes expressed CB(1), CB(2) and eCB ligand-metabolizing enzymes. Fibroblast CB(1) levels nearly equalled levels expressed by adipocytes. CB(1) levels upregulated after exposure to inflammatory cytokines and equiaxial stretching of fibroblasts. The eCB system affects fibroblast remodeling through lipid rafts associated with focal adhesions and dampens cartilage destruction by decreasing fibroblast-secreted metalloproteinase enzymes. In conclusion, the eCB system helps shape biodynamic embryological development, diminishes nociception and pain, reduces inflammation in myofascial tissues and plays a role in fascial reorganization. Practitioners wield several tools that upregulate eCB activity, including myofascial manipulation, diet and lifestyle modifications, and pharmaceutical approaches.

  10. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey

    Directory of Open Access Journals (Sweden)

    Freiberg Florentina

    2010-02-01

    Full Text Available Abstract Background Myofascial pain is a common dysfunction with a lifetime prevalence affecting up to 85% of the general population. Current guidelines for the management of myofascial pain are not available. In this study we investigated how physicians on the basis of prescription behaviour evaluate the effectiveness of treatment options in their management of myofascial pain. Methods We conducted a cross-sectional, nationwide survey with a standardized questionnaire among 332 physicians (79.8% male, 25.6% female, 47.5 ± 9.6 years experienced in treating patients with myofascial pain. Recruitment of physicians took place at three German meetings of pain therapists, rheumatologists and orthopaedists, respectively. Physicians estimated the prevalence of myofascial pain amongst patients in their practices, stated what treatments they used routinely and then rated the perceived treatment effectiveness on a six-point scale (with 1 being excellent. Data are expressed as mean ± standard deviation. Results The estimated overall prevalence of active myofascial trigger points is 46.1 ± 27.4%. Frequently prescribed treatments are analgesics, mainly metamizol/paracetamol (91.6%, non-steroidal anti-inflammatory drugs/coxibs (87.0% or weak opioids (81.8%, and physical therapies, mainly manual therapy (81.1%, TENS (72.9% or acupuncture (60.2%. Overall effectiveness ratings for analgesics (2.9 ± 0.7 and physical therapies were moderate (2.5 ± 0.8. Effectiveness ratings of the various treatment options between specialities were widely variant. 54.3% of all physicians characterized the available treatment options as insufficient. Conclusions Myofascial pain was estimated a prevalent condition. Despite a variety of commonly prescribed treatments, the moderate effectiveness ratings and the frequent characterizations of the available treatments as insufficient suggest an urgent need for clinical research to establish evidence-based guidelines for the

  11. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey

    Science.gov (United States)

    2010-01-01

    Background Myofascial pain is a common dysfunction with a lifetime prevalence affecting up to 85% of the general population. Current guidelines for the management of myofascial pain are not available. In this study we investigated how physicians on the basis of prescription behaviour evaluate the effectiveness of treatment options in their management of myofascial pain. Methods We conducted a cross-sectional, nationwide survey with a standardized questionnaire among 332 physicians (79.8% male, 25.6% female, 47.5 ± 9.6 years) experienced in treating patients with myofascial pain. Recruitment of physicians took place at three German meetings of pain therapists, rheumatologists and orthopaedists, respectively. Physicians estimated the prevalence of myofascial pain amongst patients in their practices, stated what treatments they used routinely and then rated the perceived treatment effectiveness on a six-point scale (with 1 being excellent). Data are expressed as mean ± standard deviation. Results The estimated overall prevalence of active myofascial trigger points is 46.1 ± 27.4%. Frequently prescribed treatments are analgesics, mainly metamizol/paracetamol (91.6%), non-steroidal anti-inflammatory drugs/coxibs (87.0%) or weak opioids (81.8%), and physical therapies, mainly manual therapy (81.1%), TENS (72.9%) or acupuncture (60.2%). Overall effectiveness ratings for analgesics (2.9 ± 0.7) and physical therapies were moderate (2.5 ± 0.8). Effectiveness ratings of the various treatment options between specialities were widely variant. 54.3% of all physicians characterized the available treatment options as insufficient. Conclusions Myofascial pain was estimated a prevalent condition. Despite a variety of commonly prescribed treatments, the moderate effectiveness ratings and the frequent characterizations of the available treatments as insufficient suggest an urgent need for clinical research to establish evidence-based guidelines for the treatment of myofascial

  12. Comparison of the Effectiveness of Transcutaneous Electrical Nerve Stimulation and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome: A Randomized Controlled Study.

    Science.gov (United States)

    Dissanayaka, Thusharika Dilrukshi; Pallegama, Ranjith Wasantha; Suraweera, Hilari Justus; Johnson, Mark I; Kariyawasam, Anula Padma

    2016-09-01

    The aim of this study was to compare the effectiveness of transcutaneous electrical nerve stimulation and interferential therapy (IFT) both in combination with hot pack, myofascial release, active range of motion exercise, and a home exercise program on myofascial pain syndrome patients with upper trapezius myofascial trigger point. A total of 105 patients with an upper trapezius myofascial trigger point were recruited to this single-blind randomized controlled trial. Following random allocation of patients to three groups, three therapeutic regimens-control-standard care (hot pack, active range of motion exercises, myofascial release, and a home exercise program with postural advice), transcutaneous electrical nerve stimulation-standard care and IFT-standard care-were administered eight times during 4 wks at regular intervals. Pain intensity and cervical range of motions (cervical extension, lateral flexion to the contralateral side, and rotation to the ipsilateral side) were measured at baseline, immediately after the first treatment, before the eighth treatment, and 1 wk after the eighth treatment. Immediate and short-term improvements were marked in the transcutaneous electrical nerve stimulation group (n = 35) compared with the IFT group (n = 35) and the control group (n = 35) with respect to pain intensity and cervical range of motions (P < 0.05). The IFT group showed significant improvement on these outcome measurements than the control group did (P < 0.05). Transcutaneous electrical nerve stimulation with standard care facilitates recovery better than IFT does in the same combination.

  13. Treatment experience of pulsed radiofrequency under ultrasound guided to the trapezius muscle at myofascial pain syndrome -a case report-.

    Science.gov (United States)

    Park, Chung Hoon; Lee, Yoon Woo; Kim, Yong Chan; Moon, Joo Hwa; Choi, Jong Bum

    2012-01-01

    Trigger point injection treatment is an effective and widely applied treatment for myofascial pain syndrome. The trapezius muscle frequently causes myofascial pain in neck area. We herein report a case in which direct pulsed radiofrequency (RF) treatment was applied to the trapezius muscle. We observed that the RF treatment produced continuous pain relief when the effective duration of trigger point injection was temporary in myofascial pain.

  14. A Multimodal Approach for Myofascial Pain Syndrome: A Prospective Study.

    Science.gov (United States)

    Segura-Pérez, María; Hernández-Criado, M Teresa; Calvo-Lobo, César; Vega-Piris, Lorena; Fernández-Martín, Raquel; Rodríguez-Sanz, David

    The purpose of this study was to analyze pain intensity in patients with myofascial pain syndrome (MPS) following a multimodal rehabilitation protocol. A prospective study was carried out following the Template for Intervention Description and Replication criteria. Patients were recruited from the rehabilitation unit of a university hospital in Spain between 2009 and 2013. Patients were included if they had a medical diagnosis of MPS in any of the following regions: cervicobrachial (n = 102), lumbosacral (n = 30), elbow (n = 14), ankle and foot (n = 10), and temporomandibular jaw (n = 1). The multimodal rehabilitation protocol included myofascial trigger point dry needling, spray and stretching, Kinesio taping, eccentric exercise, and patient education. The protocol was applied for 4 weeks (5 sessions) for the active and/or latent myofascial trigger points in each body region. Pain intensity was measured by using the visual analog scale (VAS) immediately before beginning of the study and 1 week after completion of the protocol. The study sample comprised 150 patients (mean ± standard deviation age, 51.5 ± 1.19 years). Statistically significant differences were obtained for reduction in pain intensity (4 ± 2.03; P = .002). Clinically relevant reductions (VAS ≥30 mm; P < .001) were obtained in 78.7% of the interventions. Four treatment sessions reduced the VAS score by 10 mm in 83.55% of the sample. There were no statistically significant differences (P = .064) for reduction in pain intensity in the different body regions. A multimodal rehabilitation protocol showed clinically relevant differences in the reduction in pain intensity in different body regions in patients with MPS. Copyright © 2017. Published by Elsevier Inc.

  15. Trigger pointy v širších souvislostech

    OpenAIRE

    Sobotková, Petra

    2010-01-01

    Title: Terminology problems in myofascial trigger points concept Objectives: The main aim of this work is to organize information in the field of myofascial pain syndrome and myofascial trigger points, and to show unclearness in using terminology. Another aim is to describe trigger points from the view of the etiology, the diagnosis and the therapy. Subsidiary aim is to evaluate the relation among trigger points, tender points and acupuncture points. Methods: Design review was used in this th...

  16. [Cervical myofascial pain syndrome. Narrative review of physiotherapeutic treatment].

    Science.gov (United States)

    Capó-Juan, M A

    2015-01-01

    Pain is a complex and multifactorial phenomenon that depends on the interaction of biopsychosocial factors. Between 15-25% of adults suffer from chronic pain at some point in their lives. Cervical chronic pain is considered a public health problem affecting 9.6% men and 21.9% women, according to the latest National Health Survey 2011-12. A high percentage of medical consultations due to muscle pain turn out to be myofascial pain syndrome (MPS). Its existence implies the presence of myofascial trigger points which can be latent or active throughout the whole population. The aim of this review is to update knowledge in the various therapies applied by the physiotherapist in the treatment of this syndrome at cervical level. From the review it appears that some of the most used techniques that may be useful in the short or medium term are: ischemic compression and/or trigger point pressure release and dry needling. Furthermore, various combinations of treatment modalities are used to treat this syndrome, taking other aspects into account, such as education.

  17. The therapeutic effect of collateral meridian therapy is comparable to acupoint pressure therapy in treating myofascial pain syndrome.

    Science.gov (United States)

    Lee, Si-Huei; Lu, Wan-An; Lee, Chang-Shun; Wang, Jia-Chi; Lin, Tsung-Ching; Yang, Jen-Lin; Chan, Rai-Chi; Ko, Shan-Chi; Kuo, Cheng-Deng

    2014-11-01

    This study compared the therapeutic effects of collateral meridian therapy (CMT) with traditional acupoint pressure therapy (APT) in patients with unilateral upper back pain. Forty-nine patients with active myofascial trigger points in upper trapezius muscle were randomly allocated to the control (CTL), APT, or CMT group. Each subject in the CMT and APT groups received 2 sessions of treatment per week over 1 month. Patients in the APT and CMT groups showed significant improvements 1 month after treatment in visual analogue scale, range of motion, pain pressure threshold, regional superficial blood flow, and physical health, as compared to the CTL group. No significant differences in outcome measures were found between APT and CMT groups 1 month after treatment. Both APT and CMT have comparable therapeutic efficacy in the treatment of unilateral upper back pain with active myofascial trigger points in the upper trapezius muscle. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

    2011-02-01

    Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

  19. Referred pain from myofascial trigger points in head, neck, shoulder, and arm muscles reproduces pain symptoms in blue-collar (manual) and white-collar (office) workers.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Gröbli, Christian; Ortega-Santiago, Ricardo; Fischer, Christine Stebler; Boesch, Daniel; Froidevaux, Philippe; Stocker, Lilian; Weissmann, Richard; González-Iglesias, Javier

    2012-07-01

    To describe the prevalence and referred pain area of trigger points (TrPs) in blue-collar (manual) and white-collar (office) workers, and to analyze if the referred pain pattern elicited from TrPs completely reproduces the overall spontaneous pain pattern. Sixteen (62% women) blue-collar and 19 (75% women) white-collar workers were included in this study. TrPs in the temporalis, masseter, upper trapezius, sternocleidomastoid, splenius capitis, oblique capitis inferior, levator scapulae, scalene, pectoralis major, deltoid, infraspinatus, extensor carpi radialis brevis and longus, extensor digitorum communis, and supinator muscles were examined bilaterally (hyper-sensible tender spot within a palpable taut band, local twitch response with snapping palpation, and elicited referred pain pattern with palpation) by experienced assessors blinded to the participants' condition. TrPs were considered active when the local and referred pain reproduced any symptom and the patient recognized the pain as familiar. The referred pain areas were drawn on anatomic maps, digitized, and measured. Blue-collar workers had a mean of 6 (SD: 3) active and 10 (SD: 5) latent TrPs, whereas white-collar workers had a mean of 6 (SD: 4) active and 11 (SD: 6) latent TrPs (P>0.548). No significant differences in the distribution of active and latent TrPs in the analyzed muscles between groups were found. Active TrPs in the upper trapezius, infraspinatus, levator scapulae, and extensor carpi radialis brevis muscles were the most prevalent in both groups. Significant differences in referred pain areas between muscles (Pmuscles showed the largest referred pain areas (Pmuscles showed the smallest (Pmuscle TrPs in blue-collar and white-collar workers.

  20. Effect of self-myofascial release on myofascial pain, muscle flexibility, and strength: A narrative review.

    Science.gov (United States)

    Kalichman, Leonid; Ben David, Chen

    2017-04-01

    Numerous techniques have been employed to treat myofascial pain syndrome. Self-myofascial release (SMFR) is a relatively new technique of soft tissue mobilization. The simplicity and portability of the SMFR tools allow it to be easily implemented in any type of fitness or rehabilitation program. It is an active method and can be used by anyone at home or at the workplace. To review the current methods of SMFR, their mechanisms, and efficacy in treating myofascial pain, improving muscle flexibility and strength. PubMed, Google Scholar, and PEDro databases were searched without search limitations from inception until July 2016 for terms relating to SMFR. During the past decade, therapists and fitness professionals have implemented SMFR mainly via foam rolling as a recovery or maintenance tool. Researchers observed a significant increase in the joint range of motion after using the SMFR technique and no decrease in muscle force or changes in performance after treatment with SMFR. SMFR has been widely used by health-care professionals in treating myofascial pain. However, we found no clinical trials which evaluated the influence of SMFR on myofascial pain. There is an acute need for these trials to evaluate the efficacy and effectiveness of SMFR in the treatment of the myofascial syndrome. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Comparison of dry needling and physiotherapy in treatment of myofascial pain syndrome.

    Science.gov (United States)

    Rayegani, Seyed Mansoor; Bayat, Masume; Bahrami, Mohammad Hasan; Raeissadat, Seyed Ahmad; Kargozar, Elham

    2014-06-01

    To compare the effects of dry needling and physiotherapy in treatment of myofascial pain syndrome, a randomized controlled trial was performed on 28 patients with myofascial pain syndrome (MPS) of upper trapezius muscle in the Physical Medicine and Rehabilitation Center of Shohadaye Tajrish Hospital from April 2009 to April 2010. After matching the age, sex, duration of symptoms, pain severity, and quality of life measures, subjects were randomly assigned into two subgroups of case (dry needling) and control (physiotherapy). One week and 1 month after receiving standard therapeutic modalities, outcomes and intragroup and intergroup changes in pain severity, pressure pain of trigger point (TP), and quality of life measures were evaluated and compared. After 1 month, both the physiotherapy and dry needling groups had decreased resting, night, and activity pain levels (pmyofascial pain of the upper trapezius muscle.

  2. An evidence-informed review of the current myofascial pain literature--January 2015.

    Science.gov (United States)

    Dommerholt, Jan; Grieve, Rob; Layton, Michelle; Hooks, Todd

    2015-01-01

    This article provides an up-to-date review of the most recent publications about myofascial pain, trigger points (TrPs) and other related topics. We have added some commentaries where indicated with supporting references. In the Basic Research section, we reviewed the work by Danish researchers about the influence of latent TrPs and a second study of the presence and distribution of both active and latent TrPs in whiplash-associated disorders. The section on Soft Tissue Approaches considered multiple studies and case reports of the efficacy of myofascial release (MFR), classic and deep muscle massage, fascial techniques, and connective tissue massage. Dry needling (DN) is becoming a common approach and we included multiple studies, reviews, and case reports, while the section on Injection Techniques features an article on TrP injections following mastectomy and several articles about the utilization of botulinum toxin. Lastly, we review several articles on modalities and other clinical approaches.

  3. 平刺和直刺肌筋膜触发点治疗颈型颈椎病疗效比较%Comparison of the Efficacies of Transverse Needling Versus Perpendicular Needling at Myofascial Trigger Points in Treating Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    王翀敏; 王延武; 楚佳梅; 朱敏

    2016-01-01

    Objective To compare the efficacies of transverse needling versus perpendicular needling at myofascial trigger points in treating cervical spondylosis and sift out a needling direction for a better improving effect on myofascial pain syndrome such as cervical spondylosis. Method One hundred and six patients with cervical spondylosis were randomly allocated to two groups. The transverse needling group received transverse needling at myofascial trigger points and the perpendicular needling group, perpendicular needling at myofascial trigger points. The symptoms and signs of cervical spondylosis were scored and the VAS score was recorded in the two groups before and after treatment. Result In the two groups, the VAS score had a statistically significant pre-/post-treatment difference (P0.05). In the two groups, the cervical spondylotic symptom and sign score had a statistically significant pre-/post-treatment difference (P<0.05) and decreased after treatment. The cervical spondylotic symptom and sign score was significantly lower in the transverse needling group than in the perpendicular needling group after treatment; there was a statistically significant difference between the two groups (P<0.05). The total efficacy rate was 94.0% in the transverse needling group, which was higher than 79.6% in the perpendicular needling group; there was a statistically significant difference between the two groups (P<0.05). Conclusion Both transverse needling and perpendicular needling can remove myofascial trigger points and treat cervical spondylosis, but transverse needling at myofascial trigger points is superior to perpendicular needling at myofascial trigger points.%目的:比较平刺和直刺肌筋膜触发点治疗颈型颈椎病的疗效差异;并筛选出改善颈型颈椎病等肌筋膜疼痛综合征的更高效的针刺方向。方法将106例颈型颈椎病患者随机分为两组,平刺组采用平刺肌筋膜触发点进行治疗,直刺组采用直刺肌

  4. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The hardware of the trigger components has been mostly finished. The ECAL Endcap Trigger Concentrator Cards (TCC) are in production while Barrel TCC firmware has been upgraded, and the Trigger Primitives can now be stored by the Data Concentrator Card for readout by the DAQ. The Regional Calorimeter Trigger (RCT) system is complete, and the timing is being finalized. All 502 HCAL trigger links to RCT run without error. The HCAL muon trigger timing has been equalized with DT, RPC, CSC and ECAL. The hardware and firmware for the Global Calorimeter Trigger (GCT) jet triggers are being commissioned and data from these triggers is available for readout. The GCT energy sums from rings of trigger towers around the beam pipe beam have been changed to include two rings from both sides. The firmware for Drift Tube Track Finder, Barrel Sorter and Wedge Sorter has been upgraded, and the synchronization of the DT trigger is satisfactory. The CSC local trigger has operated flawlessly u...

  5. TRIGGER

    CERN Multimedia

    Roberta Arcidiacono

    2013-01-01

    Trigger Studies Group (TSG) The Trigger Studies Group has just concluded its third 2013 workshop, where all POGs presented the improvements to the physics object reconstruction, and all PAGs have shown their plans for Trigger development aimed at the 2015 High Level Trigger (HLT) menu. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger menu development, path timing, Trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – this last task in collaboration with PdmV (Physics Data and Monte Carlo Validation group). In the last months the group has delivered several HLT rate estimates and comparisons, using the available data and Monte Carlo samples. The studies were presented at the Trigger workshops in September and December, and STEAM has contacted POGs and PAGs to understand the origin of the discrepancies observed between 8 TeV data and Monte Carlo simulations. The most recent results show what the...

  6. Incidence of myofascial pain syndrome in breast cancer surgery: a prospective study.

    Science.gov (United States)

    Torres Lacomba, María; Mayoral del Moral, Orlando; Coperias Zazo, José Luís; Gerwin, Robert D; Goñí, Alvaro Zapico

    2010-05-01

    Pain after breast cancer therapy is a recognized complication found to have an adverse impact on patient's quality of life, increasing psychosocial distress. In recent years, case reports about myofascial pain syndrome are emerging in thoracic surgery as a cause of postsurgery pain. Myofascial pain syndrome is a regional pain syndrome characterized by myofascial trigger points in palpable taut bands of skeletal muscle that refers pain a distance, and that can cause distant motor and autonomic effects. The objective of this study was to assess the incidence of myofascial pain syndrome prospectively 12 months after breast cancer surgery. Each participant was assessed preoperatively, postoperatively between day 3 and day 5, and at 1, 3, 6, and 12 months after surgery. A physical therapist, expert in the diagnosis of myofascial pain syndrome, performed follow-up assessments. Pain descriptions by the patients and pain pattern drawings in body forms guided the physical examination. The patients were not given any information concerning myofascial pain or other muscle pain syndromes. One year follow-up was completed by 116 women. Of these, 52 women developed myofascial pain syndrome (44.8%, 95% confidence interval: 35.6, 54.3). Myofascial pain syndrome is a common source of pain in women undergoing breast cancer surgery that includes axillary lymph node dissection at least during the first year after surgery. Myofascial pain syndrome is one potential cause of chronic pain in breast cancer survivors who have undergone this kind of surgery.

  7. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.

    Science.gov (United States)

    Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J

    2016-06-01

    Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.

  8. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The trigger synchronization procedures for running with cosmic muons and operating with the LHC were reviewed during the May electronics week. Firmware maintenance issues were also reviewed. Link tests between the new ECAL endcap trigger concentrator cards (TCC48) and the Regional Calorimeter Trigger have been performed. Firmware for the energy sum triggers and an upgraded tau trigger of the Global Calorimeter Triggers has been developed and is under test. The optical fiber receiver boards for the Track-Finder trigger theta links of the DT chambers are now all installed. The RPC trigger is being made more robust by additional chamber and cable shielding and also by firmware upgrades. For the CSC’s the front-end and trigger motherboard firmware have been updated. New RPC patterns and DT/CSC lookup tables taking into account phi asymmetries in the magnetic field configuration are under study. The motherboard for the new pipeline synchronizer of the Global Trigg...

  9. TRIGGER

    CERN Multimedia

    W. Smith

    2012-01-01

      Level-1 Trigger The Level-1 Trigger group is ready to deploy improvements to the L1 Trigger algorithms for 2012. These include new high-PT patterns for the RPC endcap, an improved CSC PT assignment, a new PT-matching algorithm for the Global Muon Trigger, and new calibrations for ECAL, HCAL, and the Regional Calorimeter Trigger. These should improve the efficiency, rate, and stability of the L1 Trigger. The L1 Trigger group also is migrating the online systems to SLC5. To make the data transfer from the Global Calorimeter Trigger to the Global Trigger more reliable and also to allow checking the data integrity online, a new optical link system has been developed by the GCT and GT groups and successfully tested at the CMS electronics integration facility in building 904. This new system is now undergoing further tests at Point 5 before being deployed for data-taking this year. New L1 trigger menus have recently been studied and proposed by Emmanuelle Perez and the L1 Detector Performance Group...

  10. TRIGGER

    CERN Multimedia

    W. Smith

    At the March meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, the program of trigger pattern tests and vertical slice tests and planning for the Global Runs starting this summer. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and integration testing is in full swing. A program of orderly connection and checkout with subsystems and central systems has been developed. This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored. After full checkout, trigger subsystems will be then operated in the CMS Global Runs. Continuous...

  11. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The production of the trigger hardware is now basically finished, and in time for the turn-on of the LHC. The last boards produced are the Trigger Concentrator Cards for the ECAL Endcaps (TCC-EE). After the recent installation of the four EE Dees, the TCC-EE prototypes were used for their commissioning. Production boards are arriving and are being tested continuously, with the last ones expected in November. The Regional Calorimeter Trigger hardware is fully integrated after installation of the last EE cables. Pattern tests from the HCAL up to the GCT have been performed successfully. The HCAL triggers are fully operational, including the connection of the HCAL-outer and forward-HCAL (HO/HF) technical triggers to the Global Trigger. The HCAL Trigger and Readout (HTR) board firmware has been updated to permit recording of the tower “feature bit” in the data. The Global Calorimeter Trigger hardware is installed, but some firmware developments are still n...

  12. Myofascial pelvic pain.

    Science.gov (United States)

    Kotarinos, Rhonda

    2012-10-01

    Myofascial pelvic pain is fraught with many unknowns. Is it the organs of the pelvis, is it the muscles of the pelvis, or is the origin of the pelvic pain from an extrapelvic muscle? Is there a single source or multiple? In this state of confusion what is the best way to manage the many symptoms that can be associated with myofascial pelvic pain. This article reviews current studies that attempt to answer some of these questions. More questions seem to develop as each study presents its findings.

  13. Effect of acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm%针刺肌筋膜触发点治疗缺血性脑卒中痉挛的效果

    Institute of Scientific and Technical Information of China (English)

    龙佳佳; 庄小强; 谭树生; 言丽燕

    2013-01-01

    Objective To study the clinical curative effect of acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm.Methods 75 patients with cerebral arterial thrombosis spasm in Department of Rehabilitation Medicine,the National Hospital of Guangxi Zhuang Autonomous Region from February 2010 to December 2012 were divided into acupuncture myofascial trigger points group (treatment group,38 cases) and traditional acupuncture group (control group,37 cases) according to random number table with single-blind method.The FuglMeyer motor function score,Barthel index of daily life ability,degree of hemiplegic limb spasm,overall evaluation of spasticity comprehensive efficacy evaluation and clinical nerve function defect score of two groups before treatment and after 1,2 courses of treatment were evaluated.The dates were statistically analyzed by SPSS 17.0 statistics software.Results The Fugl-Meyer motor function score,Barthel index of daily life ability,modified Ashworth scale,clinic spasticity index and nerve function defect score of two groups could be improved obviously.The Fugl-Meyer motor function score,Barthel index of daily life ability,modified Ashworth scale,clinic spasticity index and nerve function defect score after 2 courses of treatment in the treatment group were better than those before treatment,after 1 course of treatment in the treatment group and after 2 courses of treatment in the control group (all P < 0.05).The total effective rate of treatment group (92.11%) was better than that of control group (75.68%) (P < 0.05).Conclusion Acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm has good clinical curative effect,less side effects and it is worthy of clinical application.%目的 探讨针刺肌筋膜触发点治疗缺血性脑卒中痉挛的临床疗效.方法 选取2010年2月~2012年12月来广西壮族自治区民族医院康复医学科就诊

  14. Efficacy Observation on Acupuncture on Trigger Point of Myofascial Pain Combined with Massage Treating Lumbar Disc Herniation%针刺肌筋膜疼痛触发点联合推拿治疗腰椎间盘突出症疗效观察

    Institute of Scientific and Technical Information of China (English)

    雷迈; 李乾扬

    2014-01-01

    目的:观察针刺肌筋膜疼痛触发点联合推拿治疗腰椎间盘突出症(LDH)的疗效。方法:将60例LDH患者随机分为治疗组(30例)和对照组(30例),治疗组采用针刺肌筋膜疼痛触发点联合推拿治疗,对照组给予常规药物及理疗,比较两组患者JOA、VAS评分改善情况及临床疗效。结果:治疗组总有效率、JOA评分均高于对照组(P<0.01),VAS评分低于对照组(P<0.01)。结论:针刺肌筋膜疼痛触发点联合推拿治疗LDH疗效显著。%Objective:To observe the effects of acupuncture on trigger point of myofascial pain combined with massage treating lumbar disc hernia-tion (LDH). Methods:60 cases of LDH were randomly divided into treatment group (30 cases) and control group (30 cases), treatment group was treated with acupuncture on trigger point of myofascial pain combined with massage, control group with routine medicine and physiotherapy, im-provement of JOA and VAS score and clinical efficacy were compared between the two groups. Results:The total effective rate and JOA score of treatment group were higher than those of control group (P<0.01), VAS score was lower than that of control group (P<0.01). Conclusion:Acupunc-ture on trigger point of myofascial pain combined with massage treating lumbar disc herniation is of distinct efficacy.

  15. 针刺配合干针刺肌筋膜触发点治疗腰椎间盘突出症疗效观察%Efficacy Observation on Acupuncture Combined with Dry Needling Myofascial Trigger Points for Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    植剑龙

    2013-01-01

    Objective:To investigate the efficacy of acupuncture combined with dry needling myofascial trigger points for lumbar disc herniation. Methods:136 cases of patients were randomly divided into observation group and control group, the observation group used conventional acupunc-ture combined with dry needling myofascial trigger points, the control group only used conventional acupuncture. Results:The total effective rate of observation group was 92.65%, which was higher than 73.53 that of control group (P<0.01). Conclusion:Conventional acupuncture combined with dry needling myofascial trigger points has significant curative effect on lumbar disc herniation.%目的:探讨针刺配合干针刺肌筋膜触发点治疗腰椎间盘突出症的疗效。方法:将136例患者随机分为观察组和对照组,观察组采用常规针刺配合干针刺肌筋膜触发点治疗,对照组单纯采用常规针刺治疗。结果:观察组总有效率为92.65%,高于对照组的73.53%(P<0.01)。结论:常规针刺配合干针刺肌筋膜触发点治疗腰椎间盘突出症疗效显著。

  16. TRIGGER

    CERN Multimedia

    W. Smith

    2010-01-01

    Level-1 Trigger Hardware and Software The Level-1 Trigger hardware has performed well during both the recent proton-proton and heavy ion running. Efforts were made to improve the visibility and handling of alarms and warnings. The tracker ReTRI boards that prevent fixed frequencies of Level-1 Triggers are now configured through the Trigger Supervisor. The Global Calorimeter Trigger (GCT) team has introduced a buffer cleanup procedure at stops and a reset of the QPLL during configuring to ensure recalibration in case of a switch from the LHC clock to the local clock. A device to test the cables between the Regional Calorimeter Trigger and the GCT has been manufactured. A wrong charge bit was fixed in the CSC Trigger. The ECAL group is improving crystal masking and spike suppression in the trigger primitives. New firmware for the Drift Tube Track Finder (DTTF) sorters was developed to improve fake track tagging and sorting. Zero suppression was implemented in the DT Sector Collector readout. The track finder b...

  17. TRIGGER

    CERN Multimedia

    Wesley Smith

    Trigger Hardware The status of the trigger components was presented during the September CMS Week and Annual Review and at the monthly trigger meetings in October and November. Procedures for cold and warm starts (e.g. refreshing of trigger parameters stored in registers) of the trigger subsystems have been studied. Reviews of parts of the Global Calorimeter Trigger (GCT) and the Global Trigger (GT) have taken place in October and November. The CERN group summarized the status of the Trigger Timing and Control (TTC) system. All TTC crates and boards are installed in the underground counting room, USC55. The central clock system will be upgraded in December (after the Global Run at the end of November GREN) to the new RF2TTC LHC machine interface timing module. Migration of subsystem's TTC PCs to SLC4/ XDAQ 3.12 is being prepared. Work is on going to unify the access to Local Timing Control (LTC) and TTC CMS interface module (TTCci) via SOAP (Simple Object Access Protocol, a lightweight XML-based messaging ...

  18. A critical overview of the current myofascial pain literature - March 2016.

    Science.gov (United States)

    Dommerholt, Jan; Hooks, Todd; Finnegan, Michelle; Grieve, Rob

    2016-04-01

    The worldwide interest in myofascial pain syndrome (MPS) and trigger points (TrPs) is reflected in the increasing number of publications. In this overview of the literature, we included 26 studies, case reports and review articles by authors from 18 different countries. Several research groups are exploring the characteristic of TrPs such as Chen and colleagues, who continued their work on the quantification of the taut bands. Meng and colleagues studied the relationships between TrPs and central sensitization, while Yu and colleagues examined the electrophysiological characteristics that occur as a result of active TrPs. Several researchers used objective measurements to determine clinical outcomes, such as Koppenhaver and colleagues who measured objective changes in the function and nociceptive sensitivity of lumbar multifidus muscle subjects with low back pain. Turo and colleagues quantified muscle tissue changes after dry needling in chronic myofascial pain using elastography. Multiple studies explored various treatment options for TrPs, such as dry needling, injections with lidocaine or granisetron, traditional Thai massage, self-myofascial release, kinesiotaping, and monochromatic infrared photo energy, among others.

  19. TRIGGER

    CERN Multimedia

    R. Carlin with contributions from D. Acosta

    2012-01-01

    Level-1 Trigger Data-taking continues at cruising speed, with high availability of all components of the Level-1 trigger. We have operated the trigger up to a luminosity of 7.6E33, where we approached 100 kHz using the 7E33 prescale column.  Recently, the pause without triggers in case of an automatic "RESYNC" signal (the "settle" and "recover" time) was reduced in order to minimise the overall dead-time. This may become very important when the LHC comes back with higher energy and luminosity after LS1. We are also preparing for data-taking in the proton-lead run in early 2013. The CASTOR detector will make its comeback into CMS and triggering capabilities are being prepared for this. Steps to be taken include improved cooperation with the TOTEM trigger system and using the LHC clock during the injection and ramp phases of LHC. Studies are being finalised that will have a bearing on the Trigger Technical Design Report (TDR), which is to be rea...

  20. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The final parts of the Level-1 trigger hardware are now being put in place. For the ECAL endcaps, more than half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are now available at CERN, such that one complete endcap can be covered. The Global Trigger now correctly handles ECAL calibration sequences, without being influenced by backpressure. The Regional Calorimeter Trigger (RCT) hardware is complete and working in USC55. Intra-crate tests of all 18 RCT crates and the Global Calorimeter Trigger (GCT) are regularly taking place. Pattern tests have successfully captured data from HCAL through RCT to the GCT Source Cards. HB/HE trigger data are being compared with emulator results to track down the very few remaining hardware problems. The treatment of hot and dead cells, including their recording in the database, has been defined. For the GCT, excellent agreement between the emulator and data has been achieved for jets and HF ET sums. There is still som...

  1. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware and Software The trigger system has been constantly in use in cosmic and commissioning data taking periods. During CRAFT running it delivered 300 million muon and calorimeter triggers to CMS. It has performed stably and reliably. During the abort gaps it has also provided laser and other calibration triggers. Timing issues, namely synchronization and latency issues, have been solved. About half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are installed, and the firmware is being worked on. The production of the other half has started. The HCAL Trigger and Readout (HTR) card firmware has been updated, and new features such as fast parallel zero-suppression have been included. Repairs of drift tube (DT) trigger mini-crates, optical links and receivers of sector collectors are under way and have been completed on YB0. New firmware for the optical receivers of the theta links to the drift tube track finder is being installed. In parallel, tests with new eta track finde...

  2. New trends in the treatment and management of myofascial pain syndrome.

    Science.gov (United States)

    Srbely, John Z

    2010-10-01

    Myofascial pain syndrome presents a significant physical and financial burden to society. In view of the aging demographics, myofascial pain promises to be an even greater challenge to health care in the future. Myofascial trigger points have been identified as important anatomic and physiologic phenomena in the pathophysiology of myofascial pain. While their pathophysiologic mechanisms are still unclear, emerging research suggests that trigger points may be initiated by neurogenic mechanisms secondary to central sensitization, and not necessarily by local injury. A variety of treatments are employed in the management of trigger points, including manual therapy, electrotherapy, exercise, and needle therapy. Therapeutic ultrasound demonstrates significant potential as a safe, cost-effective, and relatively noninvasive therapeutic alternative in the treatment and management of this modern day medical enigma.

  3. TRIGGER

    CERN Multimedia

    W. Smith

    At the December meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, and results from the Magnet Test and Cosmic Challenge (MTCC) phase II. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and moving towards integration testing. A program of orderly connection and checkout with subsystems and central systems has been developed. This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored. This is combined with operations and testing without beam that will continue until startup. The plans for start-up, pilot and early running tri...

  4. TRIGGER

    CERN Multimedia

    W. Smith from contributions of C. Leonidopoulos, I. Mikulec, J. Varela and C. Wulz.

    Level-1 Trigger Hardware and Software Over the past few months, the Level-1 trigger has successfully recorded data with cosmic rays over long continuous stretches as well as LHC splash events, beam halo, and collision events. The L1 trigger hardware, firmware, synchronization, performance and readiness for beam operation were reviewed in October. All L1 trigger hardware is now installed at Point 5, and most of it is completely commissioned. While the barrel ECAL Trigger Concentrator Cards are fully operational, the recently delivered endcap ECAL TCC system is still being commissioned. For most systems there is a sufficient number of spares available, but for a few systems additional reserve modules are needed. It was decided to increase the overall L1 latency by three bunch crossings to increase the safety margin for trigger timing adjustments. In order for CMS to continue data taking during LHC frequency ramps, the clock distribution tree needs to be reset. The procedures for this have been tested. A repl...

  5. TRIGGER

    CERN Multimedia

    R. Arcidiacono

    2013-01-01

      In 2013 the Trigger Studies Group (TSG) has been restructured in three sub-groups: STEAM, for the development of new HLT menus and monitoring their performance; STORM, for the development of HLT tools, code and actual configurations; and FOG, responsible for the online operations of the High Level Trigger. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger Menu development, path timing, trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – in collaboration and with the technical support of the PdmV group. Since the end of proton-proton data taking, the group has started preparing for 2015 data taking, with collisions at 13 TeV and 25 ns bunch spacing. The reliability of the extrapolation to higher energy is being evaluated comparing the trigger rates on 7 and 8 TeV Monte Carlo samples with the data taken in the past two years. The effect of 25 ns bunch spacing is being studied on the d...

  6. TRIGGER

    CERN Multimedia

    W. Smith, from contributions of D. Acosta

    2012-01-01

      The L1 Trigger group deployed several major improvements this year. Compared to 2011, the single-muon trigger rate has been reduced by a factor of 2 and the η coverage has been restored to 2.4, with high efficiency. During the current technical stop, a higher jet seed threshold will be applied in the Global Calorimeter Trigger in order to significantly reduce the strong pile-up dependence of the HT and multi-jet triggers. The currently deployed L1 menu, with the “6E33” prescales, has a total rate of less than 100 kHz and operates with detector readout dead time of less than 3% for luminosities up to 6.5 × 1033 cm–2s–1. Further prescale sets have been created for 7 and 8 × 1033 cm–2s–1 luminosities. The L1 DPG is evaluating the performance of the Trigger for upcoming conferences and publication. Progress on the Trigger upgrade was reviewed during the May Upgrade Week. We are investigating scenarios for stagin...

  7. TRIGGER

    CERN Multimedia

    Wesley Smith

    2011-01-01

    Level-1 Trigger Hardware and Software New Forward Scintillating Counters (FSC) for rapidity gap measurements have been installed and integrated into the Trigger recently. For the Global Muon Trigger, tuning of quality criteria has led to improvements in muon trigger efficiencies. Several subsystems have started campaigns to increase spares by recovering boards or producing new ones. The barrel muon sector collector test system has been reactivated, new η track finder boards are in production, and φ track finder boards are under revision. In the CSC track finder, an η asymmetry problem has been corrected. New pT look-up tables have also improved efficiency. RPC patterns were changed from four out of six coincident layers to three out of six in the barrel, which led to a significant increase in efficiency. A new PAC firmware to trigger on heavy stable charged particles allows looking for chamber hit coincidences in two consecutive bunch-crossings. The redesign of the L1 Trigger Emulator...

  8. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware and Software The road map for the final commissioning of the level-1 trigger system has been set. The software for the trigger subsystems is being upgraded to run under CERN Scientific Linux 4 (SLC4). There is also a new release for the Trigger Supervisor (TS 1.4), which implies upgrade work by the subsystems. As reported by the CERN group, a campaign to tidy the Trigger Timing and Control (TTC) racks has begun. The machine interface was upgraded by installing the new RF2TTC module, which receives RF signals from LHC Point 4. Two Beam Synchronous Timing (BST) signals, one for each beam, can now be received in CMS. The machine group will define the exact format of the information content shortly. The margin on the locking range of the CMS QPLL is planned for study for different subsystems in the next Global Runs, using a function generator. The TTC software has been successfully tested on SLC4. Some TTC subsystems have already been upgraded to SLC4. The TTCci Trigger Supervisor ...

  9. Prevalence of myofascial pain in general internal medicine practice.

    OpenAIRE

    Skootsky, S A; Jaeger, B; Oye, R K

    1989-01-01

    Myofascial pain is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. We examined a series of 172 patients presenting to a university primary care general internal medicine practice. Of 54 patients whose reason for a visit included pain, 16 (30%) satisfied criteria for a clinical diagnosis of myofascial pain. These patients were similar in age and sex to other patients with pain, and the frequency of pain as a ...

  10. Myofascial low back pain treatment.

    Science.gov (United States)

    Sharan, Deepak; Rajkumar, Joshua Samuel; Mohandoss, Mathankumar; Ranganathan, Rameshkumar

    2014-09-01

    Myofascial pain is a common musculoskeletal problem, with the low back being one of the commonest affected regions. Several treatments have been used for myofascial low back pain through physical therapies, pharmacologic agents, injections, and other such therapies. This review will provide an update based on recently published literature in the field of myofascial low back pain along with a brief description of a sequenced, multidisciplinary treatment protocol called Skilled Hands-on Approach for the Release of myofascia, Articular, Neural and Soft tissue mobilization (SHARANS) protocol. A comprehensive multidisciplinary approach is recommended for the successful management of individuals with myofascial low back pain.

  11. TRIGGER

    CERN Multimedia

    W. Smith

    2011-01-01

    Level-1 Trigger Hardware and Software Overall the L1 trigger hardware has been running very smoothly during the last months of proton running. Modifications for the heavy-ion run have been made where necessary. The maximal design rate of 100 kHz can be sustained without problems. All L1 latencies have been rechecked. The recently installed Forward Scintillating Counters (FSC) are being used in the heavy ion run. The ZDC scintillators have been dismantled, but the calorimeter itself remains. We now send the L1 accept signal and other control signals to TOTEM. Trigger cables from TOTEM to CMS will be installed during the Christmas shutdown, so that the TOTEM data can be fully integrated within the CMS readout. New beam gas triggers have been developed, since the BSC-based trigger is no longer usable at high luminosities. In particular, a special BPTX signal is used after a quiet period with no collisions. There is an ongoing campaign to provide enough spare modules for the different subsystems. For example...

  12. TRIGGER

    CERN Multimedia

    J. Alimena

    2013-01-01

    Trigger Strategy Group The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for the development of future High-Level Trigger menus, as well as of its DQM and validation, in collaboration and with the technical support of the PdmV group. Taking into account the beam energy and luminosity expected in 2015, a rough estimate of the trigger rates indicates a factor four increase with respect to 2012 conditions. Assuming that a factor two can be tolerated thanks to the increase in offline storage and processing capabilities, a toy menu has been developed using the new OpenHLT workflow to estimate the transverse energy/momentum thresholds that would halve the current trigger rates. The CPU time needed to run the HLT has been compared between data taken with 25 ns and 50 ns bunch spacing, for equivalent pile-up: no significant difference was observed on the global time per event distribution at the only available data point, corresponding to a pile-up of about 10 interactions. Using th...

  13. TRIGGER

    CERN Multimedia

    by Wesley Smith

    2011-01-01

    Level-1 Trigger Hardware and Software After the winter shutdown minor hardware problems in several subsystems appeared and were corrected. A reassessment of the overall latency has been made. In the TTC system shorter cables between TTCci and TTCex have been installed, which saved one bunch crossing, but which may have required an adjustment of the RPC timing. In order to tackle Pixel out-of-syncs without influencing other subsystems, a special hardware/firmware re-sync protocol has been introduced in the Global Trigger. The link between the Global Calorimeter Trigger and the Global Trigger with the new optical Global Trigger Interface and optical receiver daughterboards has been successfully tested in the Electronics Integration Centre in building 904. New firmware in the GCT now allows a setting to remove the HF towers from energy sums. The HF sleeves have been replaced, which should lead to reduced rates of anomalous signals, which may allow their inclusion after this is validated. For ECAL, improvements i...

  14. Effect of yoga on the Myofascial Pain Syndrome of neck

    Directory of Open Access Journals (Sweden)

    D Sharan

    2014-01-01

    Full Text Available Myofascial Pain Syndrome (MPS refers to pain attributed to muscle and its surrounding fascia, which is associated with ′′myofascial trigger points′′ (MTrPs. MTrPs in the trapezius has been proposed as the main cause of temporal and cervicogenic headache and neck pain. Literature shows that the prevalence of various musculoskeletal disorders (MSD among physiotherapists is high. Yoga has traditionally been used to treat MSDs in various populations. But there is scarcity of literature which explains the effects of yoga on reducing MPS of the neck in terms of various physical parameters and subjective responses. Therefore, a pilot study was done among eight physiotherapists with minimum six months of experience. A structured yoga protocol was designed and implemented for five days in a week for four weeks. The outcome variables were Disability of Arm, Shoulder and Hands (DASH score, Neck Disability Index (NDI, Visual Analogue Scale (VAS, Pressure Pain Threshold (PPT for Trigger Points, Cervical Range of Motion (CROM - active & passive, grip and pinch strengths. The variables were compared before and after the intervention. Finally, the result revealed that all the variables (DASH: P<0.00, NDI: P<0.00, VAS: P<0.00, PPT: Left: P<0.00, PPT: Right: P<0.00, Grip strength: left: P<0.00, Grip strength: right: P<0.01, Key pinch: left: P<0.01, Key pinch: right: P<0.01, Palmar pinch: left: P<0.01, Palmar pinch: right: P<0.00, Tip pinch: left: P<0.01, Tip pinch: Right: P<0.01 improved significantly after intervention.

  15. Effect of yoga on the Myofascial Pain Syndrome of neck.

    Science.gov (United States)

    Sharan, D; Manjula, M; Urmi, D; Ajeesh, Ps

    2014-01-01

    Myofascial Pain Syndrome (MPS) refers to pain attributed to muscle and its surrounding fascia, which is associated with "myofascial trigger points" (MTrPs). MTrPs in the trapezius has been proposed as the main cause of temporal and cervicogenic headache and neck pain. Literature shows that the prevalence of various musculoskeletal disorders (MSD) among physiotherapists is high. Yoga has traditionally been used to treat MSDs in various populations. But there is scarcity of literature which explains the effects of yoga on reducing MPS of the neck in terms of various physical parameters and subjective responses. Therefore, a pilot study was done among eight physiotherapists with minimum six months of experience. A structured yoga protocol was designed and implemented for five days in a week for four weeks. The outcome variables were Disability of Arm, Shoulder and Hands (DASH) score, Neck Disability Index (NDI), Visual Analogue Scale (VAS), Pressure Pain Threshold (PPT) for Trigger Points, Cervical Range of Motion (CROM) - active & passive, grip and pinch strengths. The variables were compared before and after the intervention. Finally, the result revealed that all the variables (DASH: P<0.00, NDI: P<0.00, VAS: P<0.00, PPT: Left: P<0.00, PPT: Right: P<0.00, Grip strength: left: P<0.00, Grip strength: right: P<0.01, Key pinch: left: P<0.01, Key pinch: right: P<0.01, Palmar pinch: left: P<0.01, Palmar pinch: right: P<0.00, Tip pinch: left: P<0.01, Tip pinch: Right: P<0.01) improved significantly after intervention.

  16. Myofacial trigger points in advanced cancer patients

    Directory of Open Access Journals (Sweden)

    Hideaki Hasuo

    2016-01-01

    Full Text Available Myofascial pain syndrome is started to be recognized as one of important factors of pain in cancer patients. However, no reports on features of myofascial trigger points were found in terminally-ill cancer populations. This time, we encountered 5 patients with myofascial pain syndrome and terminal cancer in whom delirium developed due to increased doses of opioid without a diagnosis of myofascial pain syndrome on initial presentation. The delirium subsided with dose reductions of opioid and treatment of myofascial pain syndrome. The common reason for a delayed diagnosis among the patients included an incomplete palpation of the painful sites, which led to unsuccessful myofascial trigger points identification. The features of myofascial trigger points included single onset in the cancer pain management site with opioid and the contralateral abdominal side muscles of the non-common sites. Withdrawal reflexes associated with cancer pain in the supine position, which are increasingly seen in the terminal cancer patients, were considered to have contributed to this siuation.We consider that careful palpation of the painful site is important, in order to obtain greater knowledge and understanding of the features of myofascial trigger points.

  17. Treatment of temporomandibular myofascial pain with deep dry needling.

    Science.gov (United States)

    Gonzalez-Perez, Luis-Miguel; Infante-Cossio, Pedro; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco-Javier

    2012-09-01

    The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6.5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. We found a statistically significant relationship (p<0.01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle.

  18. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware The CERN group is working on the TTC system. Seven out of nine sub-detector TTC VME crates with all fibers cabled are installed in USC55. 17 Local Trigger Controller (LTC) boards have been received from production and are in the process of being tested. The RF2TTC module replacing the TTCmi machine interface has been delivered and will replace the TTCci module used to mimic the LHC clock. 11 out of 12 crates housing the barrel ECAL off-detector electronics have been installed in USC55 after commissioning at the Electronics Integration Centre in building 904. The cabling to the Regional Calorimeter Trigger (RCT) is terminated. The Lisbon group has completed the Synchronization and Link mezzanine board (SLB) production. The Palaiseau group has fully tested and installed 33 out of 40 Trigger Concentrator Cards (TCC). The seven remaining boards are being remade. The barrel TCC boards have been tested at the H4 test beam, and good agreement with emulator predictions were found. The cons...

  19. Spontaneous Myoelectric Phenomenon and Histopathology of Myofascial Trigger Points in Rats%大鼠肌筋膜疼痛触发点自发肌电现象和病理组织学研究

    Institute of Scientific and Technical Information of China (English)

    韩蓓; 黄强民; 谭树生; 庄小强

    2011-01-01

    Objective We attempted to observe the spontaneous myoelectric phenomenon and histopathology of myofascial trigger points. Methods Thirty two male mice were equally divided into control group (A) , and experimental groups B、 C and D. Medial vastus muscle of rat was stroked in combination with eccentric exercise once a week in groups B for 4 weeks, in group C for 8 weeks with 2 weeks rest, and in group D for 8 weeks with 4 weeks rest. The responsive taut band, spontaneous EMG, and local tic of rats were checked. Histology of the trigger points was observed as well. Results Comparing with group A: (1) the positive rate of responsive taut band was 0%, 100% (8/8, P<0.01) , and75% (6/8, P<0.01) ingroupsB, C, andD, respectively: (2) the positive rate of local tic was 37.5% (3/8, P<0.05) , 87.5% (7/8, P<0.01) , and75% (6/8, P<0.01)in groups B, C, and D, respectively: (3) the positive rate of spontaneous EMG was 12.5% (1/8,P>0.05) , 100% (8/8, P<0.01) , and 87.5% (7/8, P<0.01) ingroupsB, C, andD, respectively. The contracture of muscle fiber was found in group C and D, except in group B. Conclusion 1-week striking plus eccentric exercise can cause the development of mynfascial trigger point, but is not enough to induce the myofascial pain syndrome.%目的:观察局部损伤后肌筋膜疼痛触发点动物模型的自发肌电和触发点肌纤维的病理结构改变.方法:32只雄性SD大鼠(7周龄)随机分成4组,每组8只.A组对照组,不进行干预;B、C、D组为实验组,采取打击结合离心运动进行干预,每周1次,不同组采取的干预持续时间不同,B组干预4周,C组干预8周后饲养2周,D组干预8周后饲养4周.实验共12周.分别在不同时间检查大鼠受累肌的紧张带和局部抽搐反应,采用肌电仪观察自发肌电现象,然后解剖取材,检查触发点肌肉组织学改变,并与对照组进行比较.结果:A组各项检查均为阴性.其它3组与A组比较:(1)紧张带:B组

  20. Modificaciones del umbral de dolor en un punto gatillo miofascial tras técnica de energía muscular Changes in pain threshold in myofascial trigger point after muscle energy technique

    Directory of Open Access Journals (Sweden)

    J.C. Zuil Escobar

    2010-10-01

    écnica de energía muscular en el punto gatillo miofascial latente 1 del trapecio superior ha mostrado un aumento inmediato en el umbral de dolor, quien no se mantuvo a las 24horas. Son necesarias investigaciones con una muestra mayor y con sujetos sintomáticos.Aims: Evaluate the changes in pressure pain threshold in latent myofascial trigger points 1 of the upper trapezius after a muscle energy technique application and evaluate intra-tester reliability of an analogue algometer on this point. Material y methods: A total of 35 asymptomatic subjects with latent upper trapezius myofascial trigger point 1 were randomized in two groups: one group was treated with a muscle energy technique (group 1 and the other one (control, group 2 was not treated. Demographic variables, such as gender, age, height and weight, and pressure pain threshold was evaluated. Pressure pain threshold was evaluated using an analogue algometer three times: before the intervention, five minutes post-intervention and 24h post-intervention. For quantitative variables statistical analysis, means, ranges and standard deviations wer used; and for qualitative variables, percentages and frequencies. For inter-tester reliability intra-class correlation coefficient was used. A two-way analysis of variance for repeated measurements was used for pressure pain threshold differences. The statistical analysis was performed using a 95% confidence level. Results: Intra-class correlation coefficient showed values ranging from 0.82-0.92. No significant differences were observed for baseline values. Analysis of variance showed significant effects for time and interaction between time and group. Group 1 showed a significant increase in pressure pain threshold after five minutes intervention, but this disappeared at 24h post intervention. Group 2 showed no significant differences. Conclusions: Inter-tested reliabilty of pressure pain threshold was good. Muscle energy technique in latent upper trapezius trigger point 1 has

  1. Short-term effects of self-massage combined with home exercise on pain, daily activity, and autonomic function in patients with myofascial pain dysfunction syndrome.

    Science.gov (United States)

    Chan, Yuan-Chi; Wang, Tzyy-Jiuan; Chang, Cheng-Chiang; Chen, Liang-Cheng; Chu, Heng-Yi; Lin, Shiou-Ping; Chang, Shin-Tsu

    2015-01-01

    [Purpose] The aim of the present was to investigate the short-term effects of a program combining self-massage and home exercise for patients with myofascial pain dysfunction syndrome (MPDS). [Subjects and Methods] In this retrospective study, 63 patients were allocated to the experimental (n = 32) and control (n = 31) groups. Both groups received 6 sessions of treatment with physical modalities over the course of two weeks. The experimental group completed an additional program with a combination of self-massage and home exercise. The outcome measurements included a pain scale, pressure pain threshold (PPT), neck disability index (NDI), patient-specific functional scales (PSFS), and heart rate variability (HRV). The interactions between the groups and over time were analyzed using two-way repeated measures ANOVA. [Results] Only the experimental group demonstrated significant improvements in the pain scale with varying conditions. The PPTs of the trigger points increased significantly in the experimental group, and significant functional improvements in NDI and PSFS were observed in the same group. There were significant increases in high-frequency HRV and high-frequency % in the experimental group. [Conclusion] Treatment with physical modalities plus combination of self-massage and home exercise is more effective than the physical modalities treatment alone.

  2. Tufted angioma and myofascial pain syndrome.

    Science.gov (United States)

    Silva, Roberto Souto da; Bressan, Aline Lopes; Nascimento, Lívia Barbosa; Kac, Bernard Kawa; Azulay-Abulafia, Luna

    2011-01-01

    Tufted angioma is a rare acquired vascular tumor. It is characterized by painful purplish macules that may progress to plaques containing angiomatous papules. The condition is benign; however, it often affects extensive areas of the skin, leading to functional disability of the affected limb if painful. The present report describes a case of a tufted angioma associated with myofascial pain syndrome in which the predisposing element was the presence of this tumor since childhood. Pain at the site of the lesion affected muscle use and led to the onset of the associated syndrome. Complete relief from symptoms was achieved by blocking the trigger points of the affected limb with anesthesia.

  3. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain.

    Science.gov (United States)

    León-Hernández, Jose V; Martín-Pintado-Zugasti, Aitor; Frutos, Laura G; Alguacil-Diego, Isabel M; de la Llave-Rincón, Ana I; Fernandez-Carnero, Josue

    2016-07-11

    Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.

  4. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

    Directory of Open Access Journals (Sweden)

    Jose V. León-Hernández

    Full Text Available ABSTRACT Background Dry needling (DN and percutaneous electrical nerve stimulation (PENS are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group and 31 received DN and PENS (DN+PENS group. The primary outcomes were neck disability index (NDI and visual analog scale for pain for both post-needling soreness (PNS and neck pain intensity (NPI. Pressure pain threshold (PPT and cervical range of motion (CROM were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.

  5. Characteristics of Myofascial Pain Syndrome of the Infraspinatus Muscle.

    Science.gov (United States)

    Kwon, Junbeom; Kim, Hyoung Seop; Chang, Won Hyuk; Park, Chunung; Lee, Sang Chul

    2017-08-01

    To report the characteristics of myofascial trigger points (MTrPs) in the infraspinatus muscle and evaluate the therapeutic effect of trigger-point injections. Medical records of 297 patients (221 women; age, 53.9±11.3 years) with MTrPs in the infraspinatus muscle were reviewed retrospectively. Because there were 83 patients with MTrPs in both infraspinatus muscles, the characteristics of total 380 infraspinatus muscles with MTrPs (214 one side, 83 both sides) were investigated. Specific characteristics collected included chief complaint area, referred pain pattern, the number of local twitch responses, and distribution of MTrPs in the muscle. For statistical analysis, the paired t-test was used to compare a visual analogue scale (VAS) before and 2 weeks after the first injection. The most common chief complaint area of MTrPs in the infraspinatus muscle was the scapular area. The most common pattern of referred pain was the anterolateral aspect of the arm (above the elbow). Active MTrPs were multiple rather than single in the infraspinatus muscle. MTrPs were frequently in the center of the muscle. Trigger-point injection of the infraspinatus muscle significantly decreased the pain intensity. Mean VAS score decreased significantly after the first injection compared to the baseline (7.11 vs. 3.74; pmyofascial pain syndrome of the infraspinatus muscle.

  6. 美洛昔康痛点注射配合肌筋膜牵拉手法治疗肩关节周围炎%Clinical Observation on Trigger Point Injection with Meloxicam Combined with Myofascial Traction for treating Periarthritis of Shoulder

    Institute of Scientific and Technical Information of China (English)

    欧汉锋; 罗海燕; 魏秋实; 曾伟恒

    2013-01-01

    Objective:To observe the efficacy and safety of trigger point injection with meloxicam combined with myofascial traction for treating periarthritis of shoulder.Methods:All 106 outpatients were randomly divided into treatment group I (meloxicam combined with myofascial traction group),treatment group Ⅱ (myofascial traction group),and control group (routine massage group).Three groups were administrated with manipulation treatment and self-rehabilitation.The patients were performed with routine massage in control group and myofascial traction in treatment group,and plus trigger point injection once a weeks in treatment group Ⅰ.All groups were treated once a day,7 days for a treatment course,every 2 courses with 2 day's interval,and a total of four courses.The efficacy and safety were evaluated according to Constant-Murley score and complications.Results:The efficacy of treatment group Ⅰ (100%) and Ⅱ (93.7%) were higher than control group (70%,P<0.05),and treatment group Ⅰ was higher than treatment group Ⅱ (P<0.05).There was no complication in all groups.Conclusion:Trigger point injection with meloxicam combined with myofascial traction can effectively loosen adhesion of soft tissue in frozen shoulder,relieve pain,improve function of shoulder,and reduce labor intensity of operator.It is easy,safe,and effective for clinical application.%目的:观察美洛昔康痛点注射配合肌筋膜牵拉手法治疗肩关节周围炎的临床效果和安全性.方法:106个门诊病例应用随机分为美洛昔康+肌筋膜牵拉手法组(A组)、肌筋膜牵拉手法组(B组)和常规推拿手法组(C组),3组均进行手法治疗和自主康复训练,C组进行常规推拿手法,A、B组进行肌筋膜牵拉手法,A在手法结束后进行痛点注射;每日1次,7d为1个疗程,每2个疗程间休息2d,痛点注射每周1次,共4个疗程.根据Constant-Murley score来评价疗效,根据并发症来评价安全性.结果:疗效比较,A组(l00

  7. Therapeutic Observation of Acupuncture at Myofascial Trigger Points for Cervical Spondylosis of Vertebral Artery Type%针刺肌筋膜触发点治疗椎动脉型颈椎病疗效观察

    Institute of Scientific and Technical Information of China (English)

    王翀敏; 陈红薇; 王延武; 岳红; 朱敏

    2015-01-01

    目的:观察针刺肌筋膜触发点治疗椎动脉型颈椎病的临床疗效。方法将98例椎动脉型颈椎病患者随机分为治疗组51例和对照组47例。治疗组采用针刺肌筋膜触发点治疗,对照组采用注射消炎镇痛液治疗。比较两组治疗前后旋颈试验阳性率、眩晕评分及头项部疼痛VAS评分。结果两组治疗后VAS评分、旋颈试验阳性率及眩晕评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后VAS评分、旋颈试验阳性率及眩晕评分与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为96.1%,对照组为76.6%,两组比较差异具有统计学意义(P<0.05)。结论针刺肌筋膜触发点能改善椎动脉型颈椎病患者眩晕及头项部疼痛症状。%Objective To observe the therapeutic efficacy of acupuncture at myofascial trigger points (MTrPs) in treating cervical spondylosis of vertebral artery type. Methods Ninety-eight patients with cervical spondylosis of vertebral artery type were randomized into a treatment group of 51 cases and a control group of 47 cases. The treatment group was intervened by acupuncture at the MTrPs, while the control group was by injection of medical solution for anti-inflammation and analgesia. The positive rate of rotate-cervix test, dizziness score, and visual analogue scale (VAS) of the head and neck pain were compared before and after intervention. Results After intervention, the positive rate, dizziness score, and VAS score were significantly changed in both groups (P<0.05). There were significant differences in comparing the positive rate, dizziness score, and VAS score between the two groups after intervention (P<0.05). The total effective rate was 96.1%in the treatment group versus 76.6%in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupuncture at the MTrPs can improve the dizziness and head-neck pain in patients with

  8. Myofascial pain, fibromyalgia or fibrositis?

    Science.gov (United States)

    Pearce, J M S

    2004-01-01

    The terms myofascial pain, fibromyalgia and fibrositis are critically examined. They constitute diagnostic labels for non-specific musculoskeletal aches and pains. Analysis of the evidence shows that none of these labels is substantiated by hard physical signs or by laboratory evidence of consistent pathological or biochemical abnormality. What is the objective evidence for disorder(s) of muscle, fascia or fibrous tissues, so clearly indicated by these diagnostic names? Alternative terms such as 'regional pain syndrome' or 'chronic pain syndrome' merely redefine the clinical problem without providing a mechanism or basis for diagnosis. Despite different diagnostic criteria, these conditions, along with chronic fatigue syndrome, have many demographic and clinical similarities, most notably tender trigger points. Indeed, the terms are often used interchangeably. There are few differences in the symptoms, physical findings, laboratory tests, functional status, psychosocial features and psychiatric disorders. This paper seeks not to deny the existence of aches and pains, but to critically examine the utility of these terms. The only claimed physical sign is the presence of tender trigger points over muscles or muscle attachments. Research suggests that tender points are a measure of general distress related to pain complaints but separately associated with fatigue and depression. They are present in some normal subjects and are variable in occurrence in time in the same individual. They reflect no demonstrable pathology. It is therefore argued that none of these commonly used diagnoses represent distinct disease entities. A possible but unproven alternative hypothesis is that such symptoms relate to neural pain with both peripheral and central components, and in some instances psychological or wilful embellishment.

  9. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force.

    Science.gov (United States)

    MacDonald, Graham Z; Penney, Michael D H; Mullaley, Michelle E; Cuconato, Amanda L; Drake, Corey D J; Behm, David G; Button, Duane C

    2013-03-01

    Foam rolling is thought to improve muscular function, performance, overuse, and joint range of motion (ROM); however, there is no empirical evidence demonstrating this. Thus, the objective of the study was to determine the effect of self-myofascial release (SMR) via foam roller application on knee extensor force and activation and knee joint ROM. Eleven healthy male (height 178.9 ± 3.5 cm, mass 86.3 ± 7.4 kg, age 22.3 ± 3.8 years) subjects who were physically active participated. Subjects' quadriceps maximum voluntary contraction force, evoked force and activation, and knee joint ROM were measured before, 2 minutes, and 10 minutes after 2 conditions: (a) 2, 1-minute trials of SMR of the quadriceps via a foam roller and (b) no SMR (Control). A 2-way analysis of variance (condition × time) with repeated measures was performed on all dependent variables recorded in the precondition and postcondition tests. There were no significant differences between conditions for any of the neuromuscular dependent variables. However, after foam rolling, subjects' ROM significantly (p foam rolling, which no longer existed after foam rolling. In conclusion, an acute bout of SMR of the quadriceps was an effective treatment to acutely enhance knee joint ROM without a concomitant deficit in muscle performance.

  10. Current studies on myofascial pain syndrome.

    Science.gov (United States)

    Kuan, Ta-Shen

    2009-10-01

    Recent studies have clarified the nature of myofascial trigger points (MTrPs). In an MTrP region, multiple hyperirritable loci can be found. The sensory components of the MTrP locus are sensitized nociceptors that are responsible for pain, referred pain, and local twitch responses. The motor components are dysfunctional endplates that are responsible for taut band formation as a result of excessive acetylcholine (ACh) leakage. The concentrations of pain- and inflammation-related substances are increased in the MTrP region. It has been hypothesized that excessive ACh release, sarcomere shortening, and release of sensitizing substances are three essential features that relate to one another in a positive feedback cycle. This MTrP circuit is the connection among spinal sensory (dorsal horn) neurons responsible for the MTrP phenomena. Recent studies suggest that measurement of biochemicals associated with pain and inflammation in the MTrP region, the sonographic study of MTrPs, and the magnetic resonance elastography for taut band image are potential tools for the diagnosis of MTrPs. Many methods have been used to treat myofascial pain, including laser therapy, shockwave therapy, and botulinum toxin type A injection.

  11. Intermuscular force transmission along myofascial chains: a systematic review.

    Science.gov (United States)

    Krause, Frieder; Wilke, Jan; Vogt, Lutz; Banzer, Winfried

    2016-06-01

    The present review aims to provide a systematic overview on tensile transmission along myofascial chains based on anatomical dissection studies and in vivo experiments. Evidence for the existence of myofascial chains is growing, and the capability of force transmission via myofascial chains has been hypothesized. However, there is still a lack of evidence concerning the functional significance and capability for force transfer. A systematic literature research was conducted using MEDLINE (Pubmed), ScienceDirect and Google Scholar. Studied myofascial chains encompassed the superficial backline (SBL), the back functional line (BFL) and the front functional line (FFL). Peer-reviewed human dissection studies as well as in vivo experiments reporting intermuscular tension transfer between the constituents of a myofascial chain were included. To assess methodic quality, two independent investigators rated studies by means of validated assessment tools (QUACS and PEDro Scale). The literature research identified 1022 articles. Nine studies (moderate to excellent methodological quality) were included. Concerning the SBL and the BFL, there is moderate evidence for force transfer at all three transitions (based on six studies), and one of two transitions (three studies). One study yields moderate evidence for a slight, but not significant force transfer at one transition in the FFL. The findings of the present study indicate that tension can be transferred between some of the examined adjacent structures. Force transfer might have an impact in overuse conditions as well as on sports performance. However, different methods of force application and measurement hinder the comparability of results. Considering anatomical variations in the degree of continuity and histological differences of the linking structures is crucial for interpretation. Future studies should focus on the in vivo function of myofascial continuity during isolated active or passive tissue tensioning.

  12. The Kinesio Taping Method for Myofascial Pain Control.

    Science.gov (United States)

    Wu, Wei-Ting; Hong, Chang-Zern; Chou, Li-Wei

    2015-01-01

    Many people continue suffering from myofascial pain syndrome (MPS) defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. Muscle spasm and block of blood circulation can be noticed in the taut bands. In the MTrP region, nociceptors can be sensitized by the peripheral inflammatory factors and contracture of fascia can also be induced. Traditional treatments of MPS include stretching therapy, thermal treatment, electrical stimulation, massage, manipulation, trigger points injection, acupuncture, and medicine. However, the pain syndrome may not be relieved even under multiple therapies. Recently, the Kinesio Taping (KT) method is popularly used in sports injuries, postoperative complications, and various pain problems, but little research is focused on MPS with KT method. In this paper, we review the research studies on the application to KT in treating MPS and other related issues. It appears that the KT application can elevate the subcutaneous space and then increase the blood circulation and lymph fluid drainage to reduce the chemical factors around the MTrP region. Therefore, it is suggested that KT method can be used as a regular treatment or added to the previous treatment for myofascial pain.

  13. The Kinesio Taping Method for Myofascial Pain Control

    Directory of Open Access Journals (Sweden)

    Wei-Ting Wu

    2015-01-01

    Full Text Available Many people continue suffering from myofascial pain syndrome (MPS defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs clinically. Muscle spasm and block of blood circulation can be noticed in the taut bands. In the MTrP region, nociceptors can be sensitized by the peripheral inflammatory factors and contracture of fascia can also be induced. Traditional treatments of MPS include stretching therapy, thermal treatment, electrical stimulation, massage, manipulation, trigger points injection, acupuncture, and medicine. However, the pain syndrome may not be relieved even under multiple therapies. Recently, the Kinesio Taping (KT method is popularly used in sports injuries, postoperative complications, and various pain problems, but little research is focused on MPS with KT method. In this paper, we review the research studies on the application to KT in treating MPS and other related issues. It appears that the KT application can elevate the subcutaneous space and then increase the blood circulation and lymph fluid drainage to reduce the chemical factors around the MTrP region. Therefore, it is suggested that KT method can be used as a regular treatment or added to the previous treatment for myofascial pain.

  14. The Kinesio Taping Method for Myofascial Pain Control

    Science.gov (United States)

    Wu, Wei-Ting; Hong, Chang-Zern

    2015-01-01

    Many people continue suffering from myofascial pain syndrome (MPS) defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. Muscle spasm and block of blood circulation can be noticed in the taut bands. In the MTrP region, nociceptors can be sensitized by the peripheral inflammatory factors and contracture of fascia can also be induced. Traditional treatments of MPS include stretching therapy, thermal treatment, electrical stimulation, massage, manipulation, trigger points injection, acupuncture, and medicine. However, the pain syndrome may not be relieved even under multiple therapies. Recently, the Kinesio Taping (KT) method is popularly used in sports injuries, postoperative complications, and various pain problems, but little research is focused on MPS with KT method. In this paper, we review the research studies on the application to KT in treating MPS and other related issues. It appears that the KT application can elevate the subcutaneous space and then increase the blood circulation and lymph fluid drainage to reduce the chemical factors around the MTrP region. Therefore, it is suggested that KT method can be used as a regular treatment or added to the previous treatment for myofascial pain. PMID:26185522

  15. The use of dry needling and myofascial meridians in a case of plantar fasciitis.

    Science.gov (United States)

    Akhbari, Behnam; Salavati, Mahyar; Ezzati, Kamran; Mohammadi Rad, Shahrzad

    2014-03-01

    The purpose of this case report is to describe the use of dry needling based on myofascial meridians for management of plantar fasciitis. A 53-year-old man presented with bilateral chronic foot pain for more than 2 years. After 2 months of conventional treatment (ultrasound, plantar fascia and Achilles tendon stretching, and intrinsic foot strengthening), symptoms eventually improved; however, symptoms returned after prolonged standing or walking. Almost all previous treatment methods were localized in the site of pain that targeted only the plantar fascia. Initial examination of this individual revealed that multiple tender points were found along the insertion of Achilles tendon, medial gastrocnemius, biceps femoris, semimembranosus, and ischial tuberosity. Dry needling of the trigger points was applied. After 4 treatments over 2 weeks, the patient felt a 60% to 70% reduction in pain. His pressure pain threshold was increased, and pain was alleviated. The patient returned to full daily activities. The rapid relief of this patient's pain after 2 weeks of dry needling to additional locations along the superficial back line suggests that a more global view on management was beneficial to this patient. Dry needling based on myofascial meridians improved the symptoms for a patient with recurrent plantar fasciitis.

  16. [Myofascial pain syndrome].

    Science.gov (United States)

    Novikova, L B; Akopyan, A P

    2015-01-01

    To analyze clinical characteristics of pain syndrome in patients with dorsalgia. Authors studied 43 patients (mean age 41.9±1.2 years), 34 women and 9 men, with acute and subacute chronic back pain. The study included neurological examination, MRI and/or CT of the spine, measurement of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), The Brief Pain Inventory (BPI) and the McGill Pain Inventory. Chronic myofascial pain syndrome (MFPS) was frequently associated with anxiety-depressive disorders found in patients with cervical and cervical/pectoral pain, fibromyalgia with minimal neurological symptoms and no signs of neural structure compression according to MRI and CT. The results of the study of chronic MFPS should be taken into account in the choice of tactics of treatment of MFPS patients. The use of amelotex in the combination with compligam B in patients with dorsopathy and MFPS is effective together with correction of emotional disorders and treatment with chondroprotectors.

  17. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis.

    Science.gov (United States)

    Kietrys, David M; Palombaro, Kerstin M; Azzaretto, Erica; Hubler, Richard; Schaller, Bret; Schlussel, J Mathew; Tucker, Mary

    2013-09-01

    Systematic review and meta-analysis. Myofascial pain syndrome (MPS) is associated with hyperalgesic zones in muscle called myofascial trigger points. When palpated, active myofascial trigger points cause local or referred symptoms, including pain. Dry needling involves inserting an acupuncture-like needle into a myofascial trigger point, with the goal of reducing pain and restoring range of motion. To explore the evidence regarding the effectiveness of dry needling to reduce pain in patients with MPS of the upper quarter. An electronic literature search was performed using the key word dry needling. Articles identified with the search were screened for the following inclusion criteria: human subjects, randomized controlled trial (RCT), dry needling intervention group, and MPS involving the upper quarter. The RCTs that met these criteria were assessed and scored for internal validity using the MacDermid Quality Checklist. Four separate meta-analyses were performed: (1) dry needling compared to sham or control immediately after treatment, (2) dry needling compared to sham or control at 4 weeks, (3) dry needling compared to other treatments immediately after treatment, and (4) dry needling compared to other treatments at 4 weeks. The initial search yielded 246 articles. Twelve RCTs were ultimately selected. The methodological quality scores ranged from 23 to 40 points, with a mean of 34 points (scale range, 0-48; best possible score, 48). The findings of 3 studies that compared dry needling to sham or placebo treatment provided evidence that dry needling can immediately decrease pain in patients with upper-quarter MPS, with an overall effect favoring dry needling. The findings of 2 studies that compared dry needling to sham or placebo treatment provided evidence that dry needling can decrease pain after 4 weeks in patients with upper-quarter MPS, although a wide confidence interval for the overall effect limits the impact of the effect. Findings of studies that

  18. Efficacy of Trigger Point Biopsy Combined with Injection Therapy in the Upper Trapezius Muscle for Myofascial Pain Syndrome%斜方肌激痛点活检复合注射疗法治疗肌筋膜疼痛综合征的疗效

    Institute of Scientific and Technical Information of China (English)

    郭亚秋; 齐峰; 胡启雅; 王姿; 郭静旋; 黄海真; 丁超; 潘新; 张力

    2014-01-01

    The aim was to observe the efficacy of trigger point biopsy combined with injection therapy on the upper trapezius muscle for myofascial pain syndrome (MPS). Sixty patients of MPS were recruited and randomly divided equally into two groups. Group BI groupreceived myofascial trigger point (MTrP) biopsy plus injection therapy and group IT treated with MTrP injection therapy alone. The Visual Analogue Scale (VAS) was measured before the treatment, after the treatment immediately, and the day 7, 14, 21 and 28 after the treatment. The efficacy rate was evaluated up to three months after the treatment. Side effects were also observed during the treatment. The VAS in both groups decreased significantly after treatment (P<0. 05). The VAS in the group BI decreased significantly as compared to that in the group IT at day 14, 21, 28 after treatment (P< 0. 05). The effective rate was significantly higher than that in group IT three months after treatment (P<0. 05). Only one side effect appeared in group BI. Myofascial trigger point biopsy combined with analgesic injection therapy can provide an effective treatment for MPS than injection therapy alone.%观察斜方肌激痛点活检复合注射疗法治疗肌筋膜疼痛综合征(MPS)的疗效是否优于单纯注射治疗。选择MPS患者60例,随机分为激痛点活检复合镇痛液注射治疗组(BI组)和单纯镇痛液注射治疗组(IT组),每组30例。BI组患者行激痛点活检,并于活检处行镇痛液注射疗法;IT组患者仅于激痛点处行镇痛液注射治疗。评定患者治疗前和治疗后即刻、7天、14天、21天及28天疼痛视觉模拟评分(VAS),治疗后3个月的临床有效率以及和治疗有关的不良反应。结果两组治疗后VAS评分与治疗前相比均降低(P<0.05),从治疗后14天起BI组VAS评分低于IT组(P<0.05)。治疗3个月后BI组有效率高于IT组(P<0.05)。BI组出现1例不良反应患者。激痛点活

  19. 温和灸激痛点治疗肩背部肌筋膜疼痛综合征:随机对照研究%A Randomized Controlled Clinical Trial for Treatment of Shoulder-back Myofascial Pain Syn-drome with Mild Moxibustion at Trigger Points

    Institute of Scientific and Technical Information of China (English)

    王列; 马帅; 赵悦; 曹锐; 王颖; 马铁明

    2016-01-01

    Objective To compare the efficacy difference between the mild moxibustion and acupuncture stimulation at trigger points in the treatment of shoulder and back myofascial pain syndrome (MPS),so as to provide a reference for clinical treatment of MPS.Methods A total of 60 patients with shoulder and back MPS were equally and randomly divided into mild moxibustion group and acupuncture group.The myofascial trigger points in the shoulder and back regions were stimulated with mild moxibustion for 20- 1 00 min every time or punctured with filiform needles by retaining the needles for 30 min after twirling for a while.The treatment was conducted once daily for 1 0 days.The short-form McGill pain questionnaire (SF-MPQ)including the pain rating index [PRI consisting of 1 5 descriptors (1 1 sensory,4 affective)which are rated on an intensity scale as 0 = none,1 =mild,2=moderate and 3=severe],present pain intensity (PPI)index of the standard MPQ and a visual analogue scale (VAS) was used to assess the patient’s pain severity before and after the treatment.Results Following the treatment,of the two 30 cases of MPS patients in the acupuncture and mild moxibustion groups,1 and 7 were cured,1 1 and 1 7 experienced marked im-provement,1 4 and 5 were effective,4 and 1 was invalid,with the effective rates being 86.7% (26/30)and 96.7%(29/30),re-spectively.The cured plus markedly effective rate of the mild moxibustion group was significantly better than that of the acupunc-ture group(P 0.05).Conclusion Mild moxibustion stimulation of myofascial trigger point is effective in relieving shoulder-back MPS,being comparable to that of acupuncture therapy.%目的::比较温和灸与针刺激痛点治疗肩背部肌筋膜疼痛综合征(MPS)的疗效差异,为肩背部MPS 的治疗提供参考。方法:60例肩背部 MPS 患者随机分为温和灸组和针刺组,每组30例,两组均选取疼痛部位的激痛点进行治疗。温和灸组采用温和

  20. 肌筋膜疼痛触发点配合经络穴位治疗腰背肌筋膜疼痛综合征的临床研究%Clinical Research of Muscular Fasciae Trigger Point Combined with Meridian Point in the Treatment of Lumbar Back Myofascial Pain Syndrome

    Institute of Scientific and Technical Information of China (English)

    农洪升

    2013-01-01

    Objective:To study the clinical research of muscular fasciae trigger point combined with meridian point in the treatment of lumbar back Myofascial Pain Syndrome.Methods:200 cases with lumbar back myofascial pain syndrome were divided into control group and treatment group according to random number table method,100 cases in each group.The control group was treated with muscular fasciae trigger point.The treatment group was given additional meridian point treatment based on the control group.Both the two groups were given eight courses of treatment,each course 15 d.Compare the pain index,scleroma cords index,function index and efficient of two groups before and after the treatment.Results:The pain index,scleroma cords index,function index and efficient of two groups had greatly improved,the difference was statistically significant (P < 0.05).The effective rate was 96.0% in treatment group and 82.0% in control group.Compared the efficient of two groups,the difference was statistically significant (P < 0.05).Conclusion:Muscular fasciae trigger point combined with meridian point in the treatment of lumbar back Myofascial Pain Syndrome has obvious curative effect and high efficient.%目的:探讨肌筋膜疼痛触发点配合经络穴位治疗腰背肌筋膜疼痛综合征的临床疗效.方法:腰背肌筋膜疼痛综合征患者200例按随机数字表法分为对照组和治疗组,每组各100例.对照组采取肌筋膜疼痛触发点治疗技术进行治疗,治疗组在对照组的基础上配合经络穴位治疗.两组患者均治疗8个疗程,每个疗程15 d.治疗结束后,比较两组患者在治疗前后疼痛指数、硬结条索状物指数、功能状态指数及有效率.结果:两组患者各自在疼痛指数、功能状态指数以及硬结条索状物指数方面,治疗后都较治疗前有较大的改善,差异有统计学意义(P<0.05).治疗组有效率为96.0%,对照组有效率为82.0%,两组有效率比

  1. Influencia de la presión sobre la mucosa gingival en la medición algométrica de un punto gatillo miofascial del músculo masetero: Estudio aleatorio, cruzado, controlado The influence of pressure on the gingivae mucosa on the algometry measurement of the masseter´s myofascial trigger point: A Randomized Cross-Over Controlled Trial

    Directory of Open Access Journals (Sweden)

    R. La Touche

    2007-03-01

    Full Text Available Objetivo: Este trabajo valora mediante una aplicación algométrica si la presión sobre la mucosa gingival de la zona de los molares mandibulares influye sobre el umbral del dolor a la presión (UDP de uno de los puntos gatillo miofasciales (PGMs del músculo masetero. Material y métodos: Se estudiaron un total de 38 pacientes que presentaban dolor orofacial por PGMs a nivel del músculo masetero. Se valoro el UDP por medio de algometría y la percepción de la intensidad del dolor (PID post-medición por medio de la Escala Visual Analógica (EVA. Todos los sujetos del estudio se utilizaron como grupo experimental y control; al grupo experimental se la aplicó una medición donde se evitaba generar presión sobre la mucosa gingival y al control una medición directa sobre PGM. El orden de aplicación de las mediciones se realizó por medio de una distribución aleatoria sistemática. Resultados: Se observaron diferencias estadísticamente significativas entre el UDP obtenido en el grupo experimental con respecto al control (P 0,05 y tampoco se apreció una correlación entre el UDP y la PID postmedición para el grupo experimental (r = -0,11, P = 0,5 ni para el caso del grupo control. (r = 0,15, P = 0,36. Conclusiones: Los resultados obtenidos demuestran que el evitar la presión sobre la mucosa gingival si influye en el valor de la medición algométrica, ya que aumenta el UDP de el PGM valorado en el músculo masetero. Sin embargo, es necesario realizar más investigaciones que puedan determinar la sensibilidad y la fiabilidad de este protocolo de medición antes de ser extrapolado a la clínica.Objective: Our study sets out to determine if the pressure on the gingivae mucosa of the lower molars influences the pressure pain threshold of one of the masseter's myofascial trigger point. Material and methods: A total of 38 subjects who had orofacial pain were included in the study. The masseter's myofascial trigger point was studied. The

  2. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial.

    Science.gov (United States)

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-04-01

    [Purpose] The purpose of this study was to determine the short- and mid-term effects of Kinesio taping on the trapezius muscle in individuals with myofascial pain syndrome. [Subjects and Methods] Thirty-seven patients with active upper trapezius myofascial trigger points were randomly divided to 2 groups: group 1 received Kinesio taping for the upper trapezius muscle, and group 2 received a sham Kinesio taping application. Neck pain (Visual Analog Scale and pressure algometry) and trapezius muscle strength data were collected at baseline, immediately after Kinesio taping application, and at one month follow-up. [Results] The mean changes in Visual Analog Scale scores were significantly different between groups at T2 and T1, with less pain in group 1. The mean changes in algometry scores were significantly different between groups at T3 compared with T2 in favor of group 1. The mean changes in trapezius muscle strength were significantly different between the groups at T2 compared with T1 in favor of group 1. [Conclusion] Patients with myofascial pain syndrome receiving an application of Kinesio taping exhibited statistically significant improvements in pain and upper trapezius muscle strength.

  3. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial

    Science.gov (United States)

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-01-01

    [Purpose] The purpose of this study was to determine the short- and mid-term effects of Kinesio taping on the trapezius muscle in individuals with myofascial pain syndrome. [Subjects and Methods] Thirty-seven patients with active upper trapezius myofascial trigger points were randomly divided to 2 groups: group 1 received Kinesio taping for the upper trapezius muscle, and group 2 received a sham Kinesio taping application. Neck pain (Visual Analog Scale and pressure algometry) and trapezius muscle strength data were collected at baseline, immediately after Kinesio taping application, and at one month follow-up. [Results] The mean changes in Visual Analog Scale scores were significantly different between groups at T2 and T1, with less pain in group 1. The mean changes in algometry scores were significantly different between groups at T3 compared with T2 in favor of group 1. The mean changes in trapezius muscle strength were significantly different between the groups at T2 compared with T1 in favor of group 1. [Conclusion] Patients with myofascial pain syndrome receiving an application of Kinesio taping exhibited statistically significant improvements in pain and upper trapezius muscle strength. PMID:27190430

  4. Evaluation of the Sympathetic Skin Response to the Dry Needling Treatment in Female Myofascial Pain Syndrome Patients.

    Science.gov (United States)

    Ozden, Ali Veysel; Alptekin, Hasan Kerem; Esmaeilzadeh, Sina; Cihan, Cem; Aki, Semih; Aksoy, Cihan; Oncu, Julide

    2016-07-01

    The aim of this study was to evaluate sympathetic nervous system (SNS) activity following dry needling (DN) treatment, by using the sympathetic skin response (SSR) method in female patients diagnosed with myofascial pain syndrome (MPS). Twenty-nine MPS patients with trapezius muscle pain and 31 healthy subjects were included in this study. During a single treatment session, DN treatment was applied into trigger points, for a duration of 10 minutes. Healthy patients were subjected to SSR in weeks 1 and 4; whereas the patient group was subjected to SSR 1 week prior to their treatment and in the first, second, third and fourth weeks following the completion of their treatment. We found diminished latency on both sides. A significantly high algometer measurement (P 0.05). DN is an effective treatment in MPS and trigger point (TP). This original study is the first to deal with the SSR in MPS and weekly SSR trailing, requiring further investigation to solidy findings.

  5. Myofascial pain: from Virchow's to our days

    Directory of Open Access Journals (Sweden)

    I. V. Egorov

    2014-01-01

    Full Text Available Myalgia is not a definite nosological entity and fixes the attention of neurologists, rheumatologists, and physicians in other specialties. This is first of all associated with the high incidence of chronic pain syndrome that leads to long-term disability mainly in young and middle-aged persons. One of the most common reasons for seeking advice from a therapist and neurologist is low back pain that may be due to the involvement of three key anatomical players: facet joints (arthrosis treatment should make an emphasis on  hondroprotectors, intervertebral disks (in case of discopathy, clinicians tend to favor nonsteroidal anti-inflammatory drugs – NSAIDs, and a muscular frame. In this case, two thirds of patients with pain syndromes in the trunk and limbs are found to have myofascial dysfunction that is defined as impaired function of one orother muscle, which occurs with its overload and manifests itself as muscle spasm and the presence of painful muscle infiltrations or local muscle hypertonus and trigger points in the tense muscles. Ignoring this fact gives rise to the irrational use of analgesic and anti-inflammatory drugs and further to the increase of their doses because the treatment is ineffective. Modern-day therapy for myofascial syndrome is multimodal and encompasses physiotherapic and manual procedures and the use of myorelaxants rather than NSAIDs. To prescribe myorelaxants, it is necessary to understand their mechanisms of action and the effects of different agents in this group.

  6. Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?

    OpenAIRE

    Masi, Alfonse T.

    2014-01-01

    Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hype...

  7. Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?

    OpenAIRE

    Masi, Alfonse T.

    2014-01-01

    Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hype...

  8. [Myofascial pain syndrome--fascial muscle pain].

    Science.gov (United States)

    Partanen, Juhani; Ojala, Tuula; Arokoski, Jari P A

    2010-01-01

    Symptoms of myofascial pain syndrome, i.e. fascial muscle pain may occur in several areas of the body, particularly in the neck-shoulder region. The muscle pain symptom in the neck-shoulder region is commonly termed tension neck pain or nonspecific neck pain, but myofascial pain syndrome can also be distinguished into its own diagnosis. This review deals with the clinical picture of myofascial pain syndrome along with pathophysiological hypotheses and treatment options.

  9. Myofascial pain syndrome and its suggested role in the pathogenesis and treatment of fibromyalgia syndrome.

    Science.gov (United States)

    Meyer, Helgard P

    2002-08-01

    Myofascial pain syndrome is a chronic muscle pain disorder in one or more muscles or groups of muscles accompanied by local and referred pain, decreased range of motion, weakness, and often autonomic phenomena. Patients are readily recognized by their history of muscle pain and the presence of myofascial trigger points, which are specific areas of hyperirritability in a muscle that cause local and referred pain on palpation. Failure to recognize MPS often leads to over-investigation, unnecessary medical intervention, and iatrogenic harm with serious cost implications. The purpose of this review is to present clinically relevant data regarding myofascial pain syndrome and to discuss its possible role in the pathophysiology and optimal treatment of fibromyalgia syndrome.

  10. Update on the efficacy of extracorporeal shockwave treatment for myofascial pain syndrome and fibromyalgia.

    Science.gov (United States)

    Ramon, Silvia; Gleitz, Markus; Hernandez, Leonor; Romero, Luis David

    2015-12-01

    Chronic muscle pain syndrome is one of the main causes of musculoskeletal pathologies requiring treatment. Many terms have been used in the past to describe painful muscular syndromes in the absence of evident local nociception such as myogelosis, muscle hardening, myalgia, muscular rheumatism, fibrositis or myofascial trigger point with or without referred pain. If it persists over six months or more, it often becomes therapy resistant and frequently results in chronic generalized pain, characterized by a high degree of subjective suffering. Myofascial pain syndrome (MPS) is defined as a series of sensory, motor, and autonomic symptoms caused by a stiffness of the muscle, caused by hyperirritable nodules in musculoskeletal fibers, known as myofascial trigger points (MTP), and fascial constrictions. Fibromyalgia (FM) is a chronic condition that involves both central and peripheral sensitization and for which no curative treatment is available at the present time. Fibromyalgia shares some of the features of MPS, such as hyperirritability. Many treatments options have been described for muscle pain syndrome, with differing evidence of efficacy. Extracorporeal Shockwave Treatment (ESWT) offers a new and promising treatment for muscular disorders. We will review the existing bibliography on the evidence of the efficacy of ESWT for MPS, paying particular attention to MTP (Myofascial Trigger Point) and Fibromyalgia (FM).

  11. Skeletal muscle pain:the possible development of latent myofascial trigger points in the junction of brachioradialis muscle and tendon of obese people%骨骼肌疼痛:肥胖人群中右手臂肱桡肌肌腱结合处隐性触发点的可能性发展

    Institute of Scientific and Technical Information of China (English)

    汤莉; 黄强民

    2014-01-01

    BACKGROUND:Studies have shown that obesity is associated with skeletal muscle pain, but the specific factors have not yet been discovered. OBJECTIVE: To analyze the possible development of latent myofascial trigger points in obese people. METHODS:Fifty-seven obese persons (aged 9-20 years) who participated in the summer camp of weight loss were investigated (for participants younger than 18 years old, written consent was obtained from their parents). Their body fat rate was more than 30%. A pressure algometer was used to measure the pressure pain thresholds at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site), the mid-point of the muscle bely (site B, assumed to be the MTrP site), and the muscle-tendon junction as a control site (site C). In addition, 19 obese persons were selected randomly. They did the based exercise in badminton and table tennis in the next 2 weeks. RESULTS AND CONCLUSION:The results showed that, for al the obese participants in this study, the mean pressure pain threshold was lowest at the site B and highest at thesite C. For different genders, the pressure pain thresholds at the site A were significantly lower in the female than the male. With the increase of body mass index, the pressure pain thresholds at the site B was increased. However, no significant difference in the pressure pain thresholds at these three sites was found before and after exercise. It is concluded that the latent trigger point may appear in the brachioradialis after 9 years old. Women may be more likely to form the attachment trigger point in the tendon. Movement has no effect on the activation and elimination of latent trigger points.%背景:有研究显示肥胖与骨骼肌疼痛存在一定的相关性,但具体因素尚未发现。目的:分析肥胖人群中隐性触发点的可能性发展。  方法:选择暑期减肥夏令营中体脂率均大于30%,年龄在9-20

  12. Triggering Comet-Like Activity of Main Belt Comets

    Science.gov (United States)

    Haghighipour, Nader; Maindl, Thomas I.; Schaefer, Christoph; Speith, Roland; Dvorak, Rudolf

    2016-10-01

    Main-belt comets (MBCs) have attracted a great deal of interest since their identification as activated asteroids by Hsieh and Jewitt in 2006. It has been suggested that the comet-like activity of these objects are due to the sublimation of sub-surface water-ice that has been exposed as a result of their surfaces being impacted by small (e.g, m-sized) bodies. We have examined the viability of this scenario by simulating impacts between m-sized impactors and km-sized targets using a smooth particle hydrodynamics (SPH) approach. We have carried out simulations for a range of impact velocities and angles, material type and strength, and water content of the target allowing m-sized impactors to erode enough of an MBC's surface to trigger its activation. Results indicate that for the range of impact velocities corresponding to those in the asteroid belt, the depth of an impact crater is slightly larger than 10 m suggesting that if the activation of MBCs is due to the sublimation of sub-surface water-ice, this ice has to exist no deeper than a few meters from the surface. Our simulations point to a clearly notable spread in the aggregated crater depths due to different impact energy, impact angles, and MBC's water contents showing deeper craters due to less overall material strength. Results also show that ice-exposure occurs in the bottom and on the interior surface of impact craters as well as the surface of the target where some of the ejected icy inclusions are re-accreted. Our results, in addition to demonstrating that the impact scenario is indeed a viable mechanism to expose ice and trigger the activity of MBCs, indicate that the activity of the current MBCs is likely due to ice sublimation from multiple impact sites and/or the water contents of these objects (and other asteroids in the outer asteroid belt) is larger than the 5% that is traditionally considered in models of terrestrial planet formation. We present details of our simulations and discuss their

  13. Myofascial pain syndrome: an overview.

    Science.gov (United States)

    Saxena, Anudeep; Chansoria, Mayank; Tomar, Gaurav; Kumar, Abhyuday

    2015-03-01

    Over the last few decades, advances have been made in the understanding of myofascial pain syndromes (MPSs). In spite of its high prevalence in the society, it is not a commonly established diagnosis. MPS is said to be the great imitator. This article puts some light on the various clinical presentations of the syndrome, on the various tools to reach to a diagnosis for commencing the treatment and on the treatment modalities that have been used so far.

  14. Myofascial Pain Dysfunction Syndrome (MPDS)

    OpenAIRE

    2010-01-01

    Introduction: Myofascial Pain Dysfunction Syndrome (MPDS) is one of the most important causes of the orofacial pain. The main purpose of this study was to evaluate 40 related variables in this regard. Materials and Methods: Thirty nine patients with MPDS were evaluated in this study. Different factors including age, gender, occupation, marital status, sensitivity of masticatory muscles, maximum opening of the mouth, deviation, deflection, involvement of temporomandibular joint, habit, parafun...

  15. Changes in active site histidine hydrogen bonding trigger cryptochrome activation.

    Science.gov (United States)

    Ganguly, Abir; Manahan, Craig C; Top, Deniz; Yee, Estella F; Lin, Changfan; Young, Michael W; Thiel, Walter; Crane, Brian R

    2016-09-06

    Cryptochrome (CRY) is the principal light sensor of the insect circadian clock. Photoreduction of the Drosophila CRY (dCRY) flavin cofactor to the anionic semiquinone (ASQ) restructures a C-terminal tail helix (CTT) that otherwise inhibits interactions with targets that include the clock protein Timeless (TIM). All-atom molecular dynamics (MD) simulations indicate that flavin reduction destabilizes the CTT, which undergoes large-scale conformational changes (the CTT release) on short (25 ns) timescales. The CTT release correlates with the conformation and protonation state of conserved His378, which resides between the CTT and the flavin cofactor. Poisson-Boltzmann calculations indicate that flavin reduction substantially increases the His378 pKa Consistent with coupling between ASQ formation and His378 protonation, dCRY displays reduced photoreduction rates with increasing pH; however, His378Asn/Arg variants show no such pH dependence. Replica-exchange MD simulations also support CTT release mediated by changes in His378 hydrogen bonding and verify other responsive regions of the protein previously identified by proteolytic sensitivity assays. His378 dCRY variants show varying abilities to light-activate TIM and undergo self-degradation in cellular assays. Surprisingly, His378Arg/Lys variants do not degrade in light despite maintaining reactivity toward TIM, thereby implicating different conformational responses in these two functions. Thus, the dCRY photosensory mechanism involves flavin photoreduction coupled to protonation of His378, whose perturbed hydrogen-bonding pattern alters the CTT and surrounding regions.

  16. [Myofascial pain syndrome--frequent occurrence and often misdiagnosed].

    Science.gov (United States)

    Pongratz, D E; Späth, M

    1998-09-30

    Myofascial pain syndrome (MPS) is a very common localized--sometimes also polytopic--painful musculoskeletal condition associated with trigger points, for which, however, diagnostic criteria established in well-designed studies are still lacking. These two facts form the basis for differentiating between MPS and the fibromyalgia syndrome. The difference between trigger points (MPS) and tender points (fibromyalgia) is of central importance--not merely in a linguistic sense. A knowledge of the signs and symptoms typically associated with a trigger point often obviates the need for time-consuming and expensive technical diagnostic measures. The assumption that many cases of unspecific complaints affecting the musculoskeletal system may be ascribed to MPS makes clear the scope for the saving of costs.

  17. Contributions of myofascial pain in diagnosis and treatment of shoulder pain. A randomized control trial

    Directory of Open Access Journals (Sweden)

    Gaspar-Calvo Elena

    2009-07-01

    Full Text Available Abstract Background Rotator cuff tendinopathy and subacromial impingement syndrome present complex patomechanical situations, frequent difficulties in clinical diagnosis and lack of effectiveness in treatment. Based on clinical experience, we have therefore considered the existence of another pathological entity as the possible origin of pain and dysfunction. The hypothesis of this study is to relate subacromial impingement syndrome (SIS with myofascial pain syndrome (MPS, since myofascial trigger points (MTrPs cause pain, functional limitation, lack of coordination and alterations in quality of movement, even prior to a tendinopathy. MTrPs can coexist with any degenerative subacromial condition. If they are not taken into consideration, they could perpetuate and aggravate the problem, hindering diagnosis and making the applied treatments ineffective. The aims and methods of this study are related with providing evidence of the relationship that may exist between this condition and MPS in the diagnosis and treatment of rotator cuff tendonitis and/or SIS. Method/design A descriptive transversal study will be made to find the correlation between the diagnosis of SIS and rotator cuff tendonitis, positive provocation test responses, the existence of active MTrPs and the results obtained with ultrasonography (US and Magnetic Renonance Imaging (MRI. A randomized double blinded clinical trial will be carried out in experimental conditions: A Protocolized treatment based on active and passive joint repositioning, stabilization exercises, stretching of the periarticular shoulder muscles and postural reeducation. B. The previously described protocolized treatment, with the addition of dry needling applied to active MTrPs with the purpose of isolating the efficacy of dry needling in treatment. Discussion This study aims to provide a new vision of shoulder pain, from the perspective of MPS. This syndrome can, by itself, account for shoulder pain and

  18. Triggering Sublimation-driven Activity of Main Belt Comets

    Science.gov (United States)

    Haghighipour, N.; Maindl, T. I.; Schäfer, C.; Speith, R.; Dvorak, R.

    2016-10-01

    It has been suggested that the comet-like activity of main belt comets (MBCs) is due to the sublimation of sub-surface water–ice that has been exposed as a result of their surfaces being impacted by meter-sized bodies. We have examined the viability of this scenario by simulating impacts between meter-sized and kilometer-sized objects using a smooth particle hydrodynamics approach. Simulations have been carried out for different values of the impact velocity and impact angle, as well as different target material and water-mass fractions. Results indicate that for the range of impact velocities corresponding to those in the asteroid belt, the depth of an impact crater is slightly larger than 10 m, suggesting that if the activation of MBCs is due to the sublimation of sub-surface water–ice, this ice has to exist no deeper than a few meters from the surface. Results also show that ice exposure occurs in the bottom and on the interior surface of impact craters, as well as on the surface of the target where some of the ejected icy inclusions are re-accreted. While our results demonstrate that the impact scenario is indeed a viable mechanism to expose ice and trigger the activity of MBCs, they also indicate that the activity of the current MBCs is likely due to ice sublimation from multiple impact sites and/or the water contents of these objects (and other asteroids in the outer asteroid belt) is larger than the 5% that is traditionally considered in models of terrestrial planet formation, providing more ice for sublimation. We present the details of our simulations and discuss their results and implications.

  19. Effectiveness of Different Deep Dry Needling Dosages in the Treatment of Patients With Cervical Myofascial Pain: A Pilot RCT.

    Science.gov (United States)

    Fernández-Carnero, Josué; Gilarranz-de-Frutos, Laura; León-Hernández, Jose Vicente; Pecos-Martin, Daniel; Alguacil-Diego, Isabel; Gallego-Izquierdo, Tomás; Martín-Pintado-Zugasti, Aitor

    2017-10-01

    To assess the effectiveness of different dosages of local twitch responses (LTRs) elicited by deep dry needling (DDN) in relation to pain intensity, pressure pain threshold (PPT), cervical range of movement (CROM), and disability degree in cervical myofascial pain patients. A randomized, double-blind clinical trial. Eighty-four patients (21 males, 63 females; 27.18 ± 10.91 yrs) with cervical pain. DDN in active myofascial trigger points (MTrPs) in the upper trapezius. Patients were randomly divided into four groups: (a) no LTRs elicited, (b) four LTRs elicited, (c) six LTRs elicited, and (d) needling until no more LTRs were elicited. Pain intensity, PPT, CROM, and disability degree were assessed before treatment, post-immediate, 48 hrs, 72 hrs, and 1 wk after treatment. Significant differences were found in the time factor for all the variables (P 0.05). DDN in the upper trapezius MTrP improved pain at a 1-wk follow-up, but improvements were not significantly different among DDN dosages. A higher number of patients with neck pain improvements superior to the moderate clinically important differences were observed when eliciting 6 LTRs and LTRs until exhaustion compared with not eliciting LTRs.

  20. Actively triggered 4d cone-beam CT acquisition

    Energy Technology Data Exchange (ETDEWEB)

    Fast, Martin F.; Wisotzky, Eric [German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg (Germany); Oelfke, Uwe; Nill, Simeon [Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom)

    2013-09-15

    Purpose: 4d cone-beam computed tomography (CBCT) scans are usually reconstructed by extracting the motion information from the 2d projections or an external surrogate signal, and binning the individual projections into multiple respiratory phases. In this “after-the-fact” binning approach, however, projections are unevenly distributed over respiratory phases resulting in inefficient utilization of imaging dose. To avoid excess dose in certain respiratory phases, and poor image quality due to a lack of projections in others, the authors have developed a novel 4d CBCT acquisition framework which actively triggers 2d projections based on the forward-predicted position of the tumor.Methods: The forward-prediction of the tumor position was independently established using either (i) an electromagnetic (EM) tracking system based on implanted EM-transponders which act as a surrogate for the tumor position, or (ii) an external motion sensor measuring the chest-wall displacement and correlating this external motion to the phase-shifted diaphragm motion derived from the acquired images. In order to avoid EM-induced artifacts in the imaging detector, the authors devised a simple but effective “Faraday” shielding cage. The authors demonstrated the feasibility of their acquisition strategy by scanning an anthropomorphic lung phantom moving on 1d or 2d sinusoidal trajectories.Results: With both tumor position devices, the authors were able to acquire 4d CBCTs free of motion blurring. For scans based on the EM tracking system, reconstruction artifacts stemming from the presence of the EM-array and the EM-transponders were greatly reduced using newly developed correction algorithms. By tuning the imaging frequency independently for each respiratory phase prior to acquisition, it was possible to harmonize the number of projections over respiratory phases. Depending on the breathing period (3.5 or 5 s) and the gantry rotation time (4 or 5 min), between ∼90 and 145

  1. Trigger point needling: techniques and outcome.

    Science.gov (United States)

    Vulfsons, Simon; Ratmansky, Motti; Kalichman, Leonid

    2012-10-01

    In this review we provide the updates on last years' advancements in basic science, imaging methods, efficacy, and safety of dry needling of myofascial trigger points (MTrPs). The latest studies confirmed that dry needling is an effective and safe method for the treatment of MTrPs when provided by adequately trained physicians or physical therapists. Recent basic studies have confirmed that at the site of an active MTrP there are elevated levels of inflammatory mediators, known to be associated with persistent pain states and myofascial tenderness and that this local milieu changes with the occurrence of local twitch response. Two new modalities, sonoelastography and magnetic resonance elastography, were recently introduced allowing noninvasive imaging of MTrPs. MTrP dry needling, at least partially, involves supraspinal pain control via midbrain periaqueductal gray matter activation. A recent study demonstrated that distal muscle needling reduces proximal pain by means of the diffuse noxious inhibitory control. Therefore, in a patient too sensitive to be needled in the area of the primary pain source, the treatment can be initiated with distal needling.

  2. Active Region Jets II: Triggering and Evolution of Violent Jets

    Science.gov (United States)

    Sterling, Alphonse C.; Moore, Ronald L.; Falconer, David; Panesar, Navdeep K.; Martinez, Francisco

    2017-08-01

    We study a series of X-ray-bright, rapidly evolving active-region coronal jets outside the leading sunspot of AR 12259, using Hinode/XRT, SDO/AIA and HMI, and IRIS/SJ data. The detailed evolution of such rapidly evolving “violent” jets remained a mystery after our previous investigation of active region jets (Sterling et al. 2016, ApJ, 821, 100). The jets we investigate here erupt from three localized subregions, each containing a rapidly evolving (positive) minority-polarity magnetic-flux patch bathed in a (majority) negative-polarity magnetic-flux background. At least several of the jets begin with eruptions of what appear to be thin (thickness ˜Nature, 523, 437). For some jets strands are difficult/ impossible to detect, perhaps due to their thinness, obscuration by surrounding bright or dark features, or the absence of erupting cool-material minifilaments in those jets. Tracing in detail the flux evolution in one of the subregions, we find bursts of strong jetting occurring only during times of strong flux cancelation. Averaged over seven jetting episodes, the cancelation rate was ~1.5×10^19 Mx/hr. An average flux of ~5×10^18 Mx canceled prior to each episode, arguably building up ~10^28—10^29 ergs of free magnetic energy per jet. From these and previous observations, we infer that flux cancelation is the fundamental process responsible for the pre-eruption buildup and triggering of at least many jets in active regions, quiet regions, and coronal holes.

  3. Evolution of Muscles Dysfunction From Myofascial Pain Syndrome Through Cervical Disc-Root Conflict to Degenerative Spine Disease.

    Science.gov (United States)

    Lisiński, Przemysław; Huber, Juliusz

    2017-02-01

    Comparative clinical and neurophysiological study in three groups of patients with general diagnosis of neck pain. To determine symptoms of muscles dysfunction in patients with myofascial pain syndrome, disc-root conflict, and degenerative changes at cervical spine. The explanation for cervical pain origin should be based on results from chosen clinical and neurophysiological studies in correlation with neuroimaging findings. Three subgroups of patients (N = 60 each) with certain symptoms were examined. Clinical evaluation included examination of pain intensity in VAS scale, muscle strength in Lovett scale, evaluation of reflexes, Spurling test, assessment of active trigger points (TRPs), and superficial sensory perception. Neurophysiological testing included surface electromyography at rest (rEMG) and during maximal contraction (mcEMG) as well as electroneurography (ENG). The greatest pain intensity with its decentralization phenomenon occurred in patients with disc-root conflict. Significant decrease of muscle strength was detected in trapezius muscle in myofascial pain syndrome subgroup. Weakness of abductor pollicis brevis muscle in patients with disc-root conflict differed them from patients with myofascial pain syndrome (P = 0.05). Patients with disc-root conflict and degenerative spine disease showed differences (P = 0.03) in reflexes evoked from triceps brachii. Positive Spurling symptom was most common (56.7%) in disc-root conflict subgroup. TRPs in trapezius muscle were found in all patients with myofascial pain syndrome. Results of rEMG amplitude measurements differed patients at P = 0.05. Only mcEMG recording from abductor pollicis brevis muscle allows for their clear cut differentiation. ENG studies showed abnormalities in patients with disc-root conflict and degenerative spine disease (P from 0.05 to 0.02). Positive correlation of VAS, TRPs, and rEMG as well as Lovett scores, mcEMG, and ENG results was found. Only applying several

  4. Dry needling for myofascial pain: prognostic factors.

    Science.gov (United States)

    Huang, Yuan-Ting; Lin, Shun-Yuan; Neoh, Choo-Aun; Wang, Kuo-Yang; Jean, Yen-Hsuan; Shi, Hon-Yi

    2011-08-01

    The study objectives were to evaluate outcomes in patients who have received dry needling treatments and to identify predictors of pain and disability. The study was a prospective cohort follow-up design. The study was conducted at the Pain Clinic at Pingtung Christian Hospital, Taiwan. Ninety-two (92) patients sick-listed for 3 months or longer for myofascial pain syndrome. From February to October 2008, participants were treated at the pain clinic with dry needling of trigger points and muscle stretches of the involved muscles. Data were collected by self-administered questionnaires to assess changes in pain intensity and pain interference. Data collection was performed at baseline and after 2, 4, and 8 weeks. Sociodemographic variables, symptom characteristics, and baseline outcome measures were analyzed using generalized estimating equation methodology. The proposed dry-needling protocol reduced pain intensity and pain interference. Long duration of pain symptoms, high pain intensity, poor quality of sleep, and repetitive stress were associated with poor outcomes. Dry needling is an effective treatment for reducing pain and pain interference. However, long pain duration, high pain intensity, poor quality of sleep, and repetitive stress are associated with poor outcomes. Treatment outcome depends not only on the dry needling protocol, but also on disease characteristics and patient demographic profile.

  5. DMPD: Triggering the innate antiviral response through IRF-3 activation. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 17395583 Triggering the innate antiviral response through IRF-3 activation. Hiscott...g the innate antiviral response through IRF-3 activation. PubmedID 17395583 Title Triggering the innate anti...viral response through IRF-3 activation. Authors Hiscott J. Publication J Biol Ch

  6. Myofascial Pain: Mechanisms to Management.

    Science.gov (United States)

    Fricton, James

    2016-08-01

    More than 100 million adults in the United States have chronic pain conditions, costing more than $500 billion annually in medical care and lost productivity. They are the most common reason for seeking health care, for disability and addiction, and the highest driver of health care costs. Myofascial pain is the most common condition causing chronic pain and can be diagnosed through identifying clinical characteristics and muscle palpation. Management is focused on integrating patient training in changing lifestyle risk factors with evidence-based treatment. Understanding the cause, diagnosis, and management of myopain conditions will help prevent the impact of chronic pain.

  7. The Effect of Dry Needling on Range of Motion of Neck Lateral Flexion in Subjects With Active Trigger Point in Upper Trapezius Muscle

    Directory of Open Access Journals (Sweden)

    Ziaeifar

    2014-12-01

    Full Text Available Background Myofascial trigger point is one of the most common causes of musculoskeletal disorders. Myofascial trigger point in upper trapezius has been reported as a symptom in patients with neck and upper thoracic pain. Objectives The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on trigger point in upper trapezius muscle. Materials and Methods 28 subjects with myofascial trigger point in upper trapezius participated in this study. The subjects were randomly assigned to two groups: dry needling (n = 13 and ischemic pressure (n = 15. The neck lateral flexion range of motion was measured before and after treatment in both groups using a standard goniometer. Paired t-test was used to determine any significant difference in range of motion after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis. Results Statistical analysis (paired t-test revealed significant increase in neck lateral flexion range of motion in contra-lateral side after treatment sessions in control and experimental group compared with pre-treatment score (P < 0.05. However, only dry needling was effective in increase of range of motion in Ipsi-lateral side (P = 0.001. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups in the after treatment sessions (P = 0.06 and (P = 0.15. Conclusions The application of DN produces an improvement in ILF and CLF can be prescribed for subjects with MTP in UT muscles.

  8. A critical overview of the current myofascial pain literature - October 2015.

    Science.gov (United States)

    Dommerholt, Jan; Grieve, Rob; Hooks, Todd; Layton, Michelle

    2015-10-01

    The number of publications about myofascial pain and trigger points (TrP) seems to increase every year. In the current overview we include 27 articles published in past months. The Basic Review section includes articles about the presence and characteristics of TrPs in various neck and shoulder muscles, the correlation between referred pain from active TrPs and knee osteoarthritis, and an anatomical study exploring whether the location of TrPs may be related to the nerve innervation of muscles. Zuil-Escobar and colleagues from Spain considered the intra-rater reliability of the identification of latent TrPs in several leg muscles and the possible correlation of TrP and the presence of a lower medial longitudinal arch. In the section on manual approaches, contributing author Rob Grieve and colleagues continue their studies of TrPs in the lower extremity muscles, while Méndez-Rebolledo and colleagues studied the impact of cross taping and compression. Dry needling (DN) continues to be a topic of interest. We included twelve papers addressing a wide range of topics, such as the effectiveness and safety of DN, and the impact of DN on proprioception, spasticity, and fibromyalgia. Two papers investigated the utilization of repetitive transcranial magnetic stimulation and laser on TrPs, The final section on other clinical studies and reviews includes 8 papers. The studies originated in thirteen different countries with Spain leading the charts with 7 contributions to the literature, followed by Brazil with four. As we have mentioned in previous editions of this literature overview, many studies suffer from very small sample sizes, which makes it difficult to reach definitive conclusions. Nevertheless, myofascial pain continues to be a topic of interest to researchers and clinicians around the globe. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Ultrasound imaging of embedded shrapnel facilitates diagnosis and management of myofascial pain syndrome.

    Science.gov (United States)

    Shankar, Hariharan; Cummings, Craig

    2013-06-01

    Trigger points can result from a variety of inciting events including muscle overuse, trauma, mechanical overload, and psychological stress. When the myofascial trigger points occur in cervical musculature, they have been known to cause headaches. Ultrasound imaging is being increasingly used for the diagnosis and interventional management of various painful conditions. A veteran was referred to the pain clinic for management of his severe headache following a gunshot wound to the neck with shrapnel embedded in the neck muscles a few years prior to presentation. He had no other comorbid conditions. Physical examination revealed a taut band in the neck. An ultrasound imaging of the neck over the taut band revealed the deformed shrapnel located within the levator scapulae muscle along with an associated trigger point in the same muscle. Ultrasound guided trigger point injection, followed by physical therapy resolved his symptoms. This is a unique report of embedded shrapnel and coexisting myofascial pain syndrome revealed by ultrasound imaging. The association between shrapnel and myofascial pain syndrome requires further investigation.

  10. The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders Holsgaard

    A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter...

  11. Cellular Mechanisms of Calcium-Mediated Triggered Activity

    Science.gov (United States)

    Song, Zhen

    Life-threatening cardiac arrhythmias continue to pose a major health problem. Ventricular fibrillation, which is a complex form of electrical wave turbulence in the lower chambers of the heart, stops the heart from pumping and is the largest cause of natural death in the United States. Atrial fibrillation, a related form of wave turbulence in the upper heart chambers, is in turn the most common arrhythmia diagnosed in clinical practice. Despite extensive research to date, mechanisms of cardiac arrhythmias remain poorly understood. It is well established that both spatial disorder of the refractory period of heart cells and triggered activity (TA) jointly contribute to the initiation and maintenance of arrhythmias. TA broadly refers to the abnormal generation of a single or a sequence of abnormal excitation waves from a small submillimeter region of the heart in the interval of time between two normal waves generated by the heart's natural pacemaker (the sinoatrial node). TA has been widely investigated experimentally and occurs in several pathological conditions where the intracellular concentration of free Ca2+ ions in heart cells becomes elevated. Under such conditions, Ca2+ can be spontaneously released from intracellular stores, thereby driving an electrogenic current that exchanges 3Na+ ions for one Ca2+ ion across the cell membrane. This current in turn depolarizes the membrane of heart cells after a normal excitation. If this calcium-mediated "delayed after depolarization'' (DAD) is sufficiently large, it can generate an action potential. While the arrhythmogenic importance of spontaneous Ca2+ release and DADs is well appreciated, the conditions under which they occur in heart pathologies remain poorly understood. Calcium overload is only one factor among several other factors that can promote DADs, including sympathetic nerve stimulation, different expression levels of membrane ion channels and calcium handling proteins, and different mutations of those

  12. Basic principles of renewal of sportsmen with myofascial by a pain syndrome taking into account the psychological aspect of their rehabilitation

    Directory of Open Access Journals (Sweden)

    Kharchenko G.D.

    2014-05-01

    Full Text Available Purpose: to examine and learn the fundamentals of the recovery of athletes with myofascial pain syndrome, taking into account the psychological aspect of their rehabilitation. Material: the data analyzed and summarized the scientific and methodological literature; sites on the internet. Results: the analysis of specialized literature on development features myofascial pain syndrome in athletes. Myofascial pain syndrome is widespread in sports practice. It is characterized by muscle spasms and trigger points, palpation of which there is a growing pain. The basic principles of the recovery of athletes with myofascial pain syndrome. The questions of the effectiveness of rehabilitation measures, taking into account the influence of psychological factors on the recovery of athletes. Conclusions: the presented strategy is comprehensive physical rehabilitation. Recommended keeping the basic principles of the recovery of athletes and the psychological aspect of their rehabilitation.

  13. Low 25-Hydroxyvitamin D and Myofascial Pain: Association of Cancer, Colon Polyps, and Tendon Rupture.

    Science.gov (United States)

    Hightower, Jane M; Dalessandri, Kathie M; Pope, Karl; Hernández, Germán T

    2017-08-01

    Myofascial pain that has been associated with cancer and increased risk of morbidity and mortality in cancer patients is intrinsically associated with low magnesium and low 25-hydroxyvitamin D (25(OH)D). Therefore, this physical finding was used as a clinical diagnostic proxy. The objective of this study was to assess the association and prevalence of disease in individuals with myofascial pain and low 25(OH)D in a county with low magnesium in the drinking water. This is a retrospective cross-sectional study of a chart review of 269 subjects to assess subjects presenting with myofascial pain (assessed by tender trigger points) and 25(OH)D concentrations below 30 ng/mL or a history of 25(OH)D deficiency compared to those without these exposures. The association between the exposure of low 25(OH)D levels and myofascial pain was compared to all cancers, colon polyps, and tendon ruptures. The odds of having cancer with the combined exposures was 10.14 times the odds of not having either exposure (95% confidence interval [CI], 5.08, 20.25, p D less than 30 ng/mL, 74 were tested for red blood cell (RBC) magnesium. Half of those subjects had RBC magnesium concentrations D deficiency showed a significant association with cancer, adenomatous colon polyps, and tendon rupture. Further studies to verify these results are needed, especially in areas where there is low magnesium in the drinking water.

  14. Probable Mechanisms of Needling Therapies for Myofascial Pain Control

    Directory of Open Access Journals (Sweden)

    Li-Wei Chou

    2012-01-01

    Full Text Available Myofascial pain syndrome (MPS has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed.

  15. Myofascial Pain Syndrome in Chronic Back Pain Patients

    Science.gov (United States)

    Nizar, Abd Jalil

    2011-01-01

    Background Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS (χ2 = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P < 0.001) in Visual Analogue Score (VAS) and Modified Oswestry Disability Score (MODS) with standard management during three consecutive visits at six-month intervals. Conclusions MPS prevalence among chronic back pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome. PMID:21716607

  16. Probable Mechanisms of Needling Therapies for Myofascial Pain Control

    Science.gov (United States)

    Chou, Li-Wei; Kao, Mu-Jung; Lin, Jaung-Geng

    2012-01-01

    Myofascial pain syndrome (MPS) has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP) can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM) theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed. PMID:23346211

  17. A review of treatment approaches of Myofascial Pain Dysfunction Syndrome

    Directory of Open Access Journals (Sweden)

    Arash Mansuorian

    2017-03-01

    Full Text Available Masticatory muscle pain is the second most frequent cause of orofacial pain after dental pain. Myofascial pain dysfunction syndrome (MPDS is the most common form of temporomandibular joint dysfunction. MPDS is a pain that triggers from [sensitive] points in the muscles and fascia and is followed by spasm, tenderness to palpation, restricted movement, fatigue, and sometimes dysfunction. The researchers intended to collect comprehensive information about therapeutic interventions for myofascial pain through the conduction of a critical study based on evidence in the literature. In this review, 51 English articles, published between 1981 and 2013, were extracted from PubMed, Medline, Ovid, and Google Scholar. These articles were then reviewed in detail in two categories, namely pharmaceutical and non-pharmaceutical treatments. MPDS treatment should be first focused on the identification and correction of underlying causes. Thiocolchicoside (TCC, non-steroidal anti-inflammatory drugs (NSAIDs, and Cox-2 inhibitors are among promising pharmaceutical methods. On the other hand, ultrasound and laser therapy are among promising non-pharmaceutical methods. The complex mechanism of MPDS, along with its underlying peripheral and central nervous mechanisms may make MPDS, difficult to treat, especially in its chronic form.

  18. A role for the body burden of aluminium in vaccine-associated macrophagic myofasciitis and chronic fatigue syndrome.

    Science.gov (United States)

    Exley, Christopher; Swarbrick, Louise; Gherardi, Rhomain K; Authier, Francois-Jérôme

    2009-02-01

    Macrophagic myofasciitis and chronic fatigue syndrome are severely disabling conditions which may be caused by adverse reactions to aluminium-containing adjuvants in vaccines. While a little is known of disease aetiology both conditions are characterised by an aberrant immune response, have a number of prominent symptoms in common and are coincident in many individuals. Herein, we have described a case of vaccine-associated chronic fatigue syndrome and macrophagic myofasciitis in an individual demonstrating aluminium overload. This is the first report linking the latter with either of these two conditions and the possibility is considered that the coincident aluminium overload contributed significantly to the severity of these conditions in this individual. This case has highlighted potential dangers associated with aluminium-containing adjuvants and we have elucidated a possible mechanism whereby vaccination involving aluminium-containing adjuvants could trigger the cascade of immunological events which are associated with autoimmune conditions including chronic fatigue syndrome and macrophagic myofasciitis.

  19. Demographics features, clinical findings and functional status in a group of subjects with cervical myofascial pain syndrome.

    Science.gov (United States)

    Sahin, Nilay; Karataş, Omer; Ozkaya, Murat; Cakmak, Ayşegül; Berker, Ender

    2008-07-01

    Subjects with myofascial pain of muscles of the neck region may present with various clinical symptoms. The aim of this study was to explore the demographics features, clinical findings and functional status in a group of patients presenting with myofascial pain of the cervical muscles. 94 cervical myofascial pain syndrome patients were recruited from the out-patient clinic. Evaluated of patient short form health survey (SF-36), pain, depression, patient demographics and physical examinations. Outcome measures; SF-36 Health Survey, visual analog scale, Beck Depression Inventory, history, physical examination. A total of 82 patients with a diagnosis of cervical myofascial syndrome were included in the study. All patients were in the young age group 37.4+/-9, and 87.8% were females. 53.1% had trigger points in the trapezius muscle with high percentage of autonomic phenomena like skin reddening, lacrimation, tinnitus and vertigo. 58.5% of the series had suffered from former cervical trauma and 40.2% also had fibromyalgia syndrome and 18.5% had benign Joint hypermobility syndrome. Younger female patients presenting with autonomic phenomena and early onset cervical injury should be examined for cervical myofascial pain syndrome and also for fibromyalgia syndrome since this study demonstrated a high percentage of fibromyalgia syndrome in these patients.

  20. BH3-Triggered Structural Reorganization Drives the Activation of Pro-apoptotic BAX

    Science.gov (United States)

    Gavathiotis, Evripidis; Reyna, Denis E.; Davis, Marguerite L.; Bird, Gregory H.; Walensky, Loren D.

    2010-01-01

    Summary BAX is a pro-apoptotic BCL-2 family member that lies dormant in the cytosol until converted into a killer protein in response to cellular stress. Having recently identified the elusive trigger site for direct BAX activation, we now delineate by NMR and biochemical methods the essential allosteric conformational changes that transform ligand-triggered BAX into a fully activated monomer capable of propagating its own activation. Upon BAX engagement by a triggering BH3 helix, the unstructured loop between α-helices 1 and 2 is displaced, the carboxy terminal helix 9 is mobilized for membrane translocation, and the exposed BAX BH3 domain propagates the death signal through an auto-activating interaction with the trigger site of inactive BAX monomers. Our structure-activity analysis of this seminal apoptotic process reveals new pharmacologic opportunities to modulate cell death by interceding at key steps of the BAX activation pathway. PMID:21070973

  1. Dynamic triggering

    Science.gov (United States)

    Hill, David P.; Prejean, Stephanie; Schubert, Gerald

    2015-01-01

    Dynamic stresses propagating as seismic waves from large earthquakes trigger a spectrum of responses at global distances. In addition to locally triggered earthquakes in a variety of tectonic environments, dynamic stresses trigger tectonic (nonvolcanic) tremor in the brittle–plastic transition zone along major plate-boundary faults, activity changes in hydrothermal and volcanic systems, and, in hydrologic domains, changes in spring discharge, water well levels, soil liquefaction, and the eruption of mud volcanoes. Surface waves with periods of 15–200 s are the most effective triggering agents; body-wave trigger is less frequent. Triggering dynamic stresses can be < 1 kPa.

  2. Usefulness of diagnostic ultrasound for detecting myofascial change of the hamstring muscles due to lmmobilization: Experimental study with caged rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yoon Kyoo; Kim, Joo Hyun; Lee, Chang Hyung; Kim, Jung Ryul; Kim, Han Kyum [Korea University College of Medicine, Seoul (Korea, Republic of)

    2002-03-15

    To evaluate the usefulness of diagnostic ultrasound in the localization of soft tissue changes in the region of clinically suspected myofascial pain syndrome and to investigate the ultrasonographic and pathologic differences of the hamstring muscles between caged and freely mobile rabbits. A total of eight caged rabbits were used in this study. Four rabbits (age; two were 3-4 months, and the other two were 8-9 months) were raised in a small cage (40 X 50 X 30 cm), and the other four rabbits (age; two were 3-4 months while the other two 8-9 months) raised in a yard where they were free to move around. First, clinically identified myofascial trigger point-taut band or nodule was identified followed by diagnostic ultrasound examination of the hamstring and gluteus muscles and injection of Indian ink of the band or nodule. Biopsies were performed to include the hyperechoic regions as well as clinically identified myofascial trigger points, and the obtained specimens were stained with hematoxylin-eosin and masson-trichrome. The analysis of the results of the ultrasound study and pathologic study found correlation between the pathologic identification of myofascial trigger point and diagnostic ultrasound, where palpable nodules of caged animal, older more than younger one should greater extent of increment of echogenicity and degenerative pathologic changes such as fatty changes and appearance of hyaline fibers. Diagnostic ultrasound could be applied to identify or observe soft tissue changes in the regions of clinically identified myofascial trigger points. A pattern has emerged where soft tissue changes were ore likely to be observed in the caged animal where their movements were restricted and prone to fixed position. Further study to investigate the reversibility of pathologic changes of caged animal should be carried out.

  3. 针刺腹肌肌筋膜触发点治疗原发性痛经的疗效%Efficacy of acupuncture at abdominal myofascial trigger points for the treatment of patients with primary dysmenorrhea

    Institute of Scientific and Technical Information of China (English)

    刘琳; 黄强民; 刘庆广; 马彦韬; 赵佳敏

    2016-01-01

    Objective To retrospectively observe the efficacy of acupuncture at myofacial trigger points (MTrPs) in abdominal muscles for the treatment of patients with primary dysmenorrhea.Methods Sixtyfive patients with moderate or severe primary dysmenorrhea were treated with acupuncture therapy.The MTrPs in abdominal region were localized and repeatedly acupunctured and injected with 1% lidocaine,combined with auto-stretching exercise of abdominal muscles,0.5-1.0 min/time,3-5 times/d.VAS and effects were evaluated at the menstrual period after every acupuncture,and one year after last acupuncture.Results The effective rate was 63% (41/65 cases),100% (65/65 cases) and 100% (65/65 cases) after the acupuncture 1,2 times and 1 year after the treatment respectively.Conclusion Acupuncture at MTrPs in abdominal region combined with stretching exercise is effective for the treatment of primary dysmenorrhea.%目的 回顾性分析针刺腹肌肌筋膜触发点(MTrPs)治疗原发性痛经的效果.方法 选择中、重度原发性痛经患者65例,在腹肌肌筋膜定位MTrPs,并在月经中期对MTrPs进行针刺并注射1%利多卡因治疗,针刺时需引出腹肌局部跳动,反复针刺直至跳动消失.每次针刺结束后指导患者行腹肌牵张锻炼,保持0.5~1.0 min/次·3~5次/d.于每次治疗后的下一次月经期及最后一次治疗的1年后,评估VAS及疗效.当VAS≤3时,结束针刺治疗.结果 第1、2次治疗后及1年后随访有效率分别为63%(41/65例),100%(65/65例)和100%(65/65例).结论 针刺腹肌MTrPs结合腹肌牵张锻炼可有效缓解原发性痛经.

  4. Myofascial force transmission via extramuscular pathways occurs between antagonistic muscles.

    Science.gov (United States)

    Huijing, Peter A; Baan, Guus C

    2008-01-01

    Most often muscles (as organs) are viewed as independent actuators. To test if this is true for antagonistic muscles, force was measured simultaneously at: (1) the proximal and distal tendons of the extensor digitorum muscle (EDL) to quantify any proximo-distal force differences, as an indicator of myofascial force transmission, (2) at the distal tendons of the whole antagonistic peroneal muscle group (PER) to test if effects of EDL length changes are present and (3) at the proximal end of the tibia to test if myofascially transmitted force is exerted there. EDL length was manipulated either at the proximal or distal tendons. This way equal EDL lengths are attained at two different positions of the muscle with respect to the tibia and antagonistic muscles. Despite its relatively small size, lengthening of the EDL changed forces exerted on the tibia and forces exerted by its antagonistic muscle group. Apart from its extramuscular myofascial connections, EDL has no connections to either the tibia or these antagonistic muscles. Proximal EDL lengthening increased distal muscular forces (active PER DeltaF approximately +1.7%), but decreased tibial forces (passive from 0.3 to 0 N; active DeltaF approximately -5%). Therefore, it is concluded that these antagonistic muscles do not act independently, because of myofascial force transmission between them. Such a decrease in tibial force indicates release of pre-strained connections. Distal EDL lengthening had opposite effects (tripling passive force exerted on tibia; active PER force DeltaF approximately -3.6%). It is concluded that the length and relative position of the EDL is a co-determinant of passive and active force exerted at tendons of nearby antagonistic muscle groups. These results necessitate a new view of the locomotor apparatus, which needs to take into account the high interdependence of muscles and muscle fibres as force generators, as well as proximo-distal force differences and serial and parallel

  5. Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

    Directory of Open Access Journals (Sweden)

    José M. Climent

    2013-01-01

    Full Text Available Introduction. Botulinum toxin inhibits acetylcholine (ACh release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

  6. Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

    Science.gov (United States)

    Climent, José M.; Fenollosa, Pedro; Martin-del-Rosario, Francisco

    2013-01-01

    Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies. PMID:23533477

  7. Botulinum toxin for the treatment of myofascial pain syndromes involving the neck and back: a review from a clinical perspective.

    Science.gov (United States)

    Climent, José M; Kuan, Ta-Shen; Fenollosa, Pedro; Martin-Del-Rosario, Francisco

    2013-01-01

    Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

  8. Ultrasonic tissue characterization of the upper trapezius muscle in patients with myofascial pain syndrome.

    Science.gov (United States)

    Turo, Diego; Otto, Paul; Shah, Jay P; Heimur, Juliana; Gebreab, Tadesse; Armstrong, Katherine; Gerber, Lynn H; Sikdar, Siddhartha

    2012-01-01

    Myofascial trigger points (MTrPs) are palpable, tender nodules in skeletal muscle that produce symptomatic referred pain when palpated. MTrPs are characteristic findings in myofascial pain syndrome (MPS). The role of MTrPs in the pathophysiology of MPS is unknown. Objective characterization and quantitative measurement of the properties of MTrPs can improve their localization and diagnosis, as well as lead to clinical outcome measures. MTrPs associated with soft tissue neck pain are often found in the upper trapezius muscle. We have previously demonstrated that MTrPs can be visualized using ultrasound imaging. The goal of this study was to evaluate whether texture-based image analysis can differentiate structural heterogeneity of symptomatic MTrPs and normal muscle.

  9. Myofascial Pelvic Pain and Related Disorders.

    Science.gov (United States)

    Bonder, Jaclyn H; Chi, Michelle; Rispoli, Leia

    2017-08-01

    Myofascial pelvic pain refers to pain in the pelvic floor muscles, the pelvic floor connective tissue, and the surrounding fascia. The cause is often multifactorial and requires treatment that encompasses multiple modalities. This type of pain is often associated with other abdominopelvic disorders, so providers in these specialties need to be aware of these connections. A comprehensive musculoskeletal examination, including evaluation of the pelvic floor muscles, and history are key to diagnosing myofascial pelvic pain. Treatments include physical therapy, muscle relaxers, oral neuromodulators, cognitive-behavioral therapy, and pelvic floor muscle injections. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Myofascial release of carpal tunnel syndrome.

    Science.gov (United States)

    Sucher, B M

    1993-01-01

    Current treatment for carpal tunnel syndrome may be ineffective or associated with complications or recurrence. In the case reported here, a myofascial release by the physician combined with the patient's self-stretch reduced pain and numbness and improved electromyographic results. The manipulative approach releases the transverse carpal ligament,-and "opens" or dilates the canal. The patient stretches the wrist, digits, and thumb, including myofascial components. An aggressive, conservative approach lessens the need for surgery in mild to moderate cases. Studies with magnetic resonance imaging may be helpful to document canal size before and after treatment.

  11. A Comparative Study Between Acupuncture and Lidocaine Block Treatment for Back of the Neck Myofascial Trigger Point%针刺与利多卡因阻滞治疗颈背部肌筋膜扳机点比较研究

    Institute of Scientific and Technical Information of China (English)

    尹凤华

    2014-01-01

    目的:比较运用针刺与利多卡因阻滞治疗颈背部肌筋膜扳机点的临床疗效。方法收集菏泽市第二人民医院2013年5-12月MPS患者100例,通过PEMS3.1软件按照1:1的比例获取随机数字,随机将患者分为针刺组和对照组,每组50例。结果针刺组与对照组在治疗前VAS比较差异无统计学意义(P>0.05),两组治疗后1次以及治疗后3次均较治疗前降低(P0.05)。针刺组与对照组在治疗前NDI比较差异无统计学意义(P>0.05),两组治疗后1次以及治疗后3次均较治疗前降低(P0.05)。针刺组与对照组在治疗前PPDT与PPTO比较差异无统计学意义(P>0.05),两组治疗1次后以及治疗3次后PPDT与PPTO均较治疗前降低(P0.05)。结论针刺扳机点可降低VAS和NDI,提高患者的压痛阈和耐痛阈,临床效果明显,且无明显的不良反应,是治疗颈背部MPS的一种有效的可供选择的方法。%Objective To compare the clinical efficacy between acupuncture and lidocaine block for the treatment of back of the neck myofascial trigger point. Methods 100 cases of patients with MPS admitted in Heze Second People's Hospital from May, 2013 to December, 2013 were selected. A random number was obtained by PEMS3.1 software in accordance with the ratio of 1:1, and the patients were randomly divided into acupuncture group and control group with 50 cases in each. Results The difference in pre-treatment VAS between the acupuncture group and the control group was statistically significant (P>0.05), and after 1 time, 3 times of treatment, VAS of both groups were lower than before treatment(P0.05). Before treatment, the difference in NDI between the acupuncture group and the control group was statistically significant(P>0.05), after 1 time and 3 times of treatment, the NDI of both groups were lower than those before treatment (P0.05). Before treatment, the difference in PPDT and PPTO between the acupuncture group and the

  12. Role of Triggering Receptor Expressed on Myeloid Cells in the Activation of Innate Immunity

    Directory of Open Access Journals (Sweden)

    V. G. Matveyeva

    2011-01-01

    Full Text Available The innate immune system plays a key role in triggering a systemic inflammatory response (SIR. The triggering receptor expressed on myeloid cells (TREM-1, which is located on neutrophils and monocytes, is involved in SIR, by regulating the effector mechanisms of innate immunity. Hyperproduction of proinflammatory cytokines is a pathogenetic component of the hyperergic phase of acute systemic inflammation. The simultaneous activation of Toll-like receptors and TREM-1 increases the production of cytokines manifold. This is compensatory and adaptive, however, resulting in damage to organs and tissues during excessive production of cytokines. Key words: triggering receptor expressed on myeloid cells, Toll-like receptors, cytokines, inflammation.

  13. Myofascial Pain Dysfunction Syndrome (MPDS

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    Hamed Mortazavi

    2010-10-01

    Full Text Available Introduction: Myofascial Pain Dysfunction Syndrome (MPDS is one of the most important causes of the orofacial pain. The main purpose of this study was to evaluate 40 related variables in this regard. Materials and Methods: Thirty nine patients with MPDS were evaluated in this study. Different factors including age, gender, occupation, marital status, sensitivity of masticatory muscles, maximum opening of the mouth, deviation, deflection, involvement of temporomandibular joint, habit, parafunction, malocclusion, neck pain, headache, earache and history of jaw involvement, etc were analyzed in this  evaluation. Results: In our study, 39 patients (32 females and 7 males, 20-40 years old, with the average age of 35 ± 13.32 years were studied. 51% were housewives and 74.4% were married. The most common involvements were Clicking (74.4%, pain in temporomandibular joint (54%, headache (46.2%, earache (41%, neck-pain (35.9%, trouble in the mouth opening (71.8%, malocclusion Class I (74.4%, cross bite and deep bite (25%, clenching (64.1% and involvement of masseter and lateral pterygoid muscle (84%. Conclusion: Since MPDS consists of variable symptoms, it might be very difficult to provide any definite diagnosis and treatment. Therefore the more the specialists extend their knowledge and information about this disorder, the more they will make the best decision in this regard.

  14. Quantitative Ultrasound Assessment of Myofascial Pain Syndrome Affecting the Trapezius: A Reliability Study.

    Science.gov (United States)

    Kumbhare, Dinesh; Shaw, Saurabh; Grosman-Rimon, Liza; Noseworthy, Michael D

    2017-07-03

    Myofascial pain syndrome is one of the most common causes of chronic pain and is highlighted by the presence of myofascial trigger points. The current practice of diagnosing myofascial pain syndrome among clinicians involves manual detection of myofascial trigger points, which can be inconsistent. However, the detection process can be strengthened with the assistance of ultrasound (US). Therefore, this study aimed to characterize the upper trapezius by using quantitative techniques in healthy asymptomatic individuals with neck pain. Study participants were recruited on the basis of the inclusion and exclusion criteria established, and US images of the trapezius, along the axial and longitudinal orientations, were obtained. Each set was obtained by 2 investigators: experienced and inexperienced personnel. Fifteen participants were recruited. The mean gray scale US echo intensity distribution obtained was 41.9. A paired t test of the global mean echo intensity value obtained for each image from the US operators did not show any significant difference (P = .77). A t test was performed, comparing the echo intensity of the group of patients with neck pain and healthy control participants, and the difference was found to be significant (P = .052). The median blob area was 2.71. The quartile range for the blob area was 1.72 for the 25th percentile to 4.90 for the 75th percentile. This study demonstrated that quantitative analysis of the echo intensity of US images can provide important information. However, further research is necessary to explore the relationships among sex, age, blob area, count, body mass index, regional anatomy, and extent of training or exercise of the particular muscle. © 2017 by the American Institute of Ultrasound in Medicine.

  15. EFFECTIVENESS OF MUSCLE ENERGY TECHNIQUE ON PAIN AND CERVICAL RANGE OF MOTION IN PATIENTS WITH MYOFASCIAL PAIN IN UPPER TRAPEZIUS

    Directory of Open Access Journals (Sweden)

    M. Srikanth

    2015-02-01

    Full Text Available Back ground: Myofascial trigger point (MTPt can be defined as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. MTPt is associated with pain on compression, the pain is typically of a referred type. MTPt symptoms, cause severe discomfort and inability to work. The pain is aggravated with activity or stress. Untreated, chronic cases might lead to symptoms like depression, fatigue and behavioural disturbances. The objective of the study is to examine the effectiveness of MET on pain with VAS and cervical ROM with inch tape method in patients with myofascial pain in upper trapezius. Methods: participants were randomized into intervention group (n =15 and control group (n = 15.The intervention group was given muscle energy technique, ischemic compression and ultrasound. The control group was given only ischemic compression and ultrasound. Ultrasound 1 MHz continuous mode, intensity 1.5W/cm2 for 5 minutes. Home exercises taught to both the groups. This program designed for daily for 1 week. Outcome measures: Pain-VAS, ROM-Inch tape method (cervical lateral flexion. Results: values within the groups were compared by using paired `t` test. According to obtained values, the pre & posttest values of pain and ROM had an significant effect on p-values 0.00 in experimental group. The difference between the pretest and posttest scores of 95% confidence intervals for each outcome variable was reported. Conclusion: After 1 week of intervention protocol, the present study concludes that MET has significant improvement in pain, ROM in intervention group.

  16. Acid sphingomyelinase activity triggers microparticle release from glial cells.

    Science.gov (United States)

    Bianco, Fabio; Perrotta, Cristiana; Novellino, Luisa; Francolini, Maura; Riganti, Loredana; Menna, Elisabetta; Saglietti, Laura; Schuchman, Edward H; Furlan, Roberto; Clementi, Emilio; Matteoli, Michela; Verderio, Claudia

    2009-04-22

    We have earlier shown that microglia, the immune cells of the CNS, release microparticles from cell plasma membrane after ATP stimulation. These vesicles contain and release IL-1beta, a crucial cytokine in CNS inflammatory events. In this study, we show that microparticles are also released by astrocytes and we get insights into the mechanism of their shedding. We show that, on activation of the ATP receptor P2X7, microparticle shedding is associated with rapid activation of acid sphingomyelinase, which moves to plasma membrane outer leaflet. ATP-induced shedding and IL-1beta release are markedly reduced by the inhibition of acid sphingomyelinase, and completely blocked in glial cultures from acid sphingomyelinase knockout mice. We also show that p38 MAPK cascade is relevant for the whole process, as specific kinase inhibitors strongly reduce acid sphingomyelinase activation, microparticle shedding and IL-1beta release. Our results represent the first demonstration that activation of acid sphingomyelinase is necessary and sufficient for microparticle release from glial cells and define key molecular effectors of microparticle formation and IL-1beta release, thus, opening new strategies for the treatment of neuroinflammatory diseases.

  17. Sleep bruxism and myofascial temporomandibular disorders

    Science.gov (United States)

    Raphael, Karen G.; Sirois, David A.; Janal, Malvin N.; Wigren, Pia E.; Dubrovsky, Boris; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2015-01-01

    Background Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients’ self-reports rather than on direct observation. Methods The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants. Results The results of independent sample t tests and χ2 analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent). Conclusions Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned. Clinical Implications Although other reasons to consider treating SB may exist, misplaced concern about SB’s sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment. PMID:23115152

  18. SARM1 activation triggers axon degeneration locally via NAD+ destruction

    OpenAIRE

    Gerdts, Josiah; Brace, E. J.; Sasaki, Yo; DiAntonio, Aaron; Milbrandt, Jeffrey

    2015-01-01

    Axon degeneration is an intrinsic self-destruction program that underlies axon loss during injury and disease. Sterile alpha and TIR motif containing 1 (SARM1) protein is an essential mediator of axon degeneration. We report that SARM1 initiates a local destruction program involving rapid breakdown of NAD+ after injury. We used an engineered protease-sensitized SARM1 to demonstrate that SARM1 activity is required after axon injury to induce axon degeneration. Dimerization of the Toll-Interleu...

  19. Exposure to Leishmania braziliensis triggers neutrophil activation and apoptosis.

    Directory of Open Access Journals (Sweden)

    Sarah A C Falcão

    2015-03-01

    Full Text Available BACKGROUND: Neutrophils are the first line of defense against invading pathogens and are rapidly recruited to the sites of Leishmania inoculation. During Leishmania braziliensis infection, depletion of inflammatory cells significantly increases the parasite load whereas co-inoculation of neutrophils plus L. braziliensis had an opposite effect. Moreover, the co-culture of infected macrophages and neutrophils also induced parasite killing leading us to ask how neutrophils alone respond to an L. braziliensis exposure. Herein we focused on understanding the interaction between neutrophils and L. braziliensis, exploring cell activation and apoptotic fate. METHODS AND FINDINGS: Inoculation of serum-opsonized L. braziliensis promastigotes in mice induced neutrophil accumulation in vivo, peaking at 24 h. In vitro, exposure of thyoglycollate-elicited inflammatory or bone marrow neutrophils to L. braziliensis modulated the expression of surface molecules such as CD18 and CD62L, and induced the oxidative burst. Using mCherry-expressing L. braziliensis, we determined that such effects were mainly observed in infected and not in bystander cells. Neutrophil activation following contact with L. braziliensis was also confirmed by the release of TNF-α and neutrophil elastase. Lastly, neutrophils infected with L. braziliensis but not with L. major displayed markers of early apoptosis. CONCLUSIONS: We show that L. braziliensis induces neutrophil recruitment in vivo and that neutrophils exposed to the parasite in vitro respond through activation and release of inflammatory mediators. This outcome may impact on parasite elimination, particularly at the early stages of infection.

  20. TLR2 is a primary receptor for Alzheimer's amyloid beta peptide to trigger neuroinflammatory activation.

    NARCIS (Netherlands)

    Liu, S.; Liu, Y.; Hao, W.; Wolf, L.; Kiliaan, A.J.; Penke, B.; Rube, C.E.; Walter, J.; Heneka, M.T.; Hartmann, T.; Menger, M.D.; Fassbender, K.

    2012-01-01

    Microglia activated by extracellularly deposited amyloid beta peptide (Abeta) act as a two-edged sword in Alzheimer's disease pathogenesis: on the one hand, they damage neurons by releasing neurotoxic proinflammatory mediators (M1 activation); on the other hand, they protect neurons by triggering an

  1. TLR2 is a primary receptor for Alzheimer's amyloid beta peptide to trigger neuroinflammatory activation.

    NARCIS (Netherlands)

    Liu, S.; Liu, Y.; Hao, W.; Wolf, L.; Kiliaan, A.J.; Penke, B.; Rube, C.E.; Walter, J.; Heneka, M.T.; Hartmann, T.; Menger, M.D.; Fassbender, K.

    2012-01-01

    Microglia activated by extracellularly deposited amyloid beta peptide (Abeta) act as a two-edged sword in Alzheimer's disease pathogenesis: on the one hand, they damage neurons by releasing neurotoxic proinflammatory mediators (M1 activation); on the other hand, they protect neurons by triggering

  2. Trigger values for investigation of hormonal activity in drinking water and its sources using CALUX bioassays

    NARCIS (Netherlands)

    Brand, W.; de Jongh, C.M.; Linden, S.C.; Mennes, W.; Puijker, L.M.; van Leeuwen, C.J.|info:eu-repo/dai/nl/071976817; van Wezel, Annemarie; Schriks, M.; Heringa, M.B.

    2013-01-01

    To screen for hormonal activity in water samples, highly sensitive in vitro CALUX bioassays are available which allow detection of estrogenic (ERα), androgenic (AR), progestagenic (PR), and glucocorticoid (GR) activities. This paper presents trigger values for the ERα, AR, PR, and GR CALUX bioassays

  3. Trigger values for investigation of hormonal activity in drinking water and its sources using CALUX bioassays

    NARCIS (Netherlands)

    Brand, W.; de Jongh, C.M.; Linden, S.C.; Mennes, W.; Puijker, L.M.; van Leeuwen, C.J.; van Wezel, Annemarie; Schriks, M.; Heringa, M.B.

    2013-01-01

    To screen for hormonal activity in water samples, highly sensitive in vitro CALUX bioassays are available which allow detection of estrogenic (ERα), androgenic (AR), progestagenic (PR), and glucocorticoid (GR) activities. This paper presents trigger values for the ERα, AR, PR, and GR CALUX bioassays

  4. Triggering Sublimation-Driven Activity of Main Belt Comets

    CERN Document Server

    Haghighipour, Nader; Schaefer, Christoph; Speith, Roland; Dvorak, Rudolf

    2016-01-01

    It has been suggested that the comet-like activity of Main Belt Comets are due to the sublimation of sub-surface water-ice that has been exposed as a result of their surfaces being impacted by m-sized bodies. We have examined the viability of this scenario by simulating impacts between m-sized and km-sized objects using a smooth particle hydrodynamics approach. Simulations have been carried out for different values of the impact velocity and impact angle as well as different target material and water-mass fraction. Results indicate that for the range of impact velocities corresponding to those in the asteroid belt, the depth of an impact crater is slightly larger than 10 m suggesting that if the activation of MBCs is due to the sublimation of sub-surface water-ice, this ice has to exist no deeper than a few meters from the surface. Results also show that ice-exposure occurs in the bottom and on the interior surface of impact craters as well as the surface of the target where some of the ejected icy inclusions...

  5. Microstructural Abnormalities Were Found in Brain Gray Matter from Patients with Chronic Myofascial Pain

    Directory of Open Access Journals (Sweden)

    Peng Xie

    2016-12-01

    Full Text Available Myofascial pain, presented as myofascial trigger points (MTrPs-related pain, is a common, chronic disease involving skeletal muscle, but its underlying mechanisms have been poorly understood. Previous studies have revealed that chronic pain can induce microstructural abnormalities in the cerebral gray matter. However, it remains unclear whether the brain gray matter of patients with chronic MTrPs-related pain undergo alteration. In this study, we employed the Diffusion Kurtosis Imaging (DKI technique, which is particularly sensitive to brain microstructural perturbation, to monitor the MTrPs-related microstructural alterations in brain gray matter of patients with chronic pain. Our results revealed that, in comparison with the healthy controls, patients with chronic myofascial pain exhibited microstructural abnormalities in the cerebral gray matter and these lesions were mainly distributed in the limbic system and the brain areas involved in the pain matrix. In addition, we showed that microstructural abnormalities in the right anterior cingulate cortex (ACC and medial prefrontal cortex (mPFC had a significant negative correlation with the course of disease and pain intensity. The results of this study demonstrated for the first time that there are microstructural abnormalities in the brain gray matter of patients with MTrPs-related chronic pain. Our findings may provide new insights into the future development of appropriate therapeutic strategies to this disease.

  6. Value of transcutaneous electric nerve stimulation in the treatment of myofascial pain dysfunction syndrome

    Directory of Open Access Journals (Sweden)

    Hina Handa

    2017-01-01

    Full Text Available Pain in facial region originating from both temporomandibular joint (TMJ and jaw muscles is a common clinical problem and is a diagnostic dilemma till today. There are many synonyms for this condition including myofascial pain dysfunction syndrome, mandibular dysfunction syndrome, and the TMJ dysfunction syndrome. With change in time, advances and new diagnostic criteria have been made in the diagnosis of myofascial pain syndrome, its epidemiology, clinical characteristics, and etiopathogenesis, but many unknowns remain. An integrated hypothesis has provided a greater understanding of the physiopathology of trigger points, which may allow the development of new diagnostic criteria and treatment of this chronic disease and combined pharmacological as well as physical therapy for the management of the disease. The purpose of this paper is to describe the multidisciplinary approach highlighting the effect of transcutaneous electric nerve stimulation (TENS for the treatment of a 60-year-old female who suffered from myofascial pain and 5-day TENS therapy for management of pain.

  7. A critical overview of the current myofascial pain literature - January 2016.

    Science.gov (United States)

    Dommerholt, Jan; Finnegan, Michelle; Grieve, Rob; Hooks, Todd

    2016-01-01

    Reflecting on the past year, the number of publications on myofascial pain continues to increase in a steady rate. The current review includes 30 basic and clinical studies, case reports, reviews, and reports from fifteen different countries about trigger points (TrP), myofascial pain (MP), dry needling (DN) and other related interventions. We are pleased that during 2015 this article made the top 15 of most downloaded articles as many as three times! In general, the quality of published papers is improving as well. Nevertheless, several papers included in this overview, mention the application of "ischemic compression", which is a questionable concept in the context of TrP inactivation. As we have outlined previously, in the current thinking about myofascial pain, TrPs feature significant hypoxia and a lowered pH (Ballyns et al., 2011; Shah and Gilliams, 2008), and attempts to induce more ischemia would be counterproductive. Already in 1999, Simons, Travell and Simons changed the terminology from ischemic compression to TrP compression (Simons et al., 1999) and we recommend that contemporary researchers and clinicians adopt the new terminology and stop using the term "ischemic compression."

  8. Chronic refractory myofascial pain and denervation supersensitivity as global public health disease.

    Science.gov (United States)

    Chu, J; Bruyninckx, F; Neuhauser, D V

    2016-01-13

    Chronic pain with a 30.3% global prevalence significantly impacts universal health. Low back pain has a 9.4% prevalence worldwide causing the most widespread disability. Neck pain ranks 4th highest regarding years lived with disability with a 4.9% prevalence worldwide. The principal cause of pain in 85% of patients visiting a tertiary pain clinic has a myofascial origin. The root cause is multifocal neuromuscular ischaemia at myofascial trigger points from muscle tightening and shortening following spondylotic radiculopathy induced partial denervation. Chronic refractory myofascial pain (CRMP) is a neuromusculoskeletal disease needing management innovations. Using electrical twitch-obtaining intramuscular stimulation (eToims), we provide objective evidence of denervation supersensitivity in multiple myotomes as cause, aggravation and maintenance of CRMP. This study underscores our previous findings that eToims is safe and efficacious for long-term use in CRMP. eToims aids potential prevention (pre-rehabilitation), simultaneous diagnosis, treatment (rehabilitation) and prognosis in real time for acute and CRMP management.

  9. Rhinovirus-induced calcium flux triggers NLRP3 and NLRC5 activation in bronchial cells.

    Science.gov (United States)

    Triantafilou, Kathy; Kar, Satwik; van Kuppeveld, Frank J M; Triantafilou, Martha

    2013-12-01

    Human rhinoviruses have been linked with underlying lung disorders, such as asthma and chronic obstructive pulmonary disease, in children and adults. However, the mechanism of virus-induced airway inflammation is poorly understood. In this study, using virus deletion mutants and silencing for nucleotide-binding oligomerization domain-like receptors (NLRs), we show that the rhinovirus ion channel protein 2B triggers NLRP3 and NLRC5 inflammasome activation and IL-1β secretion in bronchial cells. 2B protein targets the endoplasmic reticulum and Golgi and induces Ca(2+) reduction in these organelles, thereby disturbing the intracellular calcium homeostasis. NLRP3 and NLRC5 act in a cooperative manner during the inflammasome assembly by sensing intracellular Ca(2+) fluxes and trigger IL-1β secretion. These results reveal for the first time that human rhinovirus infection in primary bronchial cells triggers inflammasome activation.

  10. Two- and three-dimensional ultrasound imaging to facilitate detection and targeting of taut bands in myofascial pain syndrome.

    Science.gov (United States)

    Shankar, Hariharan; Reddy, Sapna

    2012-07-01

    Ultrasound imaging has gained acceptance in pain management interventions. Features of myofascial pain syndrome have been explored using ultrasound imaging and elastography. There is a paucity of reports showing the benefit clinically. This report provides three-dimensional features of taut bands and highlights the advantages of using two-dimensional ultrasound imaging to improve targeting of taut bands in deeper locations. Fifty-eight-year-old man with pain and decreased range of motion of the right shoulder was referred for further management of pain above the scapula after having failed conservative management for myofascial pain syndrome. Three-dimensional ultrasound images provided evidence of aberrancy in the architecture of the muscle fascicles around the taut bands compared to the adjacent normal muscle tissue during serial sectioning of the accrued image. On two-dimensional ultrasound imaging over the palpated taut band, areas of hyperechogenicity were visualized in the trapezius and supraspinatus muscles. Subsequently, the patient received ultrasound-guided real-time lidocaine injections to the trigger points with successful resolution of symptoms. This is a successful demonstration of utility of ultrasound imaging of taut bands in the management of myofascial pain syndrome. Utility of this imaging modality in myofascial pain syndrome requires further clinical validation. Wiley Periodicals, Inc.

  11. Distinct DNA-based epigenetic switches trigger transcriptional activation of silent genes in human dermal fibroblasts.

    Science.gov (United States)

    Pandian, Ganesh N; Taniguchi, Junichi; Junetha, Syed; Sato, Shinsuke; Han, Le; Saha, Abhijit; AnandhaKumar, Chandran; Bando, Toshikazu; Nagase, Hiroki; Vaijayanthi, Thangavel; Taylor, Rhys D; Sugiyama, Hiroshi

    2014-01-24

    The influential role of the epigenome in orchestrating genome-wide transcriptional activation instigates the demand for the artificial genetic switches with distinct DNA sequence recognition. Recently, we developed a novel class of epigenetically active small molecules called SAHA-PIPs by conjugating selective DNA binding pyrrole-imidazole polyamides (PIPs) with the histone deacetylase inhibitor SAHA. Screening studies revealed that certain SAHA-PIPs trigger targeted transcriptional activation of pluripotency and germ cell genes in mouse and human fibroblasts, respectively. Through microarray studies and functional analysis, here we demonstrate for the first time the remarkable ability of thirty-two different SAHA-PIPs to trigger the transcriptional activation of exclusive clusters of genes and noncoding RNAs. QRT-PCR validated the microarray data, and some SAHA-PIPs activated therapeutically significant genes like KSR2. Based on the aforementioned results, we propose the potential use of SAHA-PIPs as reagents capable of targeted transcriptional activation.

  12. DRY NEEDLING AS A PAIN MODULATING MODALITY IN MYOFASCIAL PAIN SYNDROME

    Directory of Open Access Journals (Sweden)

    Ravinder Kumar

    2016-06-01

    Full Text Available BACKGROUND Myofascial Pain Syndrome (MPS is a significant health problem affecting as much as 85% of the general population, sometime in their lifetime, while the estimated overall prevalence is 46%. Low back pain is the most common MPS affecting all age groups with no gender discrimination. It can be acute or chronic. It can cause localised, diffuse, radicular or referred type of pains. Dry Needling or intramuscular stimulation is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular and connective tissues for the management of neuromusculoskeletal pain and movement impairments in Myofascial Pain Syndrome (MPS. MATERIALS AND METHODS 90 patients (57 male and 33 female who attended the Department of Physio-Occupation Therapy, which is a part of the Department of Orthopaedics, Osmania General Hospital, were randomly chosen after clearance from the Ethical Committee. The study period extended from June 2015 to Jan 2016. They were divided into groups according to their position in Visual Analogue Scale (VAS and their respective scores were noted. Their scores were once again noted after they received the Dry Needling treatment of about 6 sittings. RESULTS Out of the 90 cases, 65 cases showed excellent results (VAS 0-1 after treatment, 18 cases showed good results (VAS 2-3 after treatment, 6 cases showed fair results (VAS 4-5 after treatment, 2 cases showed VAS-6 after treatment. CONCLUSION Dry Needling is a relatively new treatment modality with specific subjective pain modulation efficacy in myofascial pain syndrome, which can help us in alleviating the pain in chronic conditions and acts adjuvant to the specific treatment.

  13. TRIGGERED ACTIVITY AS ARRHYTHMOGENIC MECHANISM AFTER MYOCARDIAL-INFARCTION - CLINICAL AND ELECTROPHYSIOLOGIC STUDY OF ONE CASE

    NARCIS (Netherlands)

    WIESFELD, ACP; CRIJNS, HJGM; VANVELDHUISEN, DJ; VANGILST, WH; LIE, KI

    1992-01-01

    In a woman with an old infarction and sustained ventricular tachycardia, tachycardias were only inducible after short-long RR sequences. After isoprenaline, tachycardias became incessant and all were preceded by short-long RR sequences. This strongly suggests that triggered activity plays a role in

  14. Trigger values for investigation of hormonal activity in drinking water and its sources using CALUX bioassays.

    Science.gov (United States)

    Brand, Walter; de Jongh, Cindy M; van der Linden, Sander C; Mennes, Wim; Puijker, Leo M; van Leeuwen, Cornelis J; van Wezel, Annemarie P; Schriks, Merijn; Heringa, Minne B

    2013-05-01

    To screen for hormonal activity in water samples, highly sensitive in vitro CALUX bioassays are available which allow detection of estrogenic (ERα), androgenic (AR), progestagenic (PR), and glucocorticoid (GR) activities. This paper presents trigger values for the ERα, AR, PR, and GR CALUX bioassays for agonistic hormonal activities in (drinking) water, which define a level above which human health risk cannot be waived a priori and additional examination of specific endocrine activity may be warranted. The trigger values are based on 1) acceptable or tolerable daily intake (ADI/TDI) values of specific compounds, 2) pharmacokinetic factors defining their bioavailability, 3) estimations of the bioavailability of unknown compounds with equivalent hormonal activity, 4) relative endocrine potencies, and 5) physiological, and drinking water allocation factors. As a result, trigger values of 3.8ng 17β-estradiol (E2)-equivalents (eq)/L, 11ng dihydrotestosterone (DHT)-eq/L, 21ng dexamethasone (DEX)-eq/L, and 333ng Org2058-eq/L were derived. Benchmark Quotient (BQ) values were derived by dividing hormonal activity in water samples by the derived trigger using the highest concentrations detected in a recent, limited screening of Dutch water samples, and were in the order of (value) AR (0.41)>ERα (0.13)>GR (0.06)>PR (0.04). The application of trigger values derived in the present study can help to judge measured agonistic hormonal activities in water samples using the CALUX bioassays and help to decide whether further examination of specific endocrine activity followed by a subsequent safety evaluation may be warranted, or whether concentrations of such activity are of low priority with respect to health concerns in the human population. For instance, at one specific drinking water production site ERα and AR (but no GR and PR) activities were detected in drinking water, however, these levels are at least a factor 83 smaller than the respective trigger values, and

  15. Augmented supraorbital skin sympathetic nerve activity responses to symptom trigger events in rosacea patients.

    Science.gov (United States)

    Metzler-Wilson, Kristen; Toma, Kumika; Sammons, Dawn L; Mann, Sarah; Jurovcik, Andrew J; Demidova, Olga; Wilson, Thad E

    2015-09-01

    Facial flushing in rosacea is often induced by trigger events. However, trigger causation mechanisms are currently unclear. This study tested the central hypothesis that rosacea causes sympathetic and axon reflex-mediated alterations resulting in trigger-induced symptomatology. Twenty rosacea patients and age/sex-matched controls participated in one or a combination of symptom triggering stressors. In protocol 1, forehead skin sympathetic nerve activity (SSNA; supraorbital microneurography) was measured during sympathoexcitatory mental (2-min serial subtraction of novel numbers) and physical (2-min isometric handgrip) stress. In protocol 2, forehead skin blood flow (laser-Doppler flowmetry) and transepithelial water loss/sweat rate (capacitance hygrometry) were measured during sympathoexcitatory heat stress (whole body heating by perfusing 50°C water through a tube-lined suit). In protocol 3, cheek, forehead, forearm, and palm skin blood flow were measured during nonpainful local heating to induce axon reflex vasodilation. Heart rate (HR) and mean arterial pressure (MAP) were recorded via finger photoplethysmography to calculate cutaneous vascular conductance (CVC; flux·100/MAP). Higher patient transepithelial water loss was observed (rosacea 0.20 ± 0.02 vs. control 0.10 ± 0.01 mg·cm(-2)·min(-1), P rosacea and controls, respectively) stress was augmented in rosacea (both P rosacea compared with controls. No axon reflex vasodilation differences were observed between groups. These data indicate that rosacea affects SSNA and that hyperresponsiveness to trigger events appears to have a sympathetic component.

  16. Increased Risk of Myofascial Pain Syndrome Among Patients with Insomnia.

    Science.gov (United States)

    Lin, Wei-Chen; Shen, Cheng-Che; Tsai, Shih-Jen; Yang, Albert C

    2017-08-01

    The aim of this study is to evaluate the risk of developing myofascial pain syndrome among patients diagnosed with insomnia. We conducted a population-based longitudinal study of a matched cohort with 7,895 participants (1,579 patients with insomnia and 6,316 controls) who were selected from the Taiwan National Health Insurance Research Database. The patients were observed for a maximum of 10 years to determine the incidence of newly diagnosed myofascial pain syndrome. A Cox regression analysis was performed to identify the risk factors associated with myofascial pain syndrome in patients with insomnia. During the 10-year follow-up period, 182 insomnia patients (14.9 per 1,000 person-years) and 379 controls (7.5 per 1,000 person-years) were diagnosed with myofascial pain syndrome. The incidence risk ratio of myofascial pain syndrome between the insomnia and control patients was 2.00 (95% confidence interval [CI] = 1.67-2.38, P  myofascial pain syndrome (95% CI = 1.62-2.31, P  myofascial pain syndrome in patients with insomnia. Patients with insomnia had a higher risk of developing myofascial pain syndrome than controls. This study adds to the understanding of the complex relationship between sleep disturbance and pain.

  17. Microglial CR3 activation triggers long-term synaptic depression in the hippocampus via NADPH oxidase.

    Science.gov (United States)

    Zhang, Jingfei; Malik, Aqsa; Choi, Hyun B; Ko, Rebecca W Y; Dissing-Olesen, Lasse; MacVicar, Brian A

    2014-04-02

    Complement receptor 3 (CR3) activation in microglia is involved in neuroinflammation-related brain disorders and pruning of neuronal synapses. Hypoxia, often observed together with neuroinflammation in brain trauma, stroke, and neurodegenerative diseases, is thought to exacerbate inflammatory responses and synergistically enhance brain damage. Here we show that when hypoxia and an inflammatory stimulus (lipopolysaccharide [LPS]) are combined, they act synergistically to trigger long-term synaptic depression (LTD) that requires microglial CR3, activation of nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase), and GluA2-mediated A-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) internalization. Microglial CR3-triggered LTD is independent of N-methyl-D-aspartate receptors (NMDARs), metabotropic glutamate receptors (mGluRs), or patterned synaptic activity. This type of LTD may contribute to memory impairments and synaptic disruptions in neuroinflammation-related brain disorders.

  18. Prevalence of Myofascial Pain Syndrome in Chronic Non-Specific Neck Pain: A Population-Based Cross-Sectional Descriptive Study.

    Science.gov (United States)

    Cerezo-Téllez, Ester; Torres-Lacomba, María; Mayoral-Del Moral, Orlando; Sánchez-Sánchez, Beatriz; Dommerholt, Jan; Gutiérrez-Ortega, Carlos

    2016-12-01

    Chronic non-specific neck pain is a frequent complaint. It is a recognized medical and socioeconomic problem and a frequent cause of job absenteeism. In recent years, case reports about myofascial pain syndrome (MPS) are emerging among patients suffering from pain. MPS is a regional pain syndrome characterized by myofascial trigger points (MTrP) in palpable taut bands of skeletal muscle that refer pain to a distance, and that can cause distant motor and autonomic effects. To assess the prevalence of active and latent MTrPs in subjects suffering from chronic non-specific neck pain. A population-based cross-sectional descriptive study was carried out from January 2012 to December 2014. Three primary healthcare centers in Alcalá de Henares, Madrid (Spain). Two hundred and twenty-four participants diagnosed by their family doctor with chronic non-specific neck pain. Participants were examined by a physical therapist to determine the presence of MPS. Pain descriptions from the subjects and pain body diagrams guided the physical examination. The subjects were not given any information concerning MPS or other muscle pain syndromes. All participants presented with MPS. MTrPs of the trapezius muscles were the most prevalent, in 93.75% of the participants. The most prevalent active MTrPs were located right (82.1%) and left (79%) in the nearly-horizontal fibers of the upper trapezius muscle. Furthermore, active MTrPs in the levator scapulae, multifidi, and splenius cervicis muscles reached a prevalence of 82.14%, 77.68%, and 62.5%, respectively. MPS is a common source of pain in subjects presenting chronic non-specific neck pain. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. A randomized, placebo-controlled double-blinded comparative clinical study of five over-the-counter non-pharmacological topical analgesics for myofascial pain: single session findings

    Directory of Open Access Journals (Sweden)

    Avrahami Daniel

    2012-03-01

    Full Text Available Abstract Objectives To investigate the effects of topical agents for the treatment of Myofascial Pain Syndrome (MPS and Myofascial Trigger Point (MTRP. Methods Subjects with an identifiable trigger point in the trapezius muscle, age 18-80 were recruited for a single-session randomized, placebo-blinded clinical study. Baseline measurements of trapezius muscle pressure pain threshold (PPT: by pressure algometer along with right and left cervical lateral flexion (rangiometer were obtained by a blinded examiner. An assessor blinded to the outcomes assessments applied one of 6 topical formulations which had been placed in identical plastic containers. Five of these topicals were proposed active formulations; the control group was given a non-active formulation (PLA. Five minutes after the application of the formula the outcome measures were re-tested. Data were analyzed with a 5-way ANOVA and Holms-adjusted t-tests with an alpha level of 0.05. Results 120 subjects were entered into the study (63 females; ages 16-82; 20 subjects randomly allocated into each group. The pre- and post-treatment results for pressure threshold did show significant intra-group increases for the Ben-Gay Ultra Strength Muscle Pain Ointment (BG, the Professional Therapy MuscleCare Roll-on (PTMC roll-on and Motion Medicine Cream (MM with an increased threshold of 0.5 kg/cm2 (+/-0.15, 0.72 kg/cm2 (+/-0.17 and 0.47 Kg/cm2 (+/-0.19 respectively. With respect to the inter-group comparisons, PTMC roll-on showed significant increases in pressure threshold compared with Placebo (PLA (p = 0.002 and Icy Hot Extra Strength Cream (IH (p = 0.006. In addition, BG demonstrated significant increases in pressure threshold compared with PLA (p = 0.0003. Conclusions With regards to pressure threshold, PTMC roll-on, BG and MM showed significant increases in pain threshold tolerance after a short-term application on a trigger points located in the trapezius muscle. PTMC roll-on and BG were both

  20. Activation of CDK4 Triggers Development of Non-alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Jingling Jin

    2016-07-01

    Full Text Available The development of non-alcoholic fatty liver disease (NAFLD is a multiple step process. Here, we show that activation of cdk4 triggers the development of NAFLD. We found that cdk4 protein levels are elevated in mouse models of NAFLD and in patients with fatty livers. This increase leads to C/EBPα phosphorylation on Ser193 and formation of C/EBPα-p300 complexes, resulting in hepatic steatosis, fibrosis, and hepatocellular carcinoma (HCC. The disruption of this pathway in cdk4-resistant C/EBPα-S193A mice dramatically reduces development of high-fat diet (HFD-mediated NAFLD. In addition, inhibition of cdk4 by flavopiridol or PD-0332991 significantly reduces development of hepatic steatosis, the first step of NAFLD. Thus, this study reveals that activation of cdk4 triggers NAFLD and that inhibitors of cdk4 may be used for the prevention/treatment of NAFLD.

  1. PBL Trigger Design by Medical Students: An Effective Active Learning Strategy Outside the Classroom.

    Science.gov (United States)

    Roche, Maya; Adiga, Indira Kakkunje; Nayak, Akshatha G

    2016-12-01

    Problem Based Learning (PBL) is known world over as an effective, active learning strategy with many benefits for the student. Usually, in medical schools, PBL triggers are designed by a well-trained group of faculty from basic and clinical sciences. The challenge was whether this task could be given to students in the first year of their curriculum and be executed by them effectively. To enhance active learning, comprehension and critical thinking with a view to promote horizontal and vertical integration between subjects. Student volunteers of the first year MBBS course (n=10), who had been exposed to the curriculum for approximately 38 weeks and were familiar with the PBL process were recruited for the study. In addition to a handout on the topic 'gout', they were given the freedom to access any resource in the university library to construct the PBL triggers. The PBL triggers were vetted by two faculties. In addition to a focus group discussion with students, students' and faculty's responses were collected on a Likert scale. Students opined that the exercise helped improve their comprehension (100%), critical thinking abilities (90%) and clinical orientation to the topic (100%). They felt that designing a PBL trigger was a relevant active learning strategy (100%) and would help them answer questions on this topic better in the future (90%). The clinicians who examined the PBL triggers, felt that they were of good quality and that the process was a good tool for vertical integration between basic and clinical sciences. The results prove that students when given a challenge will rise to the occasion. Unfamiliarity with the nuances of a disease did not prevent them from going the extra mile to achieve their target. By taking part in this exercise, students benefitted in many ways and got a holistic understanding of the topic. PBL trigger design can be introduced as an active learning strategy for students in medical schools where PBL is part of the curriculum. It

  2. PBL Trigger Design by Medical Students: An Effective Active Learning Strategy Outside the Classroom

    Science.gov (United States)

    Adiga, Indira Kakkunje; Nayak, Akshatha G.

    2016-01-01

    Introduction Problem Based Learning (PBL) is known world over as an effective, active learning strategy with many benefits for the student. Usually, in medical schools, PBL triggers are designed by a well-trained group of faculty from basic and clinical sciences. The challenge was whether this task could be given to students in the first year of their curriculum and be executed by them effectively. Aim To enhance active learning, comprehension and critical thinking with a view to promote horizontal and vertical integration between subjects. Materials and Methods Student volunteers of the first year MBBS course (n=10), who had been exposed to the curriculum for approximately 38 weeks and were familiar with the PBL process were recruited for the study. In addition to a handout on the topic ‘gout’, they were given the freedom to access any resource in the university library to construct the PBL triggers. The PBL triggers were vetted by two faculties. In addition to a focus group discussion with students, students’ and faculty’s responses were collected on a Likert scale. Results Students opined that the exercise helped improve their comprehension (100%), critical thinking abilities (90%) and clinical orientation to the topic (100%). They felt that designing a PBL trigger was a relevant active learning strategy (100%) and would help them answer questions on this topic better in the future (90%). The clinicians who examined the PBL triggers, felt that they were of good quality and that the process was a good tool for vertical integration between basic and clinical sciences. Discussion The results prove that students when given a challenge will rise to the occasion. Unfamiliarity with the nuances of a disease did not prevent them from going the extra mile to achieve their target. By taking part in this exercise, students benefitted in many ways and got a holistic understanding of the topic. Conclusion PBL trigger design can be introduced as an active learning

  3. Effectiveness of dry needling for the treatment of temporomandibular myofascial pain: a double-blind, randomized, placebo controlled study.

    Science.gov (United States)

    Dıraçoğlu, Demirhan; Vural, Meltem; Karan, Ayşe; Aksoy, Cihan

    2012-01-01

    To test the hypothesis that dry needling is more effective than sham dry needling in relieving myofascial pain of the temporomandibular muscles. Fifty-two subjects with established myofascial trigger points were randomized into two groups; study group (N: 26) and placebo group (N: 26). Dry needling was applied using acupuncture needles. Sham dry needling was applied to the placebo group. Pain pressure threshold was measured with pressure algometry, pain intensity was rated using a 10-cm visual analog scale (VAS) and the unassisted jaw opening without pain measurement was performed. Evaluations were done by a physician blinded to the data. Of 52 patients assigned, 50 completed the study. Mean algometric values were significantly higher in the study group when compared to the placebo group (p values being less than 0.05). There were no differences between the two groups in terms of VAS and unassisted jaw-opening without pain values. Dry needling appears to be an effective treatment method in relieving the pain and tenderness of myofascial trigger points.

  4. A critical overview of the current myofascial pain literature - July 2016.

    Science.gov (United States)

    Dommerholt, Jan; Grieve, Rob; Finnegan, Michelle; Hooks, Todd

    2016-07-01

    The overview of the myofascial pain literature includes a wide variety of basic and clinical studies, ranging from assessing muscle activation patterns to the impact of platelet-rich plasma injections. Contributions to the literature once again came from all corners of the world, such as Australia, Belgium, Brazil, Germany, Greece, Iran, Italy, Japan, Korea, the Netherlands, Norway, Poland, Spain, Taiwan, Turkey, and the USA. A total of 30 papers are included in this overview.

  5. Malt1 ubiquitination triggers NF-κB signaling upon T-cell activation

    OpenAIRE

    Oeckinghaus, Andrea; Wegener, Elmar; Welteke, Verena; Ferch, Uta; Arslan, Seda Çöl; Ruland, Jürgen; Scheidereit, Claus; Krappmann, Daniel

    2007-01-01

    Triggering of antigen receptors on lymphocytes is critical for initiating adaptive immune response against pathogens. T-cell receptor (TCR) engagement induces the formation of the Carma1–Bcl10–Malt1 (CBM) complex that is essential for activation of the IκB kinase (IKK)/NF-κB pathway. However, the molecular mechanisms that link CBM complex formation to IKK activation remain unclear. Here we report that Malt1 is polyubiquitinated upon T-cell activation. Ubiquitin chains on Malt1 provide a docki...

  6. Constraining AGN triggering mechanisms through the clustering analysis of active black holes

    CERN Document Server

    Gatti, M; Bouillot, V; Menci, N; Lamastra, A; Hirschmann, M; Fiore, F

    2015-01-01

    The triggering mechanisms for Active Galactic Nuclei (AGN) are still debated. Some of the most popular ones include galaxy interactions (IT) and disk instabilities (DI). Using an advanced semi analytic model (SAM) of galaxy formation, coupled to accurate halo occupation distribution modeling, we investigate the imprint left by each separate triggering process on the clustering strength of AGN at small and large scales. Our main results are as follows: i) DIs, irrespective of their exact implementation in the SAM, tend to fall short in triggering AGN activity in galaxies at the center of halos with $M_h>10^{13.5} h^{-1}M_{\\odot}$. On the contrary, the IT scenario predicts abundance of active, central galaxies that generally agrees well with observations at every halo mass. ii) The relative number of satellite AGN in DIs at intermediate-to-low luminosities is always significantly higher than in IT models, especially in groups and clusters. The low AGN satellite fraction predicted for the IT scenario might sugge...

  7. Mechanical unloading activates FoxO3 to trigger Bnip3-dependent cardiomyocyte atrophy.

    Science.gov (United States)

    Cao, Dian J; Jiang, Nan; Blagg, Andrew; Johnstone, Janet L; Gondalia, Raj; Oh, Misook; Luo, Xiang; Yang, Kai-Chun; Shelton, John M; Rothermel, Beverly A; Gillette, Thomas G; Dorn, Gerald W; Hill, Joseph A

    2013-04-08

    Mechanical assist device therapy has emerged recently as an important and rapidly expanding therapy in advanced heart failure, triggering in some patients a beneficial reverse remodeling response. However, mechanisms underlying this benefit are unclear. In a model of mechanical unloading of the left ventricle, we observed progressive myocyte atrophy, autophagy, and robust activation of the transcription factor FoxO3, an established regulator of catabolic processes in other cell types. Evidence for FoxO3 activation was similarly detected in unloaded failing human myocardium. To determine the role of FoxO3 activation in cardiac muscle in vivo, we engineered transgenic mice harboring a cardiomyocyte-specific constitutively active FoxO3 mutant (caFoxO3(flox);αMHC-Mer-Cre-Mer). Expression of caFoxO3 triggered dramatic and progressive loss of cardiac mass, robust increases in cardiomyocyte autophagy, declines in mitochondrial biomass and function, and early mortality. Whereas increases in cardiomyocyte apoptosis were not apparent, we detected robust increases in Bnip3 (Bcl2/adenovirus E1B 19-kDa interacting protein 3), an established downstream target of FoxO3. To test the role of Bnip3, we crossed the caFoxO3(flox);αMHC-Mer-Cre-Mer mice with Bnip3-null animals. Remarkably, the atrophy and autophagy phenotypes were significantly blunted, yet the early mortality triggered by FoxO3 activation persisted. Rather, declines in cardiac performance were attenuated by proteasome inhibitors. Consistent with involvement of FoxO3-driven activation of the ubiquitin-proteasome system, we detected time-dependent activation of the atrogenes program and sarcomere protein breakdown. In aggregate, these data point to FoxO3, a protein activated by mechanical unloading, as a master regulator that governs both the autophagy-lysosomal and ubiquitin-proteasomal pathways to orchestrate cardiac muscle atrophy.

  8. Mechanical Unloading Activates FoxO3 to Trigger Bnip3‐Dependent Cardiomyocyte Atrophy

    Science.gov (United States)

    Cao, Dian J.; Jiang, Nan; Blagg, Andrew; Johnstone, Janet L.; Gondalia, Raj; Oh, Misook; Luo, Xiang; Yang, Kai‐Chun; Shelton, John M.; Rothermel, Beverly A.; Gillette, Thomas G.; Dorn, Gerald W.; Hill, Joseph A.

    2013-01-01

    Background Mechanical assist device therapy has emerged recently as an important and rapidly expanding therapy in advanced heart failure, triggering in some patients a beneficial reverse remodeling response. However, mechanisms underlying this benefit are unclear. Methods and Results In a model of mechanical unloading of the left ventricle, we observed progressive myocyte atrophy, autophagy, and robust activation of the transcription factor FoxO3, an established regulator of catabolic processes in other cell types. Evidence for FoxO3 activation was similarly detected in unloaded failing human myocardium. To determine the role of FoxO3 activation in cardiac muscle in vivo, we engineered transgenic mice harboring a cardiomyocyte‐specific constitutively active FoxO3 mutant (caFoxO3flox;αMHC‐Mer‐Cre‐Mer). Expression of caFoxO3 triggered dramatic and progressive loss of cardiac mass, robust increases in cardiomyocyte autophagy, declines in mitochondrial biomass and function, and early mortality. Whereas increases in cardiomyocyte apoptosis were not apparent, we detected robust increases in Bnip3 (Bcl2/adenovirus E1B 19‐kDa interacting protein 3), an established downstream target of FoxO3. To test the role of Bnip3, we crossed the caFoxO3flox;αMHC‐Mer‐Cre‐Mer mice with Bnip3‐null animals. Remarkably, the atrophy and autophagy phenotypes were significantly blunted, yet the early mortality triggered by FoxO3 activation persisted. Rather, declines in cardiac performance were attenuated by proteasome inhibitors. Consistent with involvement of FoxO3‐driven activation of the ubiquitin‐proteasome system, we detected time‐dependent activation of the atrogenes program and sarcomere protein breakdown. Conclusions In aggregate, these data point to FoxO3, a protein activated by mechanical unloading, as a master regulator that governs both the autophagy‐lysosomal and ubiquitin‐proteasomal pathways to orchestrate cardiac muscle atrophy. PMID:23568341

  9. [Comparative study on effect of acupuncture and lidocaine block for lumbar myofascial pain syndrome].

    Science.gov (United States)

    Jiang, Gui-Mei; Lin, Mou-De; Wang, Lu-Ying

    2013-03-01

    To observe the clinical efficacy of acupuncture at Jiaji (EX-B 2) points mainly for lumbar myofascial pain syndrome (MPS). Sixty-six cases of MPS were randomized into an acupuncture group and a lidocaine group, 33 cases in each group. The acupuncture group was treated with acupuncture at Jiaji (EX-B 2) points combined with needling local myofascial trigger points (MTrP), and the lidocaine group was treated with local block at trigger points with lidocaine injection. The treatment was given once every 2 days. After three and five times of the treatment, the simplified McGill scale, Oswestry disability index (ODI) and pressure-pain threshold were assessed to compare the therapeutic effects between the two groups. After treatment, the scores of simplified McGill and ODI of two groups were obviously reduced while the score of pressure-pain threshold was obviously increased (all P 0.05). Acupuncture at Jiaji (EX-B 2) points combined with needling MTrP is an effective and safe therapy for lumbar MPS, the therapeutic effect is equal to lidocaine block.

  10. Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.

    Science.gov (United States)

    Buskila, D

    2000-03-01

    Fibromyalgia and widespread pain were common in Gulf War veterans with unexplained illness referred to a rheumatology clinic. Increased tenderness was demonstrated in the postmenstrual phase of the cycle compared with the intermenstrual phase in normally cycling women but not in users of oral contraceptives. Patients with fibromyalgia had high levels of symptoms that have been used to define silicone implant-associated syndrome. Tender points were found to be a common transient finding associated with acute infectious mononucleosis, but fibromyalgia was an unusual long-term outcome. The common association of fibromyalgia with other rheumatic and systemic illnesses was further explored. A preliminary study revealed a possible linkage of fibromyalgia to the HLA region. Patients with fibromyalgia were found to have an impaired ability to activate the hypothalamic pituitary portion of the hypothalamic pituitary adrenal axis as well as the sympathoadrenal system, leading to reduced corticotropin and epinephrine response to hypoglycemia. Much interest has been expressed in the literature on the possible role of autonomic dysfunction in the development or exacerbation of fatigue and other symptoms in chronic fatigue syndrome. Mycoplasma genus and mycoplasma fermentans were detected by polymerase chain reaction in patients with chronic fatigue syndrome. It was reported that myofascial temporomandibular disorder does not run in families. No major therapeutic trials in fibromyalgia, chronic fatigue syndrome, or myofascial pain syndrome were reported over the past year. The effectiveness of cognitive behavioral therapy and behavior therapy for chronic pain in adults was emphasized. A favorable outcome of fibromyalgia and chronic fatigue syndrome in children and adolescents was reported.

  11. Lipid profile in patients with fibromyalgia and myofascial pain syndromes.

    Science.gov (United States)

    Ozgocmen, S; Ardicoglu, O

    2000-10-01

    In this study serum lipid profile of patients with fibromyalgia syndrome (FMS) and myofascial pain syndrome (MPS) were investigated and compared with healthy controls. Thirty women who had FMS and 32 women who had MPS with the characteristic trigger points (TrP), especially on the periscapular region were included in this study. Thirty one age matched healthy women were assigned as a control group. All of the subjects were sedentary healthy housewives. Total cholesterol, triglyceride and high-density lipoprotein cholesterol (HDL-c) levels were not significantly different between the FMS and control groups. On the other hand the MPS group had total cholesterol (198.7 vs 172.9 mg/dL, p=0.003), triglyceride (124.7 vs 87.6 mg/dL, p=0.01), low-density lipoprotein cholesterol (LDL-c) (127.5 vs 108.4 mg/dL, p=0.02) and very low-density lipoprotein cholesterol (VLDL-c) (24.9 vs 17.3 mg/dL, p=0.008) levels, which were significantly higher than the controls. There was no significant difference between the lipid profiles in the FMS and MPS groups. Tissue compliance, which was measured from trigger points in the MPS group, correlated significantly with total cholesterol and LDL-c levels. In conclusion, a significant difference was found between the lipid levels of patients with MPS and the controls. More extensive investigation of lipid and lipoprotein levels is required to determine whether high lipid levels are the cause or result of MPS.

  12. Nonlinear wake amplification by an active medium in a cylindrical waveguide using a modulated trigger bunch

    Institute of Scientific and Technical Information of China (English)

    Zeev; Toroker; Miron; Voin; Levi; Schchter

    2014-01-01

    Cerenkov wake amplification can be used as an accelerating scheme,in which a trigger bunch of electrons propagating inside a cylindrical waveguide filled with an active medium generates an initial wake field.Due to the multiple reflections inside the waveguide,the wake may be amplified significantly more strongly than when propagating in a boundless medium.Sufficiently far away from the trigger bunch the wake,which travels with the same phase velocity as the bunch,reaches saturation and it can accelerate a second bunch of electrons trailing behind.For a CO2 gas mixture our numerical and analytical calculations indicate that a short saturation length and a high gradient can be achieved with a large waveguide radius filled with a high density of excited atoms and a trigger bunch that travels at a velocity slightly above the Cerenkov velocity.To obtain a stable level of saturated wake that will be suitable for particle acceleration,it is crucial to satisfy the single-mode resonance condition,which requires high accuracy in the waveguide radius and the ratio between the electron phase velocity and the Cerenkov velocity.For single-mode propagation our model indicates that it is feasible to obtain gradients as high as GV m-1 in a waveguide length of cm.

  13. Rapidly activated epidermal growth factor receptor mediates lipopolysaccharide-triggered migration of microglia.

    Science.gov (United States)

    Qu, Wen-Sheng; Liu, Jun-Li; Li, Chun-Yu; Li, Xiao; Xie, Min-Jie; Wang, Wei; Tian, Dai-Shi

    2015-11-01

    Previous reports have suggested that epidermal growth factor receptor (EGFR) is involved in microglia activation characterized by cell morphology changes, cytokine production and cell migration; and the biochemical regulation of the microglia migration is a potential therapeutic target following CNS inflammatory damages. However, the role of EGFR in microglia motility after inflammatory stimulation remains unknown. In the present study, lipopolysaccharide (LPS) was found to trigger rapid EGFR phosphorylation within 10 min, which was sustained during long-term stimulation in both primary microglial cells and the cultured BV2 microglial cells, furthermore, blocking EGFR phosphorylation by AG1478 significantly attenuated the LPS-induced chemotactic and chemokinetic migration of microglia. In addition, LPS could initiate calcium oscillation in microglia during live-cell recording, however, an intracellular calcium chelator and a selective inhibitor of calcium/calmodulin-dependent protein kinase II, but not an extracellular calcium chelator, remarkably suppressed the LPS-induced EGFR phosphorylation in BV2 microglia cells. As EGFR is not a traditional receptor for LPS, these findings suggest that the rapid phosphorylation of EGFR is attributed to the LPS-triggered intracellular calcium mobilization. By examining the downstream signals of EGFR, we further proved that extracellular signal-regulated kinase (ERK) is essential for EGFR-mediated microglia migration, because ERK inhibition attenuated the chemotactic and chemokinetic migration of microglia that had been induced by either LPS or EGF. Collectively, these results suggest that LPS could trigger the rapid phosphorylation of EGFR and subsequent ERK activation through mobilizing calcium activity, which underlies the microglia migration in an inflammatory condition.

  14. A yeast surface display system for the discovery of ligands that trigger cell activation.

    Science.gov (United States)

    Cho, B K; Kieke, M C; Boder, E T; Wittrup, K D; Kranz, D M

    1998-11-01

    Opposing cells often communicate signalling events using multivalent interactions between receptors present on their cell surface. For example, T cells are typically activated when the T cell receptor (TCR) and its associated costimulatory molecules are multivalently engaged by the appropriate ligands present on an antigen presenting cell. In this report, yeast expressing high cell-surface levels of a TCR ligand (a recombinant antibody to the TCR Vbeta domain) were shown to act as 'pseudo' antigen presenting cells and induce T cell activation as monitored by increased levels of CD25 and CD69 and by downregulation of cell surface TCR. Similar levels of T cell activation could occur even when a 30-fold excess of irrelevant yeast was present, suggesting that such a yeast display system, by virtue of its ability to present ligands multivalently, may be used in highly sensitive procedures to identify novel polypeptides that interact multivalently with cell surface receptors and thereby trigger specific cellular responses.

  15. Ultrasonography in Diagnosis of Myofascial Pain Syndrome and Reliability of Novel Ultrasonic Indexes of Upper Trapezius Muscle.

    Science.gov (United States)

    Taheri, Navid; Okhovatian, Farshad; Rezasoltani, Asghar; Karami, Mehdi; Hosseini, Sayed Mohsen; Mohammadi, Hosein Kouhzad

    2016-03-23

    Myofascial pain syndrome (MPS) is a common non-articular musculoskeletal disorder. It is characterized by local and referred pain due to the presence of myofascial trigger points (MTrPs). MTrPs most commonly involve the upper trapezius muscle and can be visualized using ultrasound imaging. This study was designed to determine the inter-rater reliability of some new ultrasonographic indices of the upper trapezius muscle and the sensitivity and specificity of 2D ultrasound imaging in the diagnosis of MPS. This semi-experimental study enrolled 15 participants of both genders (mean age: 40.60 ± 5.74 years) with suspected symptoms of MPS. In the first step of the study, the sensitivity and specificity of ultrasonography for diagnosis of MPS was determined in a double blind manner. In the second step, some ultrasonographic measurements, such as muscle thickness, area of MTrPs in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and the pennation angle of the upper trapezius muscle were measured twice and their reliability was determined using the value of the mean of the two measurements. The sensitivity and specificity of ultrasonographic diagnosis were 91% and 75%, respectively. The inter-rater reliability of upper trapezius muscle thickness, pennation angle, area of MTrPs, echogenicity of active MTrPs in longitudinal view, echogenicity of muscle with MTrPs in transverse view and echogenicity of muscle with MTrPs in longitudinal view were 0.91, 0.96, 0.93, 0.83, 0.93, and 0.91, respectively. 1. Our findings indicated that ultrasonography is a useful method for the diagnosis of MPS owing to its high sensitivity. 2. Appropriate reliability of the quantitative ultrasonographic indices of interest, especially the area of MTrPs and their echogenicity, could be useful for long-term monitoring and designing interventional studies for better management of the syndrome.

  16. Epimuscular myofascial force transmission between antagonistic and synergistic muscles can explain movement limitation in spastic paresis

    NARCIS (Netherlands)

    Huijing, Peter A.

    2007-01-01

    Details and concepts of intramuscular, extramuscular and intermuscular myofascial force transmission are reviewed. Some new experimental data are added regarding myofascial force transmission between antagonistic muscles across the interosseal membrane of the lower hind limb of the rat. Combined wit

  17. Role of Arginine-304 in the Diphosphate-Triggered Active Site Closure Mechanism of Trichodiene Synthase

    Energy Technology Data Exchange (ETDEWEB)

    Vedula,L.; Cane, D.; Christianson, D.

    2005-01-01

    The X-ray crystal structures of R304K trichodiene synthase and its complexes with inorganic pyrophosphate (PPi) and aza analogues of the bisabolyl carbocation intermediate are reported. The R304K substitution does not cause large changes in the overall structure in comparison with the wild-type enzyme. The complexes with (R)- and (S)-azabisabolenes and PPi bind three Mg2+ ions, and each undergoes a diphosphate-triggered conformational change that caps the active site cavity. This conformational change is only slightly attenuated compared to that of the wild-type enzyme complexed with Mg{sup 2+}{sub 3-}PP{sub i}, in which R304 donates hydrogen bonds to PP{sub i} and D101. In R304K trichodiene synthase, K304 does not engage in any hydrogen bond interactions in the unliganded state and it donates a hydrogen bond to only PP{sub i} in the complex with (R)-azabisabolene; K304 makes no hydrogen bond contacts in its complex with PP{sub i} and (S)-azabisabolene. Thus, although the R304-D101 hydrogen bond interaction stabilizes diphosphate-triggered active site closure, it is not required for Mg{sup 2+}{sub 3-}PP{sub i} binding. Nevertheless, since R304K trichodiene synthase generates aberrant cyclic terpenoids with a 5000-fold reduction in kcat/KM, it is clear that a properly formed R304-D101 hydrogen bond is required in the enzyme-substrate complex to stabilize the proper active site contour, which in turn facilitates cyclization of farnesyl diphosphate for the exclusive formation of trichodiene. Structural analysis of the R304K mutant and comparison with the monoterpene cyclase (+)-bornyl diphosphate synthase suggest that the significant loss in activity results from compromised activation of the PP{sub i} leaving group.

  18. Seismicity at Uturuncu Volcano, Bolivia: Volcano-Tectonic Earthquake Swarms Triggered by the 2010 Maule, Chile Earthquake and Non-Triggered Background Activity

    Science.gov (United States)

    Christensen, D. H.; Chartrand, Z. A.; Jay, J.; Pritchard, M. E.; West, M. E.; McNutt, S. R.

    2010-12-01

    We find that the 270 ky dormant Uturuncu Volcano in SW Bolivia exhibits relatively high rates of shallow, volcano-tectonic seismicity that is dominated by swarm-like activity. We also document that the 27 February 2010 Mw 8.8 Maule, Chile earthquake triggered an exceptionally high rate of seismicity in the seconds to days following the main event. Although dormant, Uturuncu is currently being studied due to its large-scale deformation rate of 1-2 cm/yr uplift as revealed by InSAR. As part of the NASA-funded Andivolc project to investigate seismicity of volcanoes in the central Andes, a seismic network of 15 stations (9 Mark Products L22 short period and 6 Guralp CMG40T intermediate period sensors) with an average spacing of about 10 km was installed at Uturuncu from April 2009 to April 2010. Volcano-tectonic earthquakes occur at an average rate of about 3-4 per day, and swarms of 5-60 events within a span of minutes to hours occur a few times per month. Most of these earthquakes are located close to the summit at depths near and above sea level. The largest swarm occurred on 28 September 2009 and consisted of 60 locatable events over a time span of 28 hours. The locations of volcano-tectonic earthquakes at Uturuncu are oriented in a NW-SE trend, which matches the dominant orientation of regional faults and suggests a relationship between the fault system at Uturuncu and the regional tectonics of the area; a NW-SE trending fault beneath Uturuncu may serve to localize stresses that are accumulating over the broad area of uplift. Based on automated locations, the maximum local magnitude of these events is approximately M = 4 and the average magnitude is approximately M = 2. An initial estimate of the b-value is about b = 1.2. The Mw 8.8 Maule earthquake on 27 February 2010 triggered hundreds of local volcano-tectonic events at Uturuncu. High-pass filtering of the long period surface waves reveals that the first triggered events occurred with the onset of the Rayleigh

  19. Study on Stress Triggering During the Activity Process of the Jiashi Strong Earthquake Swarm

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The Bachu-Jiashi earthquake of Ms6.8 occurred on February 24, 2003, about 20km from the southeast of the 1997 ~ 1998 Jiashi seismic region in Xinjiang, and its aftershocks are rich and strong. Did the 1997 ~ 1998 Jiashi strong earthquake swarm trigger the Bachu-Jiashi Ms6.8earthquake? The Atushi earthquake of Ms6.7 occurred in 1996, and the 1997 ~ 1998 Jiashi strong earthquake swarm occurred about 70km from the Atushi earthquake 10 months later.Did the Atushi earthquake of Ms6.7 encourage the 1997 ~ 1998 Jiashi strong earthquake swarm? There were 9 earthquakes with Ms6.0 from 1996 to 1997 in the Jiashi seismic region,how did they act on each other? To answer the above questions, the article studies the triggering effect of the activity process of the whole Jiashi earthquake swarm from the 1996 Atushi earthquake of Ms6.7, the 1997 ~ 1998 Jiashi strong swarm to the 2003 Bachu-Jiashi earthquake of Ms6.8, and analyzes the seismicity characteristics around the Jiashi region. The results show that the 1996 Atushi earthquake of Ms6.7 encouraged the 1997 ~ 1998 Jiashi strong swarm to some extent, the accumulative Coulomb stress change from the previous M6.0earthquakes of the Jiashi strong swarm had certain triggering effects on the following M6.0 events, and the Coulomb stress change converted from the Jiashi strong swarm strongly encouraged the 2003 Bachu-Jiashi earthquake with Ms6.8.

  20. Selective activation of parvalbumin- or somatostatin-expressing interneurons triggers epileptic seizurelike activity in mouse medial entorhinal cortex.

    Science.gov (United States)

    Yekhlef, Latefa; Breschi, Gian Luca; Lagostena, Laura; Russo, Giovanni; Taverna, Stefano

    2015-03-01

    GABAergic interneurons are thought to play a critical role in eliciting interictal spikes (IICs) and triggering ictal discharges in temporal lobe epilepsy, yet the contribution of different interneuronal subtypes to seizure initiation is still largely unknown. Here we took advantage of optogenetic techniques combined with patch-clamp and field recordings to selectively stimulate parvalbumin (PV)- or somatostatin (SOM)-positive interneurons expressing channelrhodopsin-2 (CHR-2) in layers II-III of adult mouse medial entorhinal cortical slices during extracellular perfusion with the proconvulsive compound 4-aminopyridine (4-AP, 100-200 μM). In control conditions, blue laser photostimulation selectively activated action potential firing in either PV or SOM interneurons and, in both cases, caused a robust GABAA-receptor-mediated inhibition in pyramidal cells (PCs). During perfusion with 4-AP, brief photostimuli (300 ms) activating either PV or SOM interneurons induced patterns of epileptiform activity that closely replicated spontaneously occurring IICs and tonic-clonic ictal discharges. Laser-induced synchronous firing in both interneuronal types elicited large compound GABAergic inhibitory postsynaptic currents (IPSCs) correlating with IICs and preictal spikes. In addition, spontaneous and laser-induced epileptic events were similarly initiated in concurrence with a large increase in extracellular potassium concentration. Finally, interneuron activation was unable to stop or significantly shorten the progression of seizurelike episodes. These results suggest that entorhinal PV and SOM interneurons are nearly equally effective in triggering interictal and ictal discharges that closely resemble human temporal lobe epileptic activity.

  1. Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update.

    Science.gov (United States)

    Khan, Mohammad; Nishi, Shamima Easmin; Hassan, Siti Nazihahasma; Islam, Md Asiful; Gan, Siew Hua

    2017-01-01

    Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.

  2. Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

    Directory of Open Access Journals (Sweden)

    Mohammad Khan

    2017-01-01

    Full Text Available Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.

  3. A review of myofascial pain and fibromyalgia--factors that promote their persistence.

    Science.gov (United States)

    Gerwin, Robert D

    2005-09-01

    Chronic muscle pain (myalgia) is a common problem throughout the world. Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain. The two common muscle pain conditions are fibromyalgia and myofascial pain syndrome. Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis. Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle. The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying cause(s) of persistent or chronic muscle pain in order to develop a specific treatment plan. Chronic myalgia may not improve until the underlying precipitating or perpetuating factor(s) are themselves managed. Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypomobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency. Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition.

  4. The effect of cetylated fatty esters and physical therapy on myofascial pain syndrome of the neck.

    Science.gov (United States)

    Sharan, Deepak; Jacob, Biju Nirmal; Ajeesh, P S; Bookout, Jack B; Barathur, Raj R

    2011-07-01

    Participants with Myofascial Pain Syndrome (MPS) of the neck were randomly assigned into 2 groups of the double-blinded study: topical cetylated fatty ester complex (CFEC) cream application plus physical therapy (CF-PT; n=37), and placebo cream application plus physical therapy (PL-PT; n=35). There were 3 visits during 4 weeks of treatment. Physical Therapy (PT), given twice/week, included Ischaemic Compression, Deep Pressure Trigger Point Massage and Myofascial Releases. Topical cream [CFEC cream (5.6%) and 1.5% menthol] or placebo cream [1.5% menthol, in a cream base] was applied twice/day. CF-PT provided the fastest and most effective study treatment modality. The addition of CFEC cream to PT resulted in statistically significant improvements, compared to PL-PT, for reduction of pain, neck disability and life quality indicators. Our results indicate that cetylated derivatives of fatty acids can effectively reduce pain and symptoms associated with neck MPS, when combined with physical therapy.

  5. Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

    Science.gov (United States)

    Nishi, Shamima Easmin; Hassan, Siti Nazihahasma

    2017-01-01

    Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome. PMID:28827979

  6. What are the implications of rapid global warming for landslide-triggered turbidity current activity?

    Science.gov (United States)

    Clare, Michael; Peter, Talling; James, Hunt

    2014-05-01

    A geologically short-lived (~170kyr) episode of global warming occurred at ~55Ma, termed the Initial Eocene Thermal Maximum (IETM). Global temperatures rose by up to 8oC over only ~10kyr and a massive perturbation of the global carbon cycle occurred; creating a negative carbon isotopic (~-4% δ13C) excursion in sedimentary records. This interval has relevance to study of future climate change and its influence on geohazards including submarine landslides and turbidity currents. We analyse the recurrence frequency of turbidity currents, potentially initiated from large-volume slope failures. The study focuses on two sedimentary intervals that straddle the IETM and we discuss implications for turbidity current triggering. We present the results of statistical analyses (regression, generalised linear model, and proportional hazards model) for extensive turbidite records from an outcrop at Zumaia in NE Spain (N=285; 54.0 to 56.5 Ma) and based on ODP site 1068 on the Iberian Margin (N=1571; 48.2 to 67.6 Ma). The sedimentary sequences provide clear differentiation between hemipelagic and turbiditic mud with only negligible evidence of erosion. We infer dates for turbidites by converting hemipelagic bed thicknesses to time using interval-averaged accumulation rates. Multi-proxy dating techniques provide good age constraint. The background trend for the Zumaia record shows a near-exponential distribution of turbidite recurrence intervals, while the Iberian Margin shows a log-normal response. This is interpreted to be related to regional time-independence (exponential) and the effects of additive processes (log-normal). We discuss how a log-normal response may actually be generated over geological timescales from multiple shorter periods of random turbidite recurrence. The IETM interval shows a dramatic departure from both these background trends, however. This is marked by prolonged hiatuses (0.1 and 0.6 Myr duration) in turbidity current activity in contrast to the

  7. Efficacy and safety of a single botulinum type A toxin complex treatment (Dysport) for the relief of upper back myofascial pain syndrome: results from a randomized double-blind placebo-controlled multicentre study.

    Science.gov (United States)

    Göbel, Hartmut; Heinze, Axel; Reichel, Gerhard; Hefter, Harald; Benecke, Reiner

    2006-11-01

    Botulinum type A toxin (BoNT-A) has antinociceptive and muscle-relaxant properties and may help relieve the symptoms of myofascial pain syndrome. In this study we evaluated the efficacy and tolerability of BoNT-A (Dysport) in patients with myofascial pain syndrome of the upper back. We conducted a prospective, randomized, double-blind, placebo-controlled, 12-week, multicentre study. Patients with moderate-to-severe myofascial pain syndrome affecting cervical and/or shoulder muscles (10 trigger points, disease duration 6-24 months) were randomized to Dysport or saline. Injections were made into the 10 most tender trigger points (40 units per site). The primary outcome was the proportion of patients with mild or no pain at week 5. Secondary outcomes included changes in pain intensity and the number of pain-free days per week. Tolerability and safety were also assessed. At week 5, significantly more patients in the Dysport group reported mild or no pain (51%), compared with the patients in the placebo group (26%; p=0.002). Compared with placebo, Dysport resulted in a significantly greater change from baseline in pain intensity during weeks 5-8 (ppain between weeks 5 and 12 (p=0.036). Treatment was well tolerated, with most side effects resolving within 8 weeks. In conclusion, in patients with upper back myofascial pain syndrome, injections of 400 Ipsen units of Dysport at 10 individualised trigger points significantly improved pain levels 4-6 weeks after treatment. Injections were well tolerated.

  8. An interesting case of Lucio phenomenon triggered by activation of hepatitis C infection

    Directory of Open Access Journals (Sweden)

    Jacob Mareen

    2016-01-01

    Full Text Available Lucio phenomenon (LP or erythema necroticans is a rare type of reaction pattern found in untreated patients with diffuse non-nodular leprosy. It is important to distinguish this from vasculonecrotic erythema nodosum because thalidomide with high-dose steroids is the mainstay of treatment for the latter, whereas LP shows no response to thalidomide. We report a case of a 60-year-old man who presented with purpuric patches, hemorrhagic blisters, and ulcers over extremities of 15 days duration. On cutaneous examination, there were multiple stellate purpuric patches, hemorrhagic bullae, and deep necrotic ulcers, mainly over extremities. Slit-skin smear examination from six sites revealed bacteriological index 6+ with globi, and morphological index 5%. Histopathology revealed diffuse infiltration of bacilli in epidermis, dermis, and endothelial cells along with neutrophilic and lymphocytic infiltrate. Fibrinoid necrosis and thrombosis of blood vessels was also noted. The above clinicohistopathological features helped in making the diagnosis of LP. Concomitantly he was found to be infected with hepatitis C virus. Many triggering factors have been described in literature; however, activation of hepatitis C as a trigger for Lucio phenomenon has not been reported. In addition, IgM and IgG anticardiolipin antibodies were found to be positive. The patient was started on high-dose steroids along with multibacillary antileprosy therapy and improved within 2 weeks.

  9. Key physiological parameters dictate triggering of activity-dependent bulk endocytosis in hippocampal synapses.

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    Eva M Wenzel

    Full Text Available To maintain neurotransmission in central neurons, several mechanisms are employed to retrieve synaptically exocytosed membrane. The two major modes of synaptic vesicle (SV retrieval are clathrin-mediated endocytosis and activity-dependent bulk endocytosis (ADBE. ADBE is the dominant SV retrieval mode during intense stimulation, however the precise physiological conditions that trigger this mode are not resolved. To determine these parameters we manipulated rat hippocampal neurons using a wide spectrum of stimuli by varying both the pattern and duration of stimulation. Using live-cell fluorescence imaging and electron microscopy approaches, we established that stimulation frequency, rather than the stimulation load, was critical in the triggering of ADBE. Thus two hundred action potentials, when delivered at high frequency, were sufficient to induce near maximal bulk formation. Furthermore we observed a strong correlation between SV pool size and ability to perform ADBE. We also identified that inhibitory nerve terminals were more likely to utilize ADBE and had a larger SV recycling pool. Thus ADBE in hippocampal synaptic terminals is tightly coupled to stimulation frequency and is more likely to occur in terminals with large SV pools. These results implicate ADBE as a key modulator of both hippocampal neurotransmission and plasticity.

  10. Youth's Daily Activities and Situational Triggers of Gunshot Assault in Urban Environments.

    Science.gov (United States)

    Dong, Beidi; Branas, Charles C; Richmond, Therese S; Morrison, Christopher N; Wiebe, Douglas J

    2017-09-22

    Although previous research has made progress in identifying individuals predicted to face an elevated risk of being shot, it is not clear how that risk varies within individuals based on the contexts they encounter as they navigate daily life. The current study examines how the convergence of individual risk activity and neighborhood disadvantage and disorder triggers the risk of being shot. Using a novel geographic information system application, 123 male gunshot assault victims between 10 and 24 years old in Philadelphia, Pennsylvania, described their minute-by-minute movements over the course of the day of the gunshot assault. Through latent class analysis, the primary exposure was real-life circumstance where nine theoretically informed risk factors converged, compared with two other circumstances. Case-crossover analyses of subjects' 10-minute segments of full-day activities compared gunshot assault victims at the time of assault with themselves earlier in the day. Compared to when individuals were exposed to minimal situational risk or were mainly exposed to neighborhood disadvantage and disorder, the concurrence of risk activity and neighborhood disadvantage and disorder was associated with a 9.90 (95% CI: 2.72-36.14) and 6.06 (95% CI: 2.78-13.22) times higher risk of being shot. Importantly, the likelihood of being in the high-risk circumstance increased systematically over the course of the day leading up to the time when young individuals were shot. After controlled individual's propensity to be shot (e.g., inherent traits), the concurrence of situational risks emerged as significant triggers of gunshot assault. The findings suggest potential for community-based gunshot violence interventions. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Análise da atividade eletromiográfica de superfície de pontos gatilhos miofasciais Surface electromyography activity analysis of the miofascial triggers points

    Directory of Open Access Journals (Sweden)

    Aline Bigongiari

    2008-12-01

    Full Text Available Os pontos gatilhos miofasciais (PGMs são manifestações comumente encontradas na prática clínica e estão relacionados à alteração de tônus e à síndrome dolorosa miofascial (SDM. OBJETIVO: Avaliar a capacidade da EMG de superfície e detectar alterações da atividade neuromuscular no PGM, em situações de repouso e de contração isométrica voluntária máxima. MÉTODO: Participaram do estudo 56 indivíduos distribuídos em dois grupos: grupo Saudável com 28 indivíduos, que necessariamente não possuíam PGM, e o grupo Dor, constituído de 28 indivíduos que possuíam necessariamente PGM no músculo escolhido. O grupo Dor apresentava indivíduos com PGM latente e ativo, e com e sem fenômenos autonômicos (FA. RESULTADOS: O sinal EMG da porção muscular com PGM mostrou-se significativamente maior quando comparado com a porção muscular sadia do grupo Dor, e do grupo Saudável durante o repouso (26,56 ± 44,54, 5,39 ± 6,29 e 1,56 ± 0,76, respectivamente, p = 0,0001. Os indivíduos com PGM ativo obtiveram maior intensidade do sinal EMG do que aqueles que apresentaram PGM latente (17,85 ± 30,25 versus 3,74 ± 1,52, p = 0,04. Além disso, os indivíduos que apresentaram fenômenos autonômicos tiveram maior intensidade do sinal EMG do que aqueles que não os apresentaram (16,78 ± 28,44 versus 3,51 ± 3,65, na condição de repouso. CONLUSÃO: A EMG de superfície é capaz de mensurar a atividade do PGM, principalmente na condição de repouso.There are examples of common clinical conditions that clinical signals are related to alterations in muscle tone, including myofascial pain syndrome. OBJECTIVE: to discuss the application of surface EMG to detect effect of miofascial trigger point (MTP on neuromuscular activity at rest and maximum voluntary contraction of the trapezoid muscle. METHODS: Fifty-six subjects participated in the study and were divided into two groups: Healthy group (n = 28, with subjects who necessarily did not

  12. NLRP3 Inflammasome Activation in THP-1 Target Cells Triggered by Pathogenic Naegleria fowleri.

    Science.gov (United States)

    Kim, Jong-Hyun; Sohn, Hae-Jin; Yoo, Jong-Kyun; Kang, Heekyoung; Seong, Gi-Sang; Chwae, Yong-Joon; Kim, Kyongmin; Park, Sun; Shin, Ho-Joon

    2016-09-01

    Naegleria fowleri, known as the brain-eating amoeba, causes acute primary amoebic meningoencephalitis. During swimming and other recreational water activities, N. fowleri trophozoites penetrate the nasal mucosa and invade the olfactory bulbs, resulting in intense inflammatory reactions in the forebrain tissue. To investigate what kinds of inflammasome molecules are expressed in target cells due to N. fowleri infection, human macrophage cells (THP-1 cells) were cocultured with N. fowleri trophozoites in a noncontact system, and consequently, interleukin-1β (IL-1β) production was estimated. Caspase-1 activation and IL-1β production from THP-1 cells by Western blotting and the culture supernatant by enzyme-linked immunosorbent assay analysis were observed at 3 h after cocultivation. In addition, the increased expression of ASC and NLRP3, which make up an inflammasome complex, was also observed at 3 h after cocultivation. To confirm the caspase-1 activation and IL-1β production via the NLRP3 inflammasome in THP-1 cells triggered by N. fowleri trophozoites, THP-1 cells were pretreated with several inhibitors. The inhibition assay showed that CA-074 (a cathepsin B inhibitor), glybenclamide (an NLRP3 molecule inhibitor), and N-benzyloxycarbony-Val-Ala-Asp(O-methyl)-fluoromethylketone (Z-VAD-FMK; a caspase-1 inhibitor) reduced the levels of caspase-1 activation and IL-1β production from THP-1 cells. This study suggests that N. fowleri infection induces the NLRP3 inflammasome, which activates caspase-1 and subsequently produces IL-1β, thus resulting in inflammation.

  13. PLCζ or PAWP: revisiting the putative mammalian sperm factor that triggers egg activation and embryogenesis.

    Science.gov (United States)

    Kashir, Junaid; Nomikos, Michail; Swann, Karl; Lai, F Anthony

    2015-05-01

    In mammals, egg activation is initiated by multiple cytosolic Ca(2+) transients (Ca(2+) oscillations) that are triggered following delivery of a putative sperm factor from the fertilizing sperm. The identity of this 'sperm factor' thus holds much significance, not only as a vital component in creating a new life, but also for its potential therapeutic and diagnostic value in human infertility. Recent data have emerged suggesting the sperm factor may be a post-acrosomal sheath WW domain-binding protein (PAWP). However, a significant body of research points to a testis-specific phospholipase C zeta (PLCζ) as the sperm factor. Herein, we examine the evidence presented in favour of PAWP in relation to PLCζ and the requisite physiological properties of the mammalian sperm factor.

  14. MALT1 Protease Activation Triggers Acute Disruption of Endothelial Barrier Integrity via CYLD Cleavage.

    Science.gov (United States)

    Klei, Linda R; Hu, Dong; Panek, Robert; Alfano, Danielle N; Bridwell, Rachel E; Bailey, Kelly M; Oravecz-Wilson, Katherine I; Concel, Vincent J; Hess, Emily M; Van Beek, Matthew; Delekta, Phillip C; Gu, Shufang; Watkins, Simon C; Ting, Adrian T; Gough, Peter J; Foley, Kevin P; Bertin, John; McAllister-Lucas, Linda M; Lucas, Peter C

    2016-09-27

    Microvascular endothelial cells maintain a tight barrier to prevent passage of plasma and circulating immune cells into the extravascular tissue compartment, yet endothelial cells respond rapidly to vasoactive substances, including thrombin, allowing transient paracellular permeability. This response is a cornerstone of acute inflammation, but the mechanisms responsible are still incompletely understood. Here, we demonstrate that thrombin triggers MALT1 to proteolytically cleave cylindromatosis (CYLD). Fragmentation of CYLD results in microtubule disruption and a cascade of events leading to endothelial cell retraction and an acute permeability response. This finding reveals an unexpected role for the MALT1 protease, which previously has been viewed mostly as a driver of pro-inflammatory NF-κB signaling in lymphocytes. Thus, MALT1 not only promotes immune cell activation but also acutely regulates endothelial cell biology, actions that together facilitate tissue inflammation. Pharmacologic inhibition of MALT1 may therefore have synergistic impact by targeting multiple disparate steps in the overall inflammatory response.

  15. MALT1 Protease Activation Triggers Acute Disruption of Endothelial Barrier Integrity via CYLD Cleavage

    Directory of Open Access Journals (Sweden)

    Linda R. Klei

    2016-09-01

    Full Text Available Microvascular endothelial cells maintain a tight barrier to prevent passage of plasma and circulating immune cells into the extravascular tissue compartment, yet endothelial cells respond rapidly to vasoactive substances, including thrombin, allowing transient paracellular permeability. This response is a cornerstone of acute inflammation, but the mechanisms responsible are still incompletely understood. Here, we demonstrate that thrombin triggers MALT1 to proteolytically cleave cylindromatosis (CYLD. Fragmentation of CYLD results in microtubule disruption and a cascade of events leading to endothelial cell retraction and an acute permeability response. This finding reveals an unexpected role for the MALT1 protease, which previously has been viewed mostly as a driver of pro-inflammatory NF-κB signaling in lymphocytes. Thus, MALT1 not only promotes immune cell activation but also acutely regulates endothelial cell biology, actions that together facilitate tissue inflammation. Pharmacologic inhibition of MALT1 may therefore have synergistic impact by targeting multiple disparate steps in the overall inflammatory response.

  16. Spermine triggers the activation of caspase-3 in a cell-free model of apoptosis.

    Science.gov (United States)

    Stefanelli, C; Bonavita, F; Stanic', I; Pignatti, C; Flamigni, F; Guarnieri, C; Caldarera, C M

    1999-05-21

    Polyamines are ubiquitous organic cations required for cell proliferation. However, some evidence suggested that their excessive accumulation can induce apoptosis. We show here that, in a post-nuclear extract from U937 cells, the addition of spermine triggers the death program, represented by cytochrome c exit from mitochondria, the dATP-dependent processing of pro-caspase-3 and the onset of caspase activity. Spermine is more effective than spermidine, whereas putrescine has no effect. Polyamine acetylation abolishes their pro-apoptotic power. These data demonstrate a direct mechanism responsible for polyamine toxicity and also suggest that an excessive elevation of free polyamines could be involved in the transduction of a death signal.

  17. Modulation of intracellular calcium waves and triggered activities by mitochondrial ca flux in mouse cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Zhenghang Zhao

    Full Text Available Recent studies have suggested that mitochondria may play important roles in the Ca(2+ homeostasis of cardiac myocytes. However, it is still unclear if mitochondrial Ca(2+ flux can regulate the generation of Ca(2+ waves (CaWs and triggered activities in cardiac myocytes. In the present study, intracellular/cytosolic Ca(2+ (Cai (2+ was imaged in Fluo-4-AM loaded mouse ventricular myocytes. Spontaneous sarcoplasmic reticulum (SR Ca(2+ release and CaWs were induced in the presence of high (4 mM external Ca(2+ (Cao (2+. The protonophore carbonyl cyanide p-(trifluoromethoxyphenylhydrazone (FCCP reversibly raised basal Cai (2+ levels even after depletion of SR Ca(2+ in the absence of Cao (2+ , suggesting Ca(2+ release from mitochondria. FCCP at 0.01 - 0.1 µM partially depolarized the mitochondrial membrane potential (Δψ m and increased the frequency and amplitude of CaWs in a dose-dependent manner. Simultaneous recording of cell membrane potentials showed the augmentation of delayed afterdepolarization amplitudes and frequencies, and induction of triggered action potentials. The effect of FCCP on CaWs was mimicked by antimycin A (an electron transport chain inhibitor disrupting Δψ m or Ru360 (a mitochondrial Ca(2+ uniporter inhibitor, but not by oligomycin (an ATP synthase inhibitor or iodoacetic acid (a glycolytic inhibitor, excluding the contribution of intracellular ATP levels. The effects of FCCP on CaWs were counteracted by the mitochondrial permeability transition pore blocker cyclosporine A, or the mitochondrial Ca(2+ uniporter activator kaempferol. Our results suggest that mitochondrial Ca(2+ release and uptake exquisitely control the local Ca(2+ level in the micro-domain near SR ryanodine receptors and play an important role in regulation of intracellular CaWs and arrhythmogenesis.

  18. The ratio of metabolically active versus total Mycolata populations triggers foaming in a membrane bioreactor.

    Science.gov (United States)

    Maza-Márquez, P; Vílchez-Vargas, R; Boon, N; González-López, J; Martínez-Toledo, M V; Rodelas, B

    2016-04-01

    The abundance of total and metabolically active populations of Mycolata was evaluated in a full-scale membrane bioreactor (MBR) experiencing seasonal foaming, using quantitative PCR (qPCR) and retrotranscribed qPCR (RT-qPCR) targeting the 16S rRNA gene sequence. While the abundance of total Mycolata remained stable (10(10) copies of 16S rRNA genes/L activated sludge) throughout four different experimental phases, significant variations (up to one order of magnitude) were observed when the 16S rRNA was targeted. The highest ratios of metabolically active versus total Mycolata populations were observed in samples of two experimental phases when foaming was experienced in the MBR. Non-metric multidimensional scaling and BIO-ENV analyses demonstrated that this ratio was positively correlated to the concentrations of substrates in the influent water, F/M ratio, and pH, and negatively correlated to temperature and solids retention time. It the first time that the ratio of metabolically active versus total Mycolata is found to be a key parameter triggering foaming in the MBR; thus, we propose it as a candidate predictive tool.

  19. Malt1 ubiquitination triggers NF-kappaB signaling upon T-cell activation.

    Science.gov (United States)

    Oeckinghaus, Andrea; Wegener, Elmar; Welteke, Verena; Ferch, Uta; Arslan, Seda Cöl; Ruland, Jürgen; Scheidereit, Claus; Krappmann, Daniel

    2007-11-14

    Triggering of antigen receptors on lymphocytes is critical for initiating adaptive immune response against pathogens. T-cell receptor (TCR) engagement induces the formation of the Carma1-Bcl10-Malt1 (CBM) complex that is essential for activation of the IkappaB kinase (IKK)/NF-kappaB pathway. However, the molecular mechanisms that link CBM complex formation to IKK activation remain unclear. Here we report that Malt1 is polyubiquitinated upon T-cell activation. Ubiquitin chains on Malt1 provide a docking surface for the recruitment of the IKK regulatory subunit NEMO/IKKgamma. TRAF6 associates with Malt1 in response to T-cell activation and can function as an E3 ligase for Malt1 in vitro and in vivo, mediating lysine 63-linked ubiquitination of Malt1. Multiple lysine residues in the C-terminus of Malt1 serve as acceptor sites for the assembly of polyubiquitin chains. Malt1 mutants that lack C-terminal ubiquitin acceptor lysines are impaired in rescuing NF-kappaB signaling and IL-2 production in Malt1-/- T cells. Thus, our data demonstrate that induced Malt1 ubiquitination is critical for the engagement of CBM and IKK complexes, thereby directing TCR signals to the canonical NF-kappaB pathway.

  20. Surfactin triggers biofilm formation of Bacillus subtilis in melon phylloplane and contributes to the biocontrol activity.

    Science.gov (United States)

    Zeriouh, Houda; de Vicente, Antonio; Pérez-García, Alejandro; Romero, Diego

    2014-07-01

    The biocontrol activity of many Bacillus species has been traditionally related to the direct antagonism of pathogens. In previous works, we reported that B. subtilis strain UMAF6614 was an efficient biocontrol agent that produced bacillomycin, fengycin and surfactin lipopeptides. Bacillomycins and fengycins were shown to have antagonistic activity towards fungal and bacterial pathogens of cucurbits; however, the functionality of surfactin remained unclear. In this study, the role of surfactin in the biocontrol activity of this strain was investigated. We observed that a deficiency in surfactin production led to a partial reduction of disease suppression by this biocontrol agent, which coincided with a defect in biofilm formation and the colonization of the melon phylloplane. These effects were due to a dramatic reduction in the production of exopolysaccharide and the TasA protein, which are the two major components of the extracellular matrix. We propose that the biocontrol activity of this strain is the result of the coordinated action of the three families of lipopeptides. B. subtilis UMAF6614 produces surfactin to trigger biofilm formation on melon phylloplane, which ensures the long-term persistence and the adequate secretion of suppressive lipopeptides, bacillomycins and fengycins, which efficiently target pathogens.

  1. Inhibitors of arachidonate-regulated calcium channel signaling suppress triggered activity induced by the late sodium current.

    Science.gov (United States)

    Wolkowicz, Paul; Umeda, Patrick K; Sharifov, Oleg F; White, C Roger; Huang, Jian; Mahtani, Harry; Urthaler, Ferdinand

    2014-02-05

    Disturbances in myocyte calcium homeostasis are hypothesized to be one cause for cardiac arrhythmia. The full development of this hypothesis requires (i) the identification of all sources of arrhythmogenic calcium and (ii) an understanding of the mechanism(s) through which calcium initiates arrhythmia. To these ends we superfused rat left atria with the late sodium current activator type II Anemonia sulcata toxin (ATXII). This toxin prolonged atrial action potentials, induced early afterdepolarization, and provoked triggered activity. The calmodulin-dependent protein kinase II (CaMKII) inhibitor KN-93 (N-[2-[[[3-(4-chlorophenyl)-2-propenyl]methylamino]methyl]phenyl]-N-(2-hydroxyethyl)-4-methoxybenzenesulphon-amide) suppressed ATXII triggered activity but its inactive congener KN-92 (2-[N-(4-methoxy benzenesulfonyl)]amino-N-(4-chlorocinnamyl)-N-methylbenzylamine) did not. Neither drug affected normal atrial contractility. Calcium entry via L-type channels or calcium leakage from sarcoplasmic reticulum stores are not critical for this type of ectopy as neither verapamil ((RS)-2-(3,4-dimethoxyphenyl)-5-{[2-(3,4-dimethoxyphenyl)ethyl]-(methyl)amino}-2-prop-2-ylpentanenitrile) nor ryanodine affected ATXII triggered activity. By contrast, inhibitors of the voltage independent arachidonate-regulated calcium (ARC) channel and the store-operated calcium channel specifically suppressed ATXII triggered activity without normalizing action potentials or affecting atrial contractility. Inhibitors of cytosolic calcium-dependent phospholipase A2 also suppressed triggered activity suggesting that this lipase, which generates free arachidonate, plays a key role in ATXII ectopy. Thus, increased left atrial late sodium current appears to activate atrial Orai-linked ARC and store operated calcium channels, and these voltage-independent channels may be unexpected sources for the arrhythmogenic calcium that underlies triggered activity.

  2. Spike-triggered dendritic calcium transients depend on synaptic activity in the cricket giant interneurons.

    Science.gov (United States)

    Ogawa, Hiroto; Baba, Yoshichika; Oka, Kotaro

    2002-02-15

    The relationship between electrical activity and spike-induced Ca2+ increases in dendrites was investigated in the identified wind-sensitive giant interneurons in the cricket. We applied a high-speed Ca2+ imaging technique to the giant interneurons, and succeeded in recording the transient Ca2+ increases (Ca2+ transients) induced by a single action potential, which was evoked by presynaptic stimulus to the sensory neurons. The dendritic Ca2+ transients evoked by a pair of action potentials accumulated when spike intervals were shorter than 100 ms. The amplitude of the Ca2+ transients induced by a train of spikes depended on the number of action potentials. When stimulation pulses evoking the same numbers of action potentials were separately applied to the ipsi- or contra-lateral cercal sensory nerves, the dendritic Ca2+ transients induced by these presynaptic stimuli were different in their amplitude. Furthermore, the side of presynaptic stimulation that evoked larger Ca2+ transients depended on the location of the recorded dendritic regions. This result means that the spike-triggered Ca2+ transients in dendrites depend on postsynaptic activity. It is proposed that Ca2+ entry through voltage-dependent Ca2+ channels activated by the action potentials will be enhanced by excitatory synaptic inputs at the dendrites in the cricket giant interneurons.

  3. Dendrogeomorphic reconstruction of lahar activity and triggers: Shiveluch volcano, Kamchatka Peninsula, Russia

    Science.gov (United States)

    Salaorni, E.; Stoffel, M.; Tutubalina, O.; Chernomorets, S.; Seynova, I.; Sorg, A.

    2017-01-01

    Lahars are highly concentrated, water-saturated volcanic hyperconcentrated flows or debris flows containing pyroclastic material and are a characteristic mass movement process on volcanic slopes. On Kamchatka Peninsula (Russian Federation), lahars are widespread and may affect remote settlements. Historical records of past lahar occurrences are generally sparse and mostly limited to events which damaged infrastructure on the slopes or at the foot of volcanoes. In this study, we present a tree-ring-based reconstruction of spatiotemporal patterns of past lahar activity at Shiveluch volcano. Using increment cores and cross sections from 126 Larix cajanderi trees, we document 34 events covering the period AD 1729-2012. Analyses of the seasonality of damage in trees reveal that 95% of all lahars occurred between October and May and thus point to the predominant role of the sudden melt of the snow cover by volcanic material. These observations suggest that most lahars were likely syn-eruptive and that lahar activity is largely restricted to periods of volcanic activity. By contrast, rainfall events do not seem to play a significant role in lahar triggering.

  4. A force-activated trip switch triggers rapid dissociation of a colicin from its immunity protein.

    Directory of Open Access Journals (Sweden)

    Oliver E Farrance

    Full Text Available Colicins are protein antibiotics synthesised by Escherichia coli strains to target and kill related bacteria. To prevent host suicide, colicins are inactivated by binding to immunity proteins. Despite their high avidity (K(d ≈ fM, lifetime ≈ 4 days, immunity protein release is a pre-requisite of colicin intoxication, which occurs on a timescale of minutes. Here, by measuring the dynamic force spectrum of the dissociation of the DNase domain of colicin E9 (E9 and immunity protein 9 (Im9 complex using an atomic force microscope we show that application of low forces (<20 pN increases the rate of complex dissociation 10(6-fold, to a timescale (lifetime ≈ 10 ms compatible with intoxication. We term this catastrophic force-triggered increase in off-rate a trip bond. Using mutational analysis, we elucidate the mechanism of this switch in affinity. We show that the N-terminal region of E9, which has sparse contacts with the hydrophobic core, is linked to an allosteric activator region in E9 (residues 21-30 whose remodelling triggers immunity protein release. Diversion of the force transduction pathway by the introduction of appropriately positioned disulfide bridges yields a force resistant complex with a lifetime identical to that measured by ensemble techniques. A trip switch within E9 is ideal for its function as it allows bipartite complex affinity, whereby the stable colicin:immunity protein complex required for host protection can be readily converted to a kinetically unstable complex whose dissociation is necessary for cellular invasion and competitor death. More generally, the observation of two force phenotypes for the E9:Im9 complex demonstrates that force can re-sculpt the underlying energy landscape, providing new opportunities to modulate biological reactions in vivo; this rationalises the commonly observed discrepancy between off-rates measured by dynamic force spectroscopy and ensemble methods.

  5. Activation of AMP-activated protein kinase inhibits oxidized LDL-triggered endoplasmic reticulum stress in vivo.

    Science.gov (United States)

    Dong, Yunzhou; Zhang, Miao; Wang, Shuangxi; Liang, Bin; Zhao, Zhengxing; Liu, Chao; Wu, Mingyuan; Choi, Hyoung Chul; Lyons, Timothy J; Zou, Ming-Hui

    2010-06-01

    The oxidation of LDLs is considered a key step in the development of atherosclerosis. How LDL oxidation contributes to atherosclerosis remains poorly defined. Here we report that oxidized and glycated LDL (HOG-LDL) causes aberrant endoplasmic reticulum (ER) stress and that the AMP-activated protein kinase (AMPK) suppressed HOG-LDL-triggered ER stress in vivo. ER stress markers, sarcoplasmic/endoplasmic reticulum Ca(2+) ATPase (SERCA) activity and oxidation, and AMPK activity were monitored in cultured bovine aortic endothelial cells (BAECs) exposed to HOG-LDL or in isolated aortae from mice fed an atherogenic diet. Exposure of BAECs to clinically relevant concentrations of HOG-LDL induced prolonged ER stress and reduced SERCA activity but increased SERCA oxidation. Chronic administration of Tempol (a potent antioxidant) attenuated both SERCA oxidation and aberrant ER stress in mice fed a high-fat diet in vivo. Likewise, AMPK activation by pharmacological (5'-aminoimidazole-4-carboxymide-1-beta-d-ribofuranoside, metformin, and statin) or genetic means (adenoviral overexpression of constitutively active AMPK mutants) significantly mitigated ER stress and SERCA oxidation and improved the endothelium-dependent relaxation in isolated mouse aortae. Finally, Tempol administration markedly attenuated impaired endothelium-dependent vasorelaxation, SERCA oxidation, ER stress, and atherosclerosis in ApoE(-/-) and ApoE(-/-)/AMPKalpha2(-/-) fed a high-fat diet. We conclude that HOG-LDL, via enhanced SERCA oxidation, causes aberrant ER stress, endothelial dysfunction, and atherosclerosis in vivo, all of which are inhibited by AMPK activation.

  6. DEFORMATION WAVES AS A TRIGGER MECHANISM OF SEISMIC ACTIVITY IN SEISMIC ZONES OF THE CONTINENTAL LITHOSPHERE

    Directory of Open Access Journals (Sweden)

    S. I. Sherman

    2015-09-01

    Full Text Available Deformation waves as a trigger mechanism of seismic activity and migration of earthquake foci have been under discussion by researchers in seismology and geodynamics for over 50 years. Four sections of this article present available principal data on impacts of wave processes on seismicity and new data. The first section reviews analytical and experimental studies aimed at identification of relationships between wave processes in the lithosphere and seismic activity manifested as space-and-time migration of individual earthquake foci or clusters of earthquakes. It is concluded that with a systematic approach, instead of using a variety of terms to denote waves that trigger seismic process in the lithosphere, it is reasonable to apply the concise definition of ‘deformation waves’, which is most often used in fact.The second section contains a description of deformation waves considered as the trigger mechanism of seismic activity. It is concluded that a variety of methods are applied to identify deformation waves, and such methods are based on various research methods and concepts that naturally differ in sensitivity concerning detection of waves and/or impact of the waves on seismic process. Epicenters of strong earthquakes are grouped into specific linear or arc-shaped systems, which common criterion is the same time interval of the occurrence of events under analysis. On site the systems compose zones with similar time sequences, which correspond to the physical notion of moving waves (Fig. 9. Periods of manifestation of such waves are estimated as millions of years, and a direct consideration of the presence of waves and wave parameters is highly challenging. In the current state-of-the-art, geodynamics and seismology cannot provide any other solution yet.The third section presents a solution considering record of deformation waves in the lithosphere. With account of the fact that all the earthquakes with М≥3.0 are associated with

  7. Astragaloside Ⅱ triggers T cell activation through regulation of CD45 protein tyrosine phosphatase activity

    Institute of Scientific and Technical Information of China (English)

    Chun-ping WAN; Li-xin GAO; Li-fei HOU; Xiao-qian YANG; Pei-lan HE; Yi-fu YANG; Wei TANG

    2013-01-01

    Aim:To investigate the immunomodulating activity of astragalosides,the active compounds from a traditional tonic herb Astragalus membranaceus Bge,and to explore the molecular mechanisms underlying the actions,focusing on CD45 protein tyrosine phosphatase (CD45 PTPase),which plays a critical role in T lymphocyte activation.Methods:Primary splenocytes and T cells were prepared from mice.CD45 PTPase activity was assessed using a colorimetric assay.Cell proliferation was measured using a [3H]-thymidine incorporation assay.Cytokine proteins and mRNAs were examined with ELISA and RT-PCR,respectively.Activation markers,including CD25 and CD69,were analyzed using flow cytometry.Activation of LCK (Tyr505) was detected using Western blot analysis.Mice were injected with the immunosuppressant cyclophosphamide (CTX,80 mg/kg),and administered astragaloside Ⅱ (50 mg/kg).Results:Astragaloside Ⅰ,Ⅱ,Ⅲ,and Ⅳ concentration-dependently increased the CD45-mediated of pNPP/OMFP hydrolysis with the EC50 values ranged from 3.33 to 10.42 μg/mL.Astragaloside Ⅱ (10 and 30 μg/mL) significantly enhanced the proliferation of primary splenocytes induced by ConA,alloantigen or anti-CD3.Astragaloside Ⅱ (30 μg/mL) significantly increased IL-2 and IFN-y secretion,upregulated the mRNA levels of IFN-y and T-bet in primary splenocytes,and promoted CD25 and CD69 expression on primary CD4+T cells upon TCR stimulation.Furthermore,astragaloside Ⅱ (100 ng/mL) promoted CD45-mediated dephosphorylation of LCK (Tyr505) in primary T cells,which could be blocked by a specific CD45 PTPase inhibitor.In CTX-induced immunosuppressed mice,oral administration of astragaloside Ⅱ restored the proliferation of splenic T cells and the production of IFN-Y and IL-2.However,astragaloside Ⅱ had no apparent effects on B cell proliferation.Conclusion:Astragaloside Ⅱ enhances T cell activation by regulating the activity of CD45 PTPase,which may explain why Astragalus membranaceus Bge is used as a tonic

  8. A critical appraisal of the evidence for botulinum toxin type A in the treatment for cervico-thoracic myofascial pain syndrome.

    Science.gov (United States)

    Desai, Mehul J; Shkolnikova, Tatyana; Nava, Andrew; Inwald, Danielle

    2014-02-01

    Myofascial pain syndrome (MPS) is a musculoskeletal condition characterized by regional pain and muscle tenderness associated with the presence of myofascial trigger points (MTrPs). The last decade has seen an exponential increase in the use of botulinum toxin (BTX) to treat MPS. To understand the medical evidence substantiating the role of therapeutic BTX injections and to provide useful information for the medical practitioner, we applied the principles of evidence-based medicine to the treatment for cervico-thoracic MPS. A search was conducted through MEDLINE (PubMed, OVID, MDConsult), EMBASE, SCOPUS and the Cochrane database for the period 1966 to 2012 using the following keywords: myofascial pain, muscle pain, botulinum toxin, trigger points, and injections. A total of 7 trials satisfied our inclusion criteria and were evaluated in this review. Although the majority of studies found negative results, our analysis identified Gobel et al.'s as the highest quality study among these prospectively randomized investigations. This was due to appropriate identification of diagnostic criteria, excellent study design and objective endpoints. The 6 other identified studies had significant failings due to deficiencies in 1 or more major criteria. We conclude that higher quality, rigorously standardized studies are needed to more appropriately investigate this promising treatment modality. © 2013 World Institute of Pain.

  9. Arabidopsis TTG2 regulates TRY expression through enhancement of activator complex-triggered activation.

    Science.gov (United States)

    Pesch, Martina; Dartan, Burcu; Birkenbihl, Rainer; Somssich, Imre E; Hülskamp, Martin

    2014-10-01

    Trichome patterning in Arabidopsis thaliana is regulated by a regulatory feedback loop of the trichome promoting factors TRANSPARENT TESTA GLABRA1 (TTG1), GLABRA3 (GL3)/ENHANCER OF GL3 (EGL3), and GL1 and a group of homologous R3MYB proteins that act as their inhibitors. Together, they regulate the temporal and spatial expression of GL2 and TTG2, which are considered to control trichome cell differentiation. In this work, we show that TTG2 is a specific activator of TRY (but not CPC or GL2). The WRKY protein TTG2 binds to W-boxes in a minimal promoter fragment of TRY, and these W-boxes are essential for rescue of the try mutant phenotype. We further show that TTG2 alone is not able to activate TRY expression, but rather drastically enhances the activation by TTG1 and GL3. As TTG2 physically interacts with TTG1 and because TTG2 can associate with GL3 through its interaction with TTG1, we propose that TTG2 enhances the activity of TTG1 and GL3 by forming a protein complex.

  10. GnRH Agonist Trigger and LH Activity Luteal Phase Support versus hCG Trigger and Conventional Luteal Phase Support in Fresh Embryo Transfer IVF/ICSI Cycles-A Systematic PRISMA Review and Meta-analysis.

    Science.gov (United States)

    Haahr, Thor; Roque, Matheus; Esteves, Sandro C; Humaidan, Peter

    2017-01-01

    The use of GnRH agonist (GnRHa) for final oocyte maturation trigger in oocyte donation and elective frozen embryo transfer cycles is well established due to lower ovarian hyperstimulation syndrome (OHSS) rates as compared to hCG trigger. A recent Cochrane meta-analysis concluded that GnRHa trigger was associated with reduced live birth rates (LBRs) in fresh autologous IVF cycles compared to hCG trigger. However, the evidence is not unequivocal, and recent trials have found encouraging reproductive outcomes among couples undergoing GnRHa trigger and individualized luteal LH activity support. Thus, the aim was to compare GnRHa trigger followed by luteal LH activity support with hCG trigger in IVF patients undergoing fresh embryo transfer. We conducted a systematic review and meta-analysis of randomized trials published until December 14, 2016. The population was infertile patients submitted to IVF/ICSI cycles with GnRH antagonist cotreatment who underwent fresh embryo transfer. The intervention was GnRHa trigger followed by LH activity luteal phase support (LPS). The comparator was hCG trigger followed by a standard LPS. The critical outcome measures were LBR and OHSS rate. The secondary outcome measures were number of oocytes retrieved, clinical and ongoing pregnancy rates, and miscarriage rates. A total of five studies met the selection criteria comprising a total of 859 patients. The LBR was not significantly different between the GnRHa and hCG trigger groups (OR 0.84, 95% CI 0.62, 1.14). OHSS was reported in a total of 4/413 cases in the GnRHa group compared to 7/413 in the hCG group (OR 0.48, 95% CI 0.15, 1.60). We observed a slight, but non-significant increase in miscarriage rate in the GnRHa triggered group compared to the hCG group (OR 1.85; 95% CI 0.97, 3.54). GnRHa trigger with LH activity LPS resulted in comparable LBRs compared to hCG trigger. The most recent trials reported LBRs close to unity indicating that individualization of the LH activity LPS

  11. GnRH Agonist Trigger and LH Activity Luteal Phase Support versus hCG Trigger and Conventional Luteal Phase Support in Fresh Embryo Transfer IVF/ICSI Cycles—A Systematic PRISMA Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Thor Haahr

    2017-06-01

    Full Text Available IntroductionThe use of GnRH agonist (GnRHa for final oocyte maturation trigger in oocyte donation and elective frozen embryo transfer cycles is well established due to lower ovarian hyperstimulation syndrome (OHSS rates as compared to hCG trigger. A recent Cochrane meta-analysis concluded that GnRHa trigger was associated with reduced live birth rates (LBRs in fresh autologous IVF cycles compared to hCG trigger. However, the evidence is not unequivocal, and recent trials have found encouraging reproductive outcomes among couples undergoing GnRHa trigger and individualized luteal LH activity support. Thus, the aim was to compare GnRHa trigger followed by luteal LH activity support with hCG trigger in IVF patients undergoing fresh embryo transfer.Material and methodsWe conducted a systematic review and meta-analysis of randomized trials published until December 14, 2016. The population was infertile patients submitted to IVF/ICSI cycles with GnRH antagonist cotreatment who underwent fresh embryo transfer. The intervention was GnRHa trigger followed by LH activity luteal phase support (LPS. The comparator was hCG trigger followed by a standard LPS. The critical outcome measures were LBR and OHSS rate. The secondary outcome measures were number of oocytes retrieved, clinical and ongoing pregnancy rates, and miscarriage rates.ResultsA total of five studies met the selection criteria comprising a total of 859 patients. The LBR was not significantly different between the GnRHa and hCG trigger groups (OR 0.84, 95% CI 0.62, 1.14. OHSS was reported in a total of 4/413 cases in the GnRHa group compared to 7/413 in the hCG group (OR 0.48, 95% CI 0.15, 1.60. We observed a slight, but non-significant increase in miscarriage rate in the GnRHa triggered group compared to the hCG group (OR 1.85; 95% CI 0.97, 3.54.ConclusionGnRHa trigger with LH activity LPS resulted in comparable LBRs compared to hCG trigger. The most recent trials reported LBRs close to unity

  12. Clinical observation of medical ozone injection in trigger point on psoas myofascial pain syndrom%医用臭氧疼痛触发点注射治疗腰部肌筋膜疼痛综合征临床研究

    Institute of Scientific and Technical Information of China (English)

    王建国; 耿葆梁; 闫洪涛; 张雷; 冯建来; 郜时华; 贾春雨

    2010-01-01

    目的 评价医用臭氧疼痛触发点注射治疗腰部肌筋膜疼痛综合征(Myofascial Pain Syndrom,MPS)的效果与安全性.方法 采用前瞻性随机对照的研究方法,将78例患者随机分为两组,臭氧治疗组应用低浓度医用臭氧,常规治疗组应用利多卡因+维生素B6+甲钴胺和地塞米松棕榈酸酯,均行疼痛触发点漫润注射.治疗2周后采用视觉模拟评分(Visual Analogue Scale,VAS)和日本骨科学会下腰痛评估量表(Low Lumbar Pain Scales,LLPS)对照评价两组疗效.结果 治疗前后比较,两组VAS评分分别从6.2±1.7降至1.1±0.8和从5.6±1.2降至2.3±1.1(均P<0.05),LLPS明显改善(均P<0.01);两组比较,臭氧组VAS评分降低幅值显著大于对照组(P<0.05),优良率明显高于对照组(89.74%比71.79%,P<0.05);LLPS改善程度明显优干对照组(均P<0.05);不良反应明显少于对照组.结论 医用臭氧疼痛触发点注射治疗腰部MPS与常规麻醉剂加激素封闭同样有效,优良率更高,安全性较高,未见明显不良反应.

  13. TLR activation of tumor-associated macrophages from ovarian cancer patients triggers cytolytic activity of NK cells.

    Science.gov (United States)

    Bellora, Francesca; Castriconi, Roberta; Dondero, Alessandra; Pessino, Anna; Nencioni, Alessio; Liggieri, Giovanni; Moretta, Lorenzo; Mantovani, Alberto; Moretta, Alessandro; Bottino, Cristina

    2014-06-01

    We analyzed the functional outcome of the interaction between tumor-associated macrophages (TAMs) and natural killer (NK) cells. TAMs from ascites of ovarian cancer patients displayed an alternatively activated functional phenotype (M2) characterized by a remarkably high frequency and surface density of membrane-bound IL-18. Upon TLR engagement, TAMs acquired a classically activated functional phenotype (M1), released immunostimulatory cytokines (IL-12, soluble IL-18), and efficiently triggered the cytolytic activity of NK cells. TAMs also induced the release of IFN-γ from NK cells, which however was significantly lower compared with that induced by in vitro-polarized M2 cells. Most tumor-associated NK cells displayed a CD56(bright) , CD16(neg) or CD56(bright) , CD16(dim) phenotype, and very poor cytolytic activities, despite an increased expression of the activation marker CD69. They also showed downregulation of DNAM-1, 2B4, and NTB-A activating receptors, and an altered chemokine receptor repertoire. Importantly however, when appropriately stimulated, NK cells from the patients, including those cells isolated from ascites, efficiently killed autologous TAMs that expressed low, "nonprotective" levels of HLA class I molecules. Overall, our data show the existence of a complex tumor microenvironment in which poorly cytolytic/immature NK cells deal with immunosuppressive tumor-educated macrophages.

  14. The activated SA and JA signaling pathways have an influence on flg22-triggered oxidative burst and callose deposition.

    Directory of Open Access Journals (Sweden)

    So Young Yi

    Full Text Available The first line of defense in plants against pathogens is induced by the recognition of microbe-associated molecular patterns (MAMP. Perception of bacterial flagellin (flg22 by the pattern recognition receptor flagellin-sensing 2 (FLS2 is the best characterized MAMP response, although the underlying molecular mechanisms are not fully understood. Here we studied the relationship between salicylic acid (SA or jasmonic acid (JA signaling and FLS2-mediated signaling by monitoring flg22-triggered responses in known SA or JA related mutants of Arabidopsis thaliana (L. Heynh. The sid2 mutant, impaired in SA biosynthesis, had less basal FLS2 mRNA accumulation than the wild type, which correlated with suppression of early flg22 responses such as ROS production and induction of marker genes, WRKY29 and FRK1. The JA-signaling mutants, jar1 and coi1, exhibited an enhanced flg22-triggered oxidative burst and more callose accumulation than the wild type, and pretreatment with SA or coronatine (COR, a structural mimic of JA-isoleucine, altered these flg22-induced responses. Nonexpressor of pathogenesis-related genes 1 (NPR1 acted downstream of SID2 and required SA-dependent priming for the enhanced flg22-triggered oxidative burst and callose deposition. Activation of JA signaling by COR pretreatment suppressed the flg22-triggered oxidative burst and callose accumulation in a coronatine insensitive 1 (COI1 dependent manner. COR had a negative effect on flg22 responses but only the flg22-triggered oxidative burst depended on SA-JA/COR signaling antagonism. Thus the activated SA and JA signaling pathways have an influence on flg22-triggered oxidative burst and callose deposition. These results may explain how SA and JA signaling are cross talked for regulation of flg22-triggered responses.

  15. Myofascial force transmission is increasingly important at lower forces: firing frequency-related length-force characteristics of rat extensor digitorum longus

    NARCIS (Netherlands)

    Meijer, H.J.M; Baan, G.C.; Huijing, P.A.

    2006-01-01

    Aim: Effects of submaximal stimulation frequencies on myofascial force transmission were investigated for rat anterior crural muscles with all motor units activated. - Methods: Tibialis anterior and extensor hallucis longus (TAEHL) muscles were kept at constant muscle-tendon complex length, but exte

  16. Treatment of fibromyalgia, myofascial pain, and related disorders.

    Science.gov (United States)

    Borg-Stein, Joanne

    2006-05-01

    Chronic muscle pain is a common complaint among patients who seek care for musculoskeletal disorders. A spectrum of clinical presentations exists, ranging from focal or regional complaints that usually represent myofascial pain syndromes to more wide spread pain that may meet criteria for a diagnosis of fibromyalgia. This article addresses the epidemiology, pathophysiology, and clinical management of myofascial pain syndrome and fibromyalgia. These conditions are challenging to treat and require physiatrists to be aware of the wide range of pharmacologic, rehabilitative,and psychosocial interventions that can be helpful.

  17. Cutaneous silent period in myofascial pain syndrome.

    Science.gov (United States)

    Kilinc, Ozden; Sencan, Savas; Ercalik, Tulay; Koytak, Pinar Kahraman; Alibas, Hande; Gunduz, Osman Hakan; Tanridag, Tulin; Uluc, Kayihan

    2017-09-06

    An increased response to painful stimuli without spontaneous pain suggests a role of central hyperexcitability of pain pathways in the pathogenesis of myofascial pain syndrome (MPS). In this study we aimed to test the hypothesis that spinal pain pathways are affected in MPS. We used cutaneous silent period (CSP) parameters to demonstrate the hyperexcitability of spinal pain pathways in MPS. Twenty-nine patients diagnosed with MPS and 30 healthy volunteers were included in the study. The CSP recordings were performed in the right upper and left lower extremities. In both upper and lower extremities, patients had prolonged CSP latencies (P = 0.034 and P = 0.049 respectively) and shortened CSP durations (P = 0.009 and P = 0.008, respectively). Delayed and shortened CSP in MPS patients implies dysfunction in the inhibitory mechanism of the spinal/supraspinal pain pathways, suggesting central sensitization in the pathogenesis of MPS and supporting our research hypothesis. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  18. Role of Fc Gamma Receptors in Triggering Host Cell Activation and Cytokine Release by Borrelia burgdorferi

    Science.gov (United States)

    Talkington, Jeffrey; Nickell, Steven P.

    2001-01-01

    Borrelia burgdorferi, the spirochetal bacterium that causes human Lyme disease, encodes numerous lipoproteins which have the capacity to trigger the release of proinflammatory cytokines from a variety of host cell types, and it is generally believed that these cytokines contribute to the disease process in vivo. We previously reported that low-passage-number infectious B. burgdorferi spirochetes express a novel lipidation-independent activity which induces secretion of the proinflammatory cytokine tumor necrosis factor alpha (TNF-α) by the mouse MC/9 mast cell line. Using RNase protection assays, we determined that mast cells exposed in vitro to low-passage-number, but not high-passage-number, B. burgdorferi spirochetes show increased expression of additional mRNAs representing several chemokines, including macrophage-inflammatory protein 1α (MIP-1α), MIP-1β, and TCA3, as well as the proinflammatory cytokine interleukin-6. Furthermore, mast cell TNF-α secretion can be inhibited by the phosphatidylinositol 3-kinase inhibitor wortmannin and also by preincubation with purified mouse immunoglobulin G1 (IgG1) and IgG2a, but not mouse IgG3, and by a mouse Fc gamma receptor II and III (FcγRII/III)-specific rat monoclonal antibody, suggesting the likely involvement of host FcγRIII in B. burgdorferi-mediated signaling. A role for passively adsorbed rabbit or bovine IgG or serum components in B. burgdorferi-mediated FcγR signaling was excluded in control experiments. These studies confirm that low-passage-number B. burgdorferi spirochetes express a novel activity which upregulates the expression of a variety of host cell chemokine and cytokine genes, and they also establish a novel antibody-independent role for FcγRs in transduction of activation signals by bacterial products. PMID:11119532

  19. Solar Active Region Coronal Jets. II. Triggering and Evolution of Violent Jets

    Science.gov (United States)

    Sterling, Alphonse C.; Moore, Ronald L.; Falconer, David A.; Panesar, Navdeep K.; Martinez, Francisco

    2017-07-01

    We study a series of X-ray-bright, rapidly evolving active region coronal jets outside the leading sunspot of AR 12259, using Hinode/X-ray telescope, Solar Dynamics Observatory (SDO)/Atmospheric Imaging Assembly (AIA) and Helioseismic and Magnetic Imager (HMI), and Interface Region Imaging Spectrograph (IRIS) data. The detailed evolution of such rapidly evolving “violent” jets remained a mystery after our previous investigation of active region jets. The jets we investigate here erupt from three localized subregions, each containing a rapidly evolving (positive) minority-polarity magnetic-flux patch bathed in a (majority) negative-polarity magnetic-flux background. At least several of the jets begin with eruptions of what appear to be thin (thickness ≲ 2\\prime\\prime ) miniature-filament (minifilament) “strands” from a magnetic neutral line where magnetic flux cancelation is ongoing, consistent with the magnetic configuration presented for coronal-hole jets in Sterling et al. (2016). Some jets strands are difficult/impossible to detect, perhaps due to, e.g., their thinness, obscuration by surrounding bright or dark features, or the absence of erupting cool-material minifilaments in those jets. Tracing in detail the flux evolution in one of the subregions, we find bursts of strong jetting occurring only during times of strong flux cancelation. Averaged over seven jetting episodes, the cancelation rate was ˜ 1.5× {10}19 Mx hr-1. An average flux of ˜ 5× {10}18 Mx canceled prior to each episode, arguably building up ˜1028-1029 erg of free magnetic energy per jet. From these and previous observations, we infer that flux cancelation is the fundamental process responsible for the pre-eruption build up and triggering of at least many jets in active regions, quiet regions, and coronal holes.

  20. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females.

    Science.gov (United States)

    Yeganeh Lari, Ameneh; Okhovatian, Farshad; Naimi, Sedigheh sadat; Baghban, Alireza Akbarzadeh

    2016-02-01

    The purpose of this clinical trial experiment was to compare the effects of the combination of dry needling (DN) and the muscle energy technique (MET) on the upper trapezius latent myofascial trigger point. Sixty female patients, aged 18-30 with latent myofascial trigger points in the upper trapezius muscle were randomly divided into three groups: group 1 (n = 20) received DN and MET, group 2 (n = 20) received only MET, and group 3 (n = 20) received only DN. The visual analogue scale (VAS), pressure pain threshold (PPT), and range of active contra lateral flexion (CLF) were measured before each treatment. The patients were treated for three sessions in a one-week period with at least a two-day break between each session, and in session four, an assessment of primary outcomes was conducted without any treatment. All three treatment groups showed decreases in pain (p = 0.001) and increases in PPT levels (p = 0.001) as well as increases in CLF (p = 0.001). But the group receiving trigger point DN together with MET showed more significant improvement than the other two groups in VAS, PPT and ROM. No significant differences were found between the MET-only group and the DN-only group. Our results indicate that all three treatments used in this study were effective for treating MTP. According to this study, DN and MET is suggested as a new method for the treatment of MTP. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Acoustically active liposome-nanobubble complexes for enhanced ultrasonic imaging and ultrasound-triggered drug delivery.

    Science.gov (United States)

    Nguyen, An T; Wrenn, Steven P

    2014-01-01

    Ultrasound is well known as a safe, reliable imaging modality. A historical limitation of ultrasound, however, was its inability to resolve structures at length scales less than nominally 20 µm, which meant that classical ultrasound could not be used in applications such as echocardiography and angiogenesis where one requires the ability to image small blood vessels. The advent of ultrasound contrast agents, or microbubbles, removed this limitation and ushered in a new wave of enhanced ultrasound applications. In recent years, the microbubbles have been designed to achieve yet another application, namely ultrasound-triggered drug delivery. Ultrasound contrast agents are thus tantamount to 'theranostic' vehicles, meaning they can do both therapy (drug delivery) and imaging (diagnostics). The use of ultrasound contrast agents as drug delivery vehicles, however, is perhaps less than ideal when compared to traditional drug delivery vehicles (e.g., polymeric microcapsules and liposomes) which have greater drug carrying capacities. The drawback of the traditional drug delivery vehicles is that they are not naturally acoustically active and cannot be used for imaging. The notion of a theranostic vehicle is sufficiently intriguing that many attempts have been made in recent years to achieve a vehicle that combines the echogenicity of microbubbles with the drug carrying capacity of liposomes. The attempts can be classified into three categories, namely entrapping, tethering, and nesting. Of these, nesting is the newest-and perhaps the most promising.

  2. Action-projection in Japanese conversation: topic particles wa, mo, and tte for triggering categorization activities.

    Science.gov (United States)

    Tanaka, Hiroko

    2015-01-01

    Conversation analytic work has revealed how anticipatory completions and preemptive actions can offer invaluable glimpses into the cognitive, contextual, grammatical, and temporal bases of projectability in turn-taking, by virtue of their potential not only as a display of participants' online prediction of roughly what it might take to complete a turn-in-progress but also to plan the next move. While the predicate-final word order and the incremental transformability of turns in Japanese generally lead to delayed projectability of turn-endings, this may be partially offset by the capacity of certain postpositional particles to trigger and propel prospective action trajectories. This article engages in a case study of the topic particle wa (and related particles mo and tte), by demonstrating how its grammatical affordances, the categorization activities, and cognitive processing it can set in motion, coupled with the immediate contextual, and temporal-productional features may coalesce to a point of critical mass, thereby enhancing the projectability of the not-yet-produced trajectory of the current turn. The discussion attempts to contribute to recent debates on ways language-specific lexicogrammatical resources are deeply interlinked with the types of opportunities that are provided for social action.

  3. Wool Keratin 3D Scaffolds with Light-Triggered Antimicrobial Activity.

    Science.gov (United States)

    Ferroni, Claudia; Sotgiu, Giovanna; Sagnella, Anna; Varchi, Greta; Guerrini, Andrea; Giuri, Demetra; Polo, Eleonora; Orlandi, Viviana Teresa; Marras, Emanuela; Gariboldi, Marzia; Monti, Elena; Aluigi, Annalisa

    2016-09-12

    Photoactivatable keratin sponges were prepared from protein aqueous solutions by the freeze-drying method, followed by photofunctionalization with two different photosensitizers (PS): Azure A (AzA) and 5,10,15,20-tetrakis [4-(2-N,N,N-trimethylethylthio)-2,3,5,6-tetrafluorophenyl]porphyrin tetraiodide salt (TTFAP). The prepared sponges have a porosity between 49% and 80% and a mean pore size in the 37-80 μm range. As compared to AzA, TTFAP interacts more strongly with the sponges as demonstrated by a lower PS release (6% vs 20%), a decreased swelling ratio (1.6 vs 7.4), and a slower biodegradation rate. Nevertheless, AzA-loaded sponges showed the highest photoactivity, as also demonstrated by their higher antibactericidal activity toward both Gram-positive and Gram-negative bacteria. The obtained results suggest that the antimicrobial photodynamic effect can be finely triggered through a proper selection of the amount and type of photosensitizer, as well as through the irradiation time. Finally, all the prepared sponges support human fibroblast cells growth, while no significant cell viability impairment is observed upon light irradiation.

  4. Action-projection in Japanese conversation: Topic particles wa, mo and tte for triggering categorization activities

    Directory of Open Access Journals (Sweden)

    Hiroko eTanaka

    2015-08-01

    Full Text Available Conversation analytic work has revealed how anticipatory completions and preemptive actions can offer invaluable glimpses into the cognitive, contextual, grammatical and temporal bases of projectability in turn-taking, by virtue of their potential not only as a display of participants’ online prediction of roughly what it might take to complete a turn-in-progress but also to plan the next move. While the predicate-final word order and the incremental transformability of turns in Japanese generally lead to delayed projectability of turn-endings, this may be partially offset by the capacity of certain postpositional particles to trigger and propel prospective action trajectories. This article engages in a case study of the topic particle wa (and related particles mo and tte, by demonstrating how its grammatical affordances, the categorization activities and cognitive processing it can set in motion, coupled with the immediate contextual and temporal-productional features may coalesce to a point of critical mass, thereby enhancing the projectability of the not-yet-produced trajectory of the current turn. The discussion attempts to contribute to recent debates on ways language-specific lexicogrammatical resources are deeply interlinked with the types of opportunities that are provided for social action.

  5. Sexual activity as a trigger of myocardial infarction. A case-crossover analysis in the Stockholm Heart Epidemiology Programme (SHEEP)

    DEFF Research Database (Denmark)

    Möller, J; Ahlbom, A; Hulting, J

    2001-01-01

    OBJECTIVE: To investigate sexual activity as a trigger of myocardial infarction and the potential effect modification of physical fitness. DESIGN: A case-crossover study nested in the Stockholm Heart Epidemiology Programme (SHEEP). SETTING: Stockholm County from April 1993 to December 1994...

  6. The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study.

    Science.gov (United States)

    Dundar, U; Evcik, D; Samli, F; Pusak, H; Kavuncu, V

    2007-06-01

    The efficacy of low-level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. A prospective, double-blind, randomized controlled trial was conducted in patients with chronic MPS in the neck to evaluate the effects of low-level 830-nm gallium arsenide aluminum (Ga-As-Al) laser therapy. The study group consisted of 64 MPS patients. The patients were randomly assigned into two groups. In group 1 (n = 32), Ga-As-Al laser treatment was applied over three trigger points bilaterally for 2 min over each point once a day for 15 days during a period of 3 weeks. In group 2 (n = 32), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups performed daily isometric exercise and stretching exercises for cervical region. Parameters were measured at baseline and after 4 weeks. All patients were evaluated with respect to pain (at rest, movement, and night) and assessed by visual analog scale, measurement of active range of motion using an inclinometer and a goniometer, and the neck disability index. In both groups, statistically significant improvements were detected in all outcome measures compared with baseline (p 0.05). In conclusion, although the laser therapy has no superiority over placebo groups in this study, we cannot exclude the possibility of effectivity with another treatment regimen including different laser wavelengths and dosages (different intensity and density and/or treatment interval).

  7. Special astronomical configurations, solar activity and deep degassing as a trigger of natural hazards

    Science.gov (United States)

    Natyaganov, Vladimir; Syvorotkin, Vladimir; Fedorov, Valeriy; Shopin, Sergey

    2016-04-01

    Extraordinary cases of tectonic events (strong earthquakes, volcano eruptions), mine explosions, typhoons, hurricanes, tornado outbreak sequences, ball lightnings, transient luminous events are analyzed in relation with special astronomical configurations, which are specific relative positions of the Sun, Earth, Moon and the closest planets of the Solar System (Venus, Mars and Jupiter) [1]. Usage of special astronomical coordinate systems give evidence not only of correlations but also of hidden causes-and-effect relations between the analyzed phenomena. The geocentric ecliptic latitude system is an example of such astronomical coordinate systems. It gives clear evidence of coherence between strong earthquakes and the maximal Moon declination from the plane of the ecliptic. Extraordinary cases of planet activity from the beginning of XX century till the present time are shown in the years of special astronomical configurations and abrupt increasing of solar activity. According to the empirical scheme of short-term earthquake prediction [3], geomagnetic disturbances are the triggers of earthquakes. Geomagnetic disturbances perform electromagnetic pumping (electromagnetic excitation) of the Earth's interior in the regions of intersections of seismomagnetic meridians with the plate boundaries as a result of electrothermal breakdowns in the heterogeneous medium of tectonic faults. This results in the local intensification of deep degassing [4], decreasing of shear strength of the medium that triggers earthquakes usually after 2 or 3 weeks (±2 days) after the geomagnetic disturbance. Examples of officially registered predictions of Kamchatka earthquakes with M7+ without missing events, including deep-focus earthquakes in the Okhotsk Sea since the year of 2002, are shown. It is discussed correlations and possible cause-and-effect relations between a different phenomena such as - dangerous natural hazardous events such as the record tornado outbreak sequences in the USA

  8. INNERVATED RECTUS-ABDOMINIS MYOFASCIAL FLAP FOR DYNAMIC CARDIOMYOPLASTY

    NARCIS (Netherlands)

    WIJNBERG, DS; EBELS, T; ROBINSON, PH

    1994-01-01

    This study examined the rectus abdominis myofascial flap as an innervated nap for dynamic cardiomyoplastic purposes. It is common to use the latissimus dorsi to wrap or patch around or in the heart, but there is a need for more innervated skeletal muscle for a variety of reasons. The rectus abdomini

  9. Efficacy of dry needling for treatment of myofascial pain syndrome.

    Science.gov (United States)

    Fogelman, Yacov; Kent, John

    2015-01-01

    Myofascial pain is a major cause of musculoskeletal regional pain. Myofascial pain, which is a high-prevalence but eminently treatable condition, is almost universally underdiagnosed by physicians and undertreated by physical therapy modalities. Large numbers of patients can be left suffering in chronic pain for years. Dry needling, also referred to as Intramuscular Stimulation, is a method in the arsenal of pain management which has been known for almost 200 years in Western medicine, yet has been almost completely ignored. With the increase in research in this field over the past two decades, there are many high-quality studies that demonstrate dry needling to be an effective and safe method for the treatment of myofascial pain when diagnosed and treated by adequately-trained physicians or physical therapists. This article provides an overview of recent literature regarding the treatment of myofascial pain syndrome, evidence for the efficacy of dry needling as a central component of its management, and a glimpse at developments in recent imaging methods to aid in the treatment of these problems.

  10. Infrahyoid myofascial flap for tongue reconstruction.

    Science.gov (United States)

    Windfuhr, Jochen P; Remmert, Stephan

    2006-11-01

    For selected cases, reconstruction of the tongue may be required after tumor removal. This study was undertaken to demonstrate a simplified concept of tongue reconstruction with emphasis on infrahyoid myofascial flaps (IMF). The defects of the tongue were classified in 23 patients according to the extent of tumor growth, functional and surgical aspects. The oral tongue (OT; n = 1), base of tongue (BT; n = 12) or both areas (OT and BT; n = 10) were involved, with (n = 14) or without (n = 9) infiltration of adjacent tissues. Minor defects (extent (1/4) or less) required no reconstructive procedure at any area. Major defect closure (extent (1/2)-3/4) was accomplished with a combination of IMF covered by a radial forearm flap (RFF). A complete reconstruction of the OT was achieved with a combination of a bilateral IMF covered by a RFF. Whenever the complete BT has to be removed, interposition of a vein graft to establish a sufficient arterial blood supply to the remaining OT is mandatory. Moreover, a larynx lift to prevent aspiration is recommendable. Resection of adjacent soft tissues requires a larger RFF (OT; BT) or flaps from the shoulder-back region (BT and OT). Whenever the integrity of the mandible has to be sacrificed, a free fibula graft serves as an excellent tool for reconstruction. IMF serves as a reliable tool for minor or major reconstructive procedures of the tongue. Reliability and versatility of IMF may contribute to a reduced time required for surgery since harvesting is performed in the neck area immediately after neck dissection. Moreover, harvesting of the IMF does not result in an increased postoperative morbidity. Hence, functional restoration can be achieved with a more cost-effective procedure.

  11. Estudo comparativo entre toxina botulínica e bupivacaína para infiltração de pontos-gatilho em síndrome miofascial crônica Estudio comparativo entre toxina botulínica y bupivacaína para infiltración de puntos-gatillo en síndrome miofascial crónica Comparative study between botulin toxin and bupivacaine for triggering-points infiltration in chronic myofascial syndrome

    Directory of Open Access Journals (Sweden)

    Eduardo Keiichi Unno

    2005-04-01

    dos grupos. Los pacientes del G1 (n = 10 recibieron 25U de toxina botulínica y los del G2 (n = 10, bupivacaína a 0,25%, de un a tres puntos-gatillo, siendo 0,5 mL por punto. Los pacientes fueron evaluados semanalmente, durante 8 semanas. Fueron asociados 35 mg de orfenadrina, y 300 mg de dipirona, a cada 8 horas, los pacientes fueron sometidos a estimulación eléctrica transcutánea, dos veces por semana, durante 1 hora por sesión. La intensidad del dolor fue evaluada a través de la escala numérica verbal y la calidad de la analgesia, por el paciente, en los momentos cero (antes de la inyección, y después de 30 minutos, 1, 2, 3, 4, 5, 6, 7 y 8 semanas. Los resultados fueron sometidos al análisis estadístico (Mann-Whitney y Exacto de Fisher. RESULTADOS: Después de 30 minutos de la aplicación y con 1 y 4 semanas, la intensidad del dolor en el G1 fue menor que en el G2. Después de 2, 3, 5, 7 y 8 semanas de la infiltración, no hubo diferencia significativa entre los grupos. La calidad de la analgesia fue considerada mejor por los pacientes del G1 que del G2, excepto después de 2 semanas. CONCLUSIONES: El efecto analgésico fue mejor con toxina botulínica (25U que con bupivacaína a 0,25% para infiltración de puntos-gatillo.BACKGROUND AND OBJECTIVES: There are controversies about the efficacy of botulin toxin as compared to local anesthetics for triggering-points infiltration. This study aimed at comparing the analgesic effect of botulin toxin and bupivacaine for triggering-points infiltration in chronic myofascial syndrome. METHODS: Participated in this study 20 patients divided in two groups. G1 patients (n = 10 received 25U botulin toxin and G2 patients (n = 10 received 0.25% bupivacaine in one to three triggering-points, being 0.5 mL per point. Patients were weekly evaluated for 8 weeks. Orphenadrine (35 mg and dipirone (300 mg were associated every 8 hours and patients were submitted to transcutaneous electrical stimulation twice a week during 1 hour

  12. Acupuncture for Myofascial Pain Syndrome: A Network Meta-Analysis of 33 Randomized Controlled Trials.

    Science.gov (United States)

    Li, Xiuxia; Wang, Rong; Xing, Xin; Shi, Xiue; Tian, Jinhui; Zhang, Jun; Ge, Long; Zhang, Jingyun; Li, Lun; Yang, Kehu

    2017-09-01

    Acupuncture techniques are commonly used as initial treatments for myofascial pain syndrome. This study aimed to assess and compare the efficacy and safety of different techniques of acupuncture for myofascial pain syndrome. Network meta-analysis. All selected studies were randomized controlled trials (RCTs). The Cochrane Central Register of Controlled Trials, PubMed, Web of Science, EMBASE, and Chinese Biomedical Literature Database were searched from their inceptions to February 2016. Only full texts of RCTs comparing acupuncture therapies with any other therapies or placebo-sham acupuncture were included. Two reviewers independently assessed eligibility and extracted data. The primary outcomes included pain intensity, PPT, and adverse events. Secondary outcome was physical function. Thirty-three trials with 1,692 patients were included. Patients were allocated to 22 kinds of interventions, of which dry needling and manual acupuncture was the most frequently investigated intervention. Compared with placebo-sham acupuncture, scraping combined with warming acupuncture and moxibustion was found to be more effective for decreasing pain intensity (standardized mean difference (SMD) = -3.6, 95% confidence interval (CI) ranging from -5.2 to -2.1); miniscalpel-needle was more effective for increasing the PPT (SMD = 2.2, 95% CI ranging from 1.2 to 3.1); trigger points injection with bupivacaine was associated with the highest risk of adverse event (odds ratio = 557.2, 95% CI ranging from 3.6 to 86867.3); and only EA showed a significant difference in the ROM (SMD = -4.4, 95% CI ranging from -7.5 to -1.3). Lack of clarity concerning treatment periods, repetitive RCTs, and other valuable outcome measurements. The potential bias might affect the judgment of efficacy and safety. The existing evidence suggests that most acupuncture therapies, including acupuncture combined with other therapies, are effective in decreasing pain and in improving physical function, but additional

  13. Low-level laser therapy of myofascial pain syndromes of patients with osteoarthritis of knee and hip joints

    Science.gov (United States)

    Gasparyan, Levon V.

    2001-04-01

    The purpose of the given research is the comparison of efficiency of conventional treatment of myofascial pain syndromes of patients with osteoarthritis (OA) of hip and knee joints and therapy with additional application of low level laser therapy (LLLT) under dynamic control of clinical picture, rheovasographic, electromyographic examinations, and parameters of peroxide lipid oxidation. The investigation was made on 143 patients with OA of hip and knee joints. Patients were randomized in 2 groups: basic group included 91 patients, receiving conventional therapy with a course of LLLT, control group included 52 patients, receiving conventional treatment only. Transcutaneous ((lambda) equals 890 nm, output peak power 5 W, frequency 80 - 3000 Hz) and intravenous ((lambda) equals 633 nm, output 2 mW in the vein) laser irradiation were used for LLLT. Studied showed, that clinical efficiency of LLLT in the complex with conventional treatment of myofascial pain syndromes at the patients with OA is connected with attenuation of pain syndrome, normalization of parameters of myofascial syndrome, normalization of the vascular tension and parameters of rheographic curves, as well as with activation of antioxidant protection system.

  14. Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine.

    Science.gov (United States)

    Mitidieri, Andréia; Gurian, Maria Beatriz; Silva, Ana Paula; Tawasha, Kalil; Poli-Neto, Omero; Nogueira, Antônio; Reis, Francisco; Rosa-E-Silva, Júlio

    2015-12-01

    This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

  15. Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine

    Directory of Open Access Journals (Sweden)

    Andréia Mitidieri

    2015-12-01

    Full Text Available Objectives: This study used semiology based on traditional Chinese medicine (TCM to investigate vital energy (Qi behavior in women with abdominal myofascial pain syndrome (AMPS. Methods: Fifty women diagnosed with chronic pelvic pain (CPP secondary to AMPS were evaluated by using a questionnaire based on the theories of “yin-yang,” “zang-fu”, and “five elements”. We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs; onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine, menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%, possessed a elementary school (66%, and had one or two children (76%. The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 — 39.0 and 32.4% (range: 10.7 — 45.7, respectively. A large majority of women (96% exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the

  16. Efficacy of pulsed low-intensity electric neuromuscular stimulation in reducing pain and disability in patients with myofascial syndrome.

    Science.gov (United States)

    Iodice, P; Lessiani, G; Franzone, G; Pezzulo, G

    2016-01-01

    Myofascial pain syndrome (MPS) is characterized by chronic pain in multiple myofascial trigger points and fascial constrictions. In recent years, the scientific literature has recognized the need to include the patient with MPS in a multidimensional rehabilitation project. At the moment, the most widely recognized therapeutic methods for the treatment of myofascial syndrome include the stretch and spray pressure massage. Microcurrent electric neuromuscular stimulation was proposed in pain management for its effects on normalizing bioelectricity of cells and for its sub-sensory application. In this study, we tested the efficacy of low-intensity pulsed electric neuromuscular stimulus (PENS) on pain in patients with MPS of cervical spine muscles. We carried out a prospective-analytic longitudinal study at an outpatient clinic during two weeks. Forty subjects (mean age 42±13 years) were divided into two groups: treatment (TrGr, n=20) and control group (CtrlGr, n=20). Visual-analog scale (VAS) values, concerning the spontaneous and movement-related pain in the cervical-dorsal region at baseline (T0) and at the end of the study (T1), showed a reduction from 7 to 3.81 (p < 0.001) in TrGr. In the CtrlGr, VAS was reduced from 8.2 to 7.2 (n.s.). Moreover, the pressure pain threshold at T0 was 2.1 vs 4.2 at T1 (p < 0.001) in TrG. In the CtrlGR we observed no significant changes. Modulated low-intensity PENS is an innovative therapy permitting to act on the transmission of pain and on the restoration of tissue homeostasis. It seems to affect the transmission of pain through the stimulation of A-beta fibers. The above results show that low-intensity PENS can be considered as an effective treatment to reduce pain and disability in patients with MPS.

  17. Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases

    OpenAIRE

    Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

    2010-01-01

    Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain...

  18. Detection of changes in SEMG signals with myofascial pain using the pattern-classifier

    Science.gov (United States)

    Jiang, Ching-Fen; Huang, Pao-Tieh

    2013-10-01

    Myofascial pain on the upper back (MFPUB) has been a common occupational hazard associated with consistent computer use. Investigations into any sort neuromuscular functional changes due to myofascial pain are rare. This study aims to differentiate the wavelet energy patterns of the surface electromyography signals measured from 30 normal and 26 patient subjects using the K-means clustering process. The results show that the wavelet energy pattern of patient subjects was different to that of normal subject and reveals a sensitivity of 57.69% at a specificity of 76.67% in the identification of myofascial pain. Therefore, this model could provide a reliable feature for clinical diagnosis of myofascial pain.

  19. Effect of an 8-week practice of externally triggered speech on basal ganglia activity of stuttering and fluent speakers.

    Science.gov (United States)

    Toyomura, Akira; Fujii, Tetsunoshin; Kuriki, Shinya

    2015-04-01

    The neural mechanisms underlying stuttering are not well understood. It is known that stuttering appears when persons who stutter speak in a self-paced manner, but speech fluency is temporarily increased when they speak in unison with external trigger such as a metronome. This phenomenon is very similar to the behavioral improvement by external pacing in patients with Parkinson's disease. Recent imaging studies have also suggested that the basal ganglia are involved in the etiology of stuttering. In addition, previous studies have shown that the basal ganglia are involved in self-paced movement. Then, the present study focused on the basal ganglia and explored whether long-term speech-practice using external triggers can induce modification of the basal ganglia activity of stuttering speakers. Our study of functional magnetic resonance imaging revealed that stuttering speakers possessed significantly lower activity in the basal ganglia than fluent speakers before practice, especially when their speech was self-paced. After an 8-week speech practice of externally triggered speech using a metronome, the significant difference in activity between the two groups disappeared. The cerebellar vermis of stuttering speakers showed significantly decreased activity during the self-paced speech in the second compared to the first experiment. The speech fluency and naturalness of the stuttering speakers were also improved. These results suggest that stuttering is associated with defective motor control during self-paced speech, and that the basal ganglia and the cerebellum are involved in an improvement of speech fluency of stuttering by the use of external trigger. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Efficacy of EMLA cream phonophoresis comparison with ultrasound therapy on myofascial pain syndrome of the trapezius: a single-blind, randomized clinical study.

    Science.gov (United States)

    Ustun, Nilgun; Arslan, Fatma; Mansuroglu, Ayhan; Inanoglu, Deniz; Yagız, Abdullah Erman; Guler, Hayal; Turhanoglu, Ayse Dicle

    2014-04-01

    The aim of this study is to investigate whether eutectic mixture of local anesthetics (EMLA) cream phonophoresis superior to conventional US over the trigger points (TPs) in terms of improvements of pain, range of motion and disability in myofascial pain syndrome (MPS). Fifty patients (42 female, 8 male) diagnosed with MPS were included in the study. Patients were randomly assigned into two treatment groups including phonophoresis (PH) group (n = 25) and ultrasound (US) group (n = 25). PH group received EMLA cream phonophoresis (2.5 % lidocaine, 2.5 % prilocaine); US group received conventional ultrasound therapy over the all active TPs on trapezius muscle for 10 min a day for 15 sessions. Outcome measures were performed before the treatment course and at the end of a 15-session course of treatment. Student T, Mann-Whitney U, chi-square and Wilcoxon tests were used for statistical analysis. At the end of the therapy, there was statistically significant decrease in both PH group and US group in terms of number of trigger point (NTP) (p = 0.001, p = 0.029), pain intensity on movement (p = 0.001 vs. 0.002) and right/left cervical lateral ROMs (p = 0.001/p = 0.001, p = 0.009/p = 0.020) relative to baseline. The NTP decrease in PH group was significantly higher than that in US group (1.84 ± 1.46 vs. 0.72 ± 1.45; p = 0.01). Pain intensity at rest (p = 0.001) and NPDI scores (p = 0.001) were statistically improvement in only PH group. EMLA cream phonophoresis is more effective than conventional ultrasound therapy in terms of pain and associated neck disability, and it seems the complementary treatment option for MPS.

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

    Directory of Open Access Journals (Sweden)

    Ming-Ta Lin

    2012-01-01

    Full Text Available 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.

  2. Percutaneous soft tissue release for treating chronic recurrent myofascial pain associated with lateral epicondylitis: 6 case studies.

    Science.gov (United States)

    Lin, Ming-Ta; Chou, Li-Wei; Chen, Hsin-Shui; Kao, Mu-Jung

    2012-01-01

    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.

  3. Delayed triggering of radio Active Galactic Nuclei in gas-rich minor mergers in the local Universe

    CERN Document Server

    Shabala, Stanislav; Kaviraj, Sugata; Middelberg, Enno; Turner, Ross; Ting, Yuan-Sen; Allison, James; Davis, Tim

    2016-01-01

    We examine the processes triggering star formation and Active Galactic Nucleus (AGN) activity in a sample of 25 low redshift ($z10^7$ K) brightness temperature required for an mJIVE-20 detection allows us to unambiguously identify the radio AGN in our sample. We find three such objects. Our VLBI AGN identifications are classified as Seyferts or LINERs in narrow line optical diagnostic plots; mid-infrared colours of our targets and the comparison of H$\\alpha$ star formation rates with integrated radio luminosity are also consistent with the VLBI identifications. We reconstruct star formation histories in our galaxies using optical and UV photometry, and find that these radio AGN are not triggered promptly in the merger process, consistent with previous findings for non-VLBI samples of radio AGN. This delay can significantly limit the efficiency of feedback by radio AGN triggered in galaxy mergers. We find that radio AGN hosts have lower star formation rates than non-AGN radio-selected galaxies at the same star...

  4. Delayed triggering of radio Active Galactic Nuclei in gas-rich minor mergers in the local Universe

    Science.gov (United States)

    Shabala, S. S.; Deller, A.; Kaviraj, S.; Middelberg, E.; Turner, R. J.; Ting, Y. S.; Allison, J. R.; Davis, T. A.

    2016-10-01

    We examine the processes triggering star formation and Active Galactic Nucleus (AGN) activity in a sample of 25 low redshift (z 107 K) brightness temperature required for an mJIVE-20 detection allows us to unambiguously identify the radio AGN in our sample. We find three such objects. Our VLBI AGN identifications are classified as Seyferts or LINERs in narrow line optical diagnostic plots; mid-infrared colours of our targets and the comparison of Hα star formation rates with integrated radio luminosity are also consistent with the VLBI identifications. We reconstruct star formation histories in our galaxies using optical and UV photometry, and find that these radio AGN are not triggered promptly in the merger process, consistent with previous findings for non-VLBI samples of radio AGN. This delay can significantly limit the efficiency of feedback by radio AGN triggered in galaxy mergers. We find that radio AGN hosts have lower star formation rates than non-AGN radio-selected galaxies at the same starburst age. Conventional and VLBI radio imaging shows these AGN to be compact on arcsecond scales. Our modeling suggests that the actual sizes of AGN-inflated radio lobes may be much larger than this, but these are too faint to be detected in existing observations. Deep radio imaging is required to map out the true extent of the AGN, and to determine whether the low star formation rates in radio AGN hosts are a result of the special conditions required for radio jet triggering, or the effect of AGN feedback.

  5. Delayed triggering of radio active galactic nuclei in gas-rich minor mergers in the local Universe

    Science.gov (United States)

    Shabala, S. S.; Deller, A.; Kaviraj, S.; Middelberg, E.; Turner, R. J.; Ting, Y. S.; Allison, J. R.; Davis, T. A.

    2017-02-01

    We examine the processes triggering star formation and active galactic nucleus (AGN) activity in a sample of 25 low-redshift (z 107 K) brightness temperature required for an mJIVE-20 detection allows us to unambiguously identify the radio AGN in our sample. We find three such objects. Our VLBI AGN identifications are classified as Seyferts or low-ionization nuclear emission-line regions (LINERs) in narrow line optical diagnostic plots; mid-infrared colours of our targets and the comparison of Hα star formation rates with integrated radio luminosity are also consistent with the VLBI identifications. We reconstruct star formation histories in our galaxies using optical and UV photometry, and find that these radio AGN are not triggered promptly in the merger process, consistent with previous findings for non-VLBI samples of radio AGN. This delay can significantly limit the efficiency of feedback by radio AGN triggered in galaxy mergers. We find that radio AGN hosts have lower star formation rates than non-AGN radio-selected galaxies at the same starburst age. Conventional and VLBI radio imaging shows these AGN to be compact on arcsecond scales. Our modelling suggests that the actual sizes of AGN-inflated radio lobes may be much larger than this, but these are too faint to be detected in existing observations. Deep radio imaging is required to map out the true extent of the AGN, and to determine whether the low star formation rates in radio AGN hosts are a result of the special conditions required for radio jet triggering, or the effect of AGN feedback.

  6. Mechanisms and clinical management of myofascial pain syndrome%肌筋膜疼痛综合征的基础与临床研究

    Institute of Scientific and Technical Information of China (English)

    袁宏杰; 杜诗斌

    2015-01-01

    肌筋膜疼痛综合征是激痛点引起的疼痛性疾病,其发病率非常高,而治疗相对困难.本文对肌筋膜疼痛综合征的机理、诊断以及治疗作一综述.%Myofascial pain syndrome is a kind of painful disease caused by trigger points.It has extremely high prevalence and is refractory to medical therapy.So the mechanisms,diagnosis and treatment principles are reviewed in this article.

  7. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    LENUS (Irish Health Repository)

    Ryan, Aisling M

    2012-02-03

    Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

  8. Evaluation of treatments for myofascial pain syndrome and fibromyalgia.

    Science.gov (United States)

    Rudin, Nathan J

    2003-12-01

    Myofascial pain syndrome (MPS) and fibromyalgia (FM) are complex conditions and pose significant challenges to clinicians and patients. This chapter explores available treatments for MPS and FM in the context of pathophysiology, clinical evidence, and experimental support. This information may prove to be helpful in designing individualized treatment for patients with these complex syndromes. New treatments should be critically and carefully evaluated as they appear.

  9. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    Science.gov (United States)

    Ryan, Aisling M; Bermingham, Niamh; Harrington, Hugh J; Keohane, Catherine

    2006-12-01

    Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

  10. Triggering trigeminal neuralgia.

    Science.gov (United States)

    Di Stefano, Giulia; Maarbjerg, Stine; Nurmikko, Turo; Truini, Andrea; Cruccu, Giorgio

    2017-01-01

    Introduction Although it is widely accepted that facial pain paroxysms triggered by innocuous stimuli constitute a hallmark sign of trigeminal neuralgia, very few studies to date have systematically investigated the role of the triggers involved. In the recently published diagnostic classification, triggered pain is an essential criterion for the diagnosis of trigeminal neuralgia but no study to date has been designed to address this issue directly. In this study, we set out to determine, in patients with trigeminal neuralgia, how frequently triggers are present, which manoeuvres activate them and where cutaneous and mucosal trigger zones are located. Methods Clinical characteristics focusing on trigger factors were collected from 140 patients with trigeminal neuralgia, in a cross-sectional study design. Results Provocation of paroxysmal pain by various trigger manoeuvres was reported by 136 of the 140 patients. The most frequent manoeuvres were gentle touching of the face (79%) and talking (54%). Trigger zones were predominantly reported in the perioral and nasal region. Conclusion This study confirms that in trigeminal neuralgia, paroxysmal pain is associated with triggers in virtually all patients and supports the use of triggers as an essential diagnostic feature of trigeminal neuralgia.

  11. Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion.

    Science.gov (United States)

    Gerber, Lynn H; Sikdar, Siddhartha; Aredo, Jacqueline V; Armstrong, Katee; Rosenberger, William F; Shao, Hui; Shah, Jay P

    2017-02-01

    Dry needling is an effective treatment for reducing pain associated with active myofascial trigger points (a-MTrPs) in the short term. The duration of the benefits of this treatment have not been fully assessed. To determine whether the benefits of dry needling (DN) of a-MTrPs are sustained 6 weeks posttreatment. Follow-up of a prospective study. University. A total of 45 patients (13 male and 32 female) with cervical pain >3 months and a-MTrPs in the upper trapezius who completed 3 DN treatments and who were evaluated 6 weeks posttreatment. None. Primary outcomes were changes from baseline to follow-up in scores for the verbal analogue scale (VAS), Brief Pain Inventory (BPI), and MTrP status. MTrPs were rated as active (spontaneously painful), latent (painful only on compression), and nonpalpable nodule. Responders were patients whose MTrP status changed from active to latent or nonpalpable nodule (resolved). Secondary outcomes were pain pressure threshold (PPT), Profile of Mood States, Oswestry Disability Index (ODI), MOS 36-Item Short-Form Health Survey (SF-36), and cervical range of motion. Pain measures remained significantly improved 6 weeks posttreatment (P < .003), as did the SF-36 physical functioning score (0.01) and ODI (P = .002). Side bending and PPT for subjects with unilateral MTrPs had sustained improvement (P = .002). The number of subjects with sustained MTrP response at 6 weeks was significant (P < .001). Comparing responders to nonresponders, the changes in VAS and BPI were statistically significant (P = .006, P = .03) but the change in PPT was not. Patients with higher baseline VAS scores had a higher risk of not responding to DN; those with a greater drop in VAS score from baseline had a higher probability of sustained response. A 1-unit decrease in VAS at baseline resulted in a 6.3-fold increase in the odds of being a responder versus a nonresponder (P = .008). In this study, there was sustained reduction of pain scores after completion of DN

  12. Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?

    Science.gov (United States)

    Masi, Alfonse T

    2014-01-01

    Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hypertonicity was hypothesized as a potential excessive polymorphic trait which could contribute to chronic biomechanical overloading and exaggerated stresses at entheseal sites. Such a mechanism may help to integrate many of the characteristic host, pathological, and structural features of ankylosing spondylitis and axial spondyloarthritis. Biomechanical stress and strain were recently documented to correlate with peripheral entheseal inflammation and new bone formation in a murine model of spondyloarthritis. Ankylosing spondylitis has traditionally been classified by the modified New York criteria, which require the presence of definite radiographic sacroiliac joint lesions. New classification criteria for axial spondyloarthritis now include patients who do not fulfill the modified New York criteria. The male-to-female sex ratios clearly differed between the two patient categories - 2:1 or 3:1 in ankylosing spondylitis and 1:1 in non-radiographic axial spondyloarthritis - and this suggests a spectral concept of disease and, among females, milder structural alterations. Magnetic resonance imaging of active and chronic lesions in ankylosing spondylitis and axial spondyloarthritis reveals complex patterns, usually interpreted as inflammatory reactions, but shows similarities to acute degenerative disc disease, which attributed to edema formation following mechanical stresses and micro-damage. A basic question is whether mechanically induced microinjury and immunologically mediated

  13. The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders Holsgaard

    -observer agreement of TP examination among four examiners and whether reproducibility is influenced by examiner clinical experience. Two experienced and two inexperienced clinicians each performed a standardized palpation of the upper Trapezius musculature. Each observer was asked to judge the presents...... in order to improve protocol standardization. Kappa co-efficients were calculated for all possible examiner pairings. Good agreement was noted between the experienced pairing (κ= 0.63). Moderate levels of agreement were observed among the two mixed pairings (κ=0.35 and 0.47 respectively). However, poor......A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter...

  14. Control And Configuration Of The ATLAS Trigger And Data Acquisition System During Data Taking Activities

    CERN Document Server

    Bianchi, R M; The ATLAS collaboration

    2011-01-01

    The ATLAS experiment at the Large Hadron Collider at CERN relies on a complex and highly distributed Trigger and Data Acquisition (TDAQ) system to gather and select particle collision data at unprecedented energy and rates. The control and configuration (CC) system is responsible for all the software required to configure and control the ATLAS data taking. This ranges from high level applications, such as the graphical user interfaces and the desktops used within the ATLAS control room, to low level packages, such as access, process and resource management. Currently the CC system is required to supervise more than 15000 processes running on more than 1500 computers. At these scales, issues such as access, process and resource management, distribution of configuration data and access to them, run control, diagnostic and especially error recovery become predominant to guarantee a high availability of the TDAQ system and minimize the dead time of the experiment. And it is indeed during the data taking activitie...

  15. 损伤性大鼠肌筋膜疼痛触发点的肌电活动和组织形态学特征%Characteristics of electromyographical activities and histomorphology of myofascialgia trigger points in injury models of rats

    Institute of Scientific and Technical Information of China (English)

    赵贞妍; 叶刚; 黄强民; 吕娇娇

    2012-01-01

    Objective: To observe the characteristics of electromyographical(EMG) activities and the changes of histomorphology in myofascialgia trigger points on rats' models from injuries. Method; A total of 16 male SD rats (7 weeks old) were randomly divided into control group (group A) and experimental group (group B). Rats model of myofascialgia in group B were established by striking combining with eccentric exercise once per week, for continuous 8 weeks, then were reared normally and took rest for 4 weeks. At the end of the 2th week, all rats in two groups were examined to found the trigger points in palpable taut band, to record the pontaneous potential of EMG as well as local twitch response and to take the sections of musculi vastus medialis. The EMG of trigger points were analysed and the histomorphology of myofibers were observed. All the data were compared between two groups. Result: On an overage two palpable trigger points could be found in musculis vastus medialis of group B rats, but none in group A. There were local twitch responses and high frequency abnormal spontaneous electromyographical activities, in all of the palpable trigger points and a pile of large round or elliptic myofibere in cross sections and alternate thick and thin continuous spindle myofibers in longitudinal sections. Conclusion: Myofascial trigger point was a pile of abnormal contractural myofibers with characteristics of abnor-mal high frequency spontaneous elect romyographica activities and histomorphology changes. Meanwhile, these characteristics demonstrated that rats' modei of myofascialgia trigger points from injuries established by striking nom-bined with eccentric exercise was effective.%目的:观察损伤性大鼠肌筋膜疼痛模型触发点的肌电活动特征和组织形态学改变.方法:16只雄性SD大鼠(7周龄),随机分成对照组(A组)和实验组(B组)两组,实验组采取打击结合离心运动的实验方法对其进行连续8周造模干预.造模结束后,

  16. Comparison the efficacy of phonophoresis and ultrasound therapy in myofascial pain syndrome.

    Science.gov (United States)

    Ay, Saime; Doğan, Sebnem Koldaş; Evcik, Deniz; Başer, Ozgün Cakmak

    2011-09-01

    The aim of this study is to compare the effect of phonophoresis, ultrasound and placebo ultrasound therapies in the treatment of myofascial pain syndrome (MPS). This is a randomized, double-blind placebo controlled study. Sixty patients (48 women, 12 men, mean age 37.9 ± 12.2 years) with MPS were included in this study. Patients were allocated into three groups. Group 1(n = 20) was received diclofenac phonophoresis, group 2(n = 20) was received ultrasound and group 3(n = 20) was received placebo ultrasound therapies over trigger points, 10 min a day for 15 session during 3 weeks (1 MHz-1,5 watt/cm²). Additionally, all patients were given neck exercise program including isotonic, isometric and stretching. Patients were assessed by means of pain, range of motion (ROM) of neck, number of trigger points (NTP), algometric measurement and disability. Pain severity was measured by visual analog scale (VAS) and Likert scale. The neck pain disability index (NPDI) was used for assessing disability. Measurements were taken before and after treatment. After treatment, there were statistically significant improvements in pain severity, NTP, pressure pain threshold (PPT), ROM and NPDI scores both in phonophoresis and in ultrasound therapy groups (P pain levels, number of trigger points and NPDI score, pressure pain threshold (P > 0.05), also there were no significant differences in all parameters between group 1 and 2 (P = 0.05). Both diclofenac phonophoresis and ultrasound therapy were effective in the treatment of patients with MPS. Phonophoresis was not found to be superior over ultrasound therapy.

  17. Mite allergen Der-p2 triggers human B lymphocyte activation and Toll-like receptor-4 induction.

    Directory of Open Access Journals (Sweden)

    Jaw Ji Tsai

    Full Text Available BACKGROUND: Allergic disease can be characterized as manifestations of an exaggerated inflammatory response to environmental allergens triggers. Mite allergen Der-p2 is one of the major allergens of the house dust mite, which contributes to TLR4 expression and function in B cells in allergic patients. However, the precise mechanisms of Der-p2 on B cells remain obscure. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the effects of Der-p2 on proinflammatory cytokines responses and Toll-like receptor-4 (TLR4-related signaling in human B cells activation. We demonstrated that Der-p2 activates pro-inflammatory cytokines, TLR4 and its co-receptor MD2. ERK inhibitor PD98059 significantly enhanced TLR4/MD2 expression in Der-p2-treated B cells. Der-p2 markedly activated mitogen-activated protein kinase (MAPK phosphatase-1 (MKP-1 and decreased p38 phosphorylation in B cells. MKP-1-siRNA downregulated TLR4/MD2 expression in Der-p2-treated B cells. In addition, Der-p2 significantly up-regulated expression of co-stimulatory molecules and increased B cell proliferation. Neutralizing Der-p2 antibody could effectively abrogate the Der-p2-induced B cell proliferation. Der-p2 could also markedly induce NF-κB activation in B cells, which could be counteracted by dexamethasone. CONCLUSIONS/SIGNIFICANCE: These results strongly suggest that Der-p2 is capable of triggering B cell activation and MKP-1-activated p38/MAPK dephosphorylation-regulated TLR4 induction, which subsequently enhances host immune, defense responses and development of effective allergic disease therapeutics in B cells.

  18. Opioid receptor activation triggering downregulation of cAMP improves effectiveness of anti-cancer drugs in treatment of glioblastoma

    Science.gov (United States)

    Friesen, Claudia; Hormann, Inis; Roscher, Mareike; Fichtner, Iduna; Alt, Andreas; Hilger, Ralf; Debatin, Klaus-Michael; Miltner, Erich

    2014-01-01

    Glioblastoma are the most frequent and malignant human brain tumors, having a very poor prognosis. The enhanced radio- and chemoresistance of glioblastoma and the glioblastoma stem cells might be the main reason why conventional therapies fail. The second messenger cyclic AMP (cAMP) controls cell proliferation, differentiation, and apoptosis. Downregulation of cAMP sensitizes tumor cells for anti-cancer treatment. Opioid receptor agonists triggering opioid receptors can activate inhibitory Gi proteins, which, in turn, block adenylyl cyclase activity reducing cAMP. In this study, we show that downregulation of cAMP by opioid receptor activation improves the effectiveness of anti-cancer drugs in treatment of glioblastoma. The µ-opioid receptor agonist D,L-methadone sensitizes glioblastoma as well as the untreatable glioblastoma stem cells for doxorubicin-induced apoptosis and activation of apoptosis pathways by reversing deficient caspase activation and deficient downregulation of XIAP and Bcl-xL, playing critical roles in glioblastomas’ resistance. Blocking opioid receptors using the opioid receptor antagonist naloxone or increasing intracellular cAMP by 3-isobutyl-1-methylxanthine (IBMX) strongly reduced opioid receptor agonist-induced sensitization for doxorubicin. In addition, the opioid receptor agonist D,L-methadone increased doxorubicin uptake and decreased doxorubicin efflux, whereas doxorubicin increased opioid receptor expression in glioblastomas. Furthermore, opioid receptor activation using D,L-methadone inhibited tumor growth significantly in vivo. Our findings suggest that opioid receptor activation triggering downregulation of cAMP is a promising strategy to inhibit tumor growth and to improve the effectiveness of anti-cancer drugs in treatment of glioblastoma and in killing glioblastoma stem cells. PMID:24626197

  19. Delayed effort-induced swelling with myofasciitis and systemic manifestations: A so far unrecognized type of pressure-induced urticaria

    Science.gov (United States)

    Bursztejn, Anne-Claire; Lipsker, Dan

    2017-01-01

    Abstract Diseases characterized by recurrent symptoms with prolonged intervals without any clinical manifestations can pose diagnostic difficulties. Some diagnoses will be obvious but other situations can be very challenging. To nosologically delineate a new entity characterized by recurrent flares of induration of the forearms and legs with swelling of the extremities accompanied by intense fatigue and variable other symptoms. Retrospective observational study of patients recorded from 2000 to 2015. All patients included were seen during a consultation at the Dermatology Department of the University Hospital of Strasbourg, France. We retrieved the medical records from patients seen and recorded over the last 16 years having induration of the extremities, the forearm and the legs occurring between 4 and 12 hours after a physical effort accompanied by systemic signs that lasted for a few days. We analyzed in detail the clinical and biological features, evolution, and treatments of these patients. We included 6 males, with a mean age of 47 years; mean age at disease onset was 42. All patients were initially misdiagnosed as having rheumatic disorders. The mean delay before diagnosis was 5 years. The main complaint was painful induration or muscle soreness of the forearms and the legs associated with transient functional impairment and prolonged asthenia for a mean duration of 3.5 days. Induration of the deep soft tissues was very suggestive of myofasciitis. The delay between the triggering physical effort and the swelling was between 6 and 12 hours. Physical effort as triggering factor was never spontaneously mentioned. Two patients had partial response to high dose antihistamines and 2 other patients to the interleukin-1 inhibitor anakinra. One patient responded to hydroxychloroquine. The very stereotypical presentation in those 6 patients suggests that this is a recognizable entity characterized by effort-induced induration of forearms and/or legs, due to deep

  20. All-trans retinoic acid-triggered antimicrobial activity against Mycobacterium tuberculosis is dependent on NPC2.

    Science.gov (United States)

    Wheelwright, Matthew; Kim, Elliot W; Inkeles, Megan S; De Leon, Avelino; Pellegrini, Matteo; Krutzik, Stephan R; Liu, Philip T

    2014-03-01

    A role for vitamin A in host defense against Mycobacterium tuberculosis has been suggested through epidemiological and in vitro studies; however, the mechanism is unclear. In this study, we demonstrate that vitamin A-triggered antimicrobial activity against M. tuberculosis requires expression of NPC2. Comparison of monocytes stimulated with all-trans retinoic acid (ATRA) or 1,25-dihydroxyvitamin D3 (1,25D3), the biologically active forms of vitamin A and vitamin D, respectively, indicates that ATRA and 1,25D3 induce mechanistically distinct antimicrobial activities. Stimulation of primary human monocytes with ATRA did not result in expression of the antimicrobial peptide cathelicidin, which is required for 1,25D3 antimicrobial activity. In contrast, ATRA triggered a reduction in the total cellular cholesterol concentration, whereas 1,25D3 did not. Blocking ATRA-induced cellular cholesterol reduction inhibits antimicrobial activity as well. Bioinformatic analysis of ATRA- and 1,25D3-induced gene profiles suggests that NPC2 is a key gene in ATRA-induced cholesterol regulation. Knockdown experiments demonstrate that ATRA-mediated decrease in total cellular cholesterol content and increase in lysosomal acidification are both dependent upon expression of NPC2. Expression of NPC2 was lower in caseous tuberculosis granulomas and M. tuberculosis-infected monocytes compared with normal lung and uninfected cells, respectively. Loss of NPC2 expression ablated ATRA-induced antimicrobial activity. Taken together, these results suggest that the vitamin A-mediated antimicrobial mechanism against M. tuberculosis requires NPC2-dependent expression and function, indicating a key role for cellular cholesterol regulation in the innate immune response.

  1. Psychophysiological effects of massage-myofascial release after exercise: a randomized sham-control study.

    Science.gov (United States)

    Arroyo-Morales, Manuel; Olea, Nicolas; Martínez, Marin Manuel; Hidalgo-Lozano, Amparo; Ruiz-Rodríguez, Concepción; Díaz-Rodríguez, Lourdes

    2008-12-01

    The aim of this study was to evaluate the effect of massage on neuromuscular recruitment, mood state, and mechanical nociceptive threshold (MNT) after high-intensity exercise. This was a prospective randomized clinical trial using between-groups design. The study was conducted at a university-based sports medicine clinic. Sixty-two (62) healthy active students age 18-26 participated. Participants, randomized into two groups, performed three 30-second Wingate tests and immediately received whole-body massage-myofascial induction or placebo (sham ultrasound/magnetotherapy) treatment. The duration (40 minutes), position, and therapist were the same for both treatments. Dependent variables were surface electromyography (sEMG) of quadriceps, profile of mood states (POMS) and mechanical nociceptive threshold (MNT) of trapezius and masseter muscles. These data were assessed at baseline and after exercise and recovery periods. Generalized estimating equations models were performed on dependent variables to assess differences between groups. Significant differences were found in effects of treatment on sEMG of Vastus Medialis (VM) (p = 0.02) and vigor subscale (p = 0.04). After the recovery period, there was a significant decrease in electromyographic (EMG) activity of VM (p = 0.02) in the myofascial-release group versus a nonsignificant increase in the placebo group (p = 0.32), and a decrease in vigor (p exercise protocol. Massage may induce a transient loss of muscle strength or a change in the muscle fiber tension-length relationship, influenced by alterations of muscle function and a psychological state of relaxation.

  2. Depleted internal store-activated Ca2+ entry can trigger neurotransmitter release in bovine chromaffin cells.

    Science.gov (United States)

    Powis, D A; Clark, C L; O'Brien, K J

    1996-02-09

    A potential role of the intracellular Ca2+ stores in modulating catecholamine release has been investigated in bovine chromaffin cells maintained in tissue culture. Pharmacological depletion of the stores with a combination of caffeine, histamine and thapsigargin in Ca2+-free media resulted in a significantly greater release of catecholamines on re-exposure to Ca2+-containing media compared with that from non-store depleted cells. The increase in catecholamine release was prevented by intracellular BAPTA indicating that the increase was caused by a rise in Ca2+. Measurement of intracellular free Ca2+ concentration with the fluorescent indicator, fura-2, over the same time-course as the catecholamine release experiments showed that upon restoration of external Ca2+ there was an immediate, substantial and maintained increase in cytosolic Ca2+. It is most probable that the increase in catecholamine release was a consequence of an increase in Ca2+ influx triggered by prior depletion of the internal Ca2+ stores. However, the data suggest that capacitative Ca2+ entry is poorly linked to catecholamine release; although Ca2+ entry on restoration of external Ca2+ was immediate and substantial, the increase in catecholamine release, although quantitatively significant, was slowly realised.

  3. Are luminous radio-loud active galactic nuclei triggered by galaxy interactions?

    CERN Document Server

    Almeida, C Ramos; Tadhunter, C; Pérez-González, P G; Barro, G; Inskip, K J; Morganti, R; Holt, J; Dicken, D

    2011-01-01

    We present the results of a comparison between the optical morphologies of a complete sample of 46 southern 2Jy radio galaxies at intermediate redshifts (0.05triggering of powerful radio galaxies (PRGs). We find that a significant fraction of quiescent ellipticals at low and intermediate redshifts show evidence for disturbed morphologies at relatively high surface brightness levels, which are likely the result of past or on-going galaxy interactions. However, the morphological features detected in the galaxy hosts of the PRGs (e.g. tidal tails, shells, bridges, etc.) are up to 2 magnitudes brighter than those present in their quiescent counterparts. Indeed, if...

  4. Comparison of the Efficacy of Dry Needling and High-Power Pain Threshold Ultrasound Therapy with Clinical Status and Sonoelastography in Myofascial Pain Syndrome.

    Science.gov (United States)

    Aridici, Rifat; Yetisgin, Alparslan; Boyaci, Ahmet; Tutoglu, Ahmet; Bozdogan, Erol; Sen Dokumaci, Dilek; Kilicaslan, Nihat; Boyaci, Nurefsan

    2016-10-01

    The aim of this study was to compare the therapeutic efficacy of high-power pain threshold (HPPT) ultrasound therapy applied to the trigger points and dry needling (DN) in myofascial pain syndrome. Sixty-one patients were randomly assigned to an HPPT (n = 30) and dry needling (n = 31) groups. The primary outcome measures were the Visual Analog Scale (VAS) and Neck Pain and Disability Scale (NPDS), both at 1 week and 4 weeks after treatment. The secondary outcome measures were the number of painful trigger points, range of the tragus-acromioclavicular joint, the Short Form-36, the Beck Depression Inventory, the Beck Anxiety Inventory, and sonoelastographic tests after a 1-week treatment. More improvement was seen in anxiety in the HPPT group (P 0.05). A decrease in tissue stiffness was only seen in the HPPT group (P myofascial pain syndrome. Although a significant decrease was shown in tissue stiffness with HPPT, neither of these treatments had an apparent superiority.

  5. Fatiguing stimulation of one skeletal muscle triggers heat shock protein activation in several rat organs: the role of muscle innervation.

    Science.gov (United States)

    Jammes, Yves; Steinberg, Jean Guillaume; By, Youlet; Brerro-Saby, Christelle; Condo, Jocelyne; Olivier, Marine; Guieu, Regis; Delliaux, Stephane

    2012-11-15

    We hypothesised that activation of muscle afferents by fatigue triggers a widespread activation of heat shock proteins (HSPs) in resting muscles and different organs. In anaesthetised rats, HSP25 and HSP70 levels were determined in both tibialis anterior (TA) and extensor digitorum longus (EDL) muscles and in the diaphragm, kidney and brain by ELISA, which mostly identifies phosphorylated HSP, and western blotting. One TA muscle was electrically stimulated and tissues were sampled 10 or 60 min after the stimulation had ended. The nerve supply to the stimulated TA or its counterpart in the contralateral limb was left intact or suppressed. In control rats, no muscle stimulation was performed and tissues were sampled at the same time points (10 or 60 min). After TA stimulation, ELISA showed an increased HSP25 content in the contralateral TA, EDL and diaphragm at 10 min but not at 60 min, and HSP70 increased in all sampled tissues at 60 min. Western blotting did not show any changes in HSP25 and HSP70 at 10 min, while at 60 min HSP25 increased in all sampled tissues except the brain and HSP70 was elevated in all tissues. Denervation of the contralateral non-stimulated limb suppressed HSP changes in TA and after denervation of the stimulated TA the widespread activation of HSPs in other organs was absent. Our data suggest that fatigue-induced activation of skeletal muscle afferents triggers an early increase in phosphorylated HSP25 in muscles and a delayed elevation of non-phosphorylated HSP25 and HSP70 in skeletal and respiratory muscles, kidney and brain.

  6. Activation of ATP-dependent potassium channels is a trigger but not a mediator of ischaemic preconditioning in pigs.

    Science.gov (United States)

    Schulz, Rainer; Gres, Petra; Heusch, Gerd

    2003-05-01

    1. Activation of ATP-dependent potassium channels (K(ATP)) is involved in ischaemic preconditioning (IP). In isolated buffer-perfused rabbit hearts, activation of mitochondrial K(ATP)--through a generation of free radicals--acted as a trigger rather than a mediator of IP; the isolated buffer-perfused heart preparation, however, favours free radical generation. In contrast, in vivo studies in rats and dogs suggested that activation of K(ATP) acts as a mediator of IP's protection. A detailed analysis on the role of K(ATP) in IP's protection in vivo by varying the time and dose of K(ATP) blocker administration is, however, lacking. 2. In 54 enflurane-anaesthetized pigs, the left anterior descending coronary artery was perfused by an extracorporeal circuit. Infarct size (IS, %, TTC) following 90 min sustained low-flow ischaemia and 120 min reperfusion was 26.6+/-3.5 (s.e.m.) (n=8). IP with one cycle of 10 min ischaemia and 15 min reperfusion reduced IS to 6.5+/-2.1 (n=7, P<0.05). Blockade of K(ATP) with glibenclamide (0.5 mg kg(-1) i.v., 50 microg min(-1) continuous infusion) starting 10 min before or immediately following the preconditioning ischaemia abolished IS reduction by IP (20.7+/-2.7, n=7 and 21.9+/-6.6, n=6, respectively) while having no effect on IS per se (22.2+/-5.2, n=7), supporting a trigger role of K(ATP) in IP. In contrast, starting glibenclamide following the preconditioning ischaemia 10 min prior to the sustained ischaemia did not prevent IS reduction by IP (3.7+/-2.3, n=6), even when its bolus dose was increased to 1.5 mg kg(-1) (26.6+/-3.8 with IP vs 37.5+/-2.9 without IP; n=7 and 6 respectively, P<0.05), thereby refuting a mediator role of K(ATP) in IP. 3. In conclusion, activation of K(ATP) in the immediate reperfusion following the preconditioning ischaemia is pivotal for triggering IP.

  7. Gut microbiota translocation to the pancreatic lymph nodes triggers NOD2 activation and contributes to T1D onset

    Science.gov (United States)

    Costa, Frederico R.C.; Françozo, Marcela C.S.; de Oliveira, Gabriela G.; Ignacio, Aline; Castoldi, Angela; Zamboni, Dario S.; Ramos, Simone G.; Câmara, Niels O.; de Zoete, Marcel R.; Palm, Noah W.; Flavell, Richard A.; Silva, João S.

    2016-01-01

    Type 1 diabetes (T1D) is an autoimmune disease that is triggered by both genetic and environmental factors, resulting in the destruction of pancreatic β cells. The disruption of the intestinal epithelial barrier and consequent escape of microbial products may be one of these environmental triggers. However, the immune receptors that are activated in this context remain elusive. We show here that during streptozotocin (STZ)-induced T1D, the nucleotide-binding oligomerization domain containing 2 (NOD2), but not NOD1, participates in the pathogenesis of the disease by inducing T helper 1 (Th1) and Th17 cells in the pancreatic LNs (PLNs) and pancreas. Additionally, STZ-injected wild-type (WT) diabetic mice displayed an altered gut microbiota compared with vehicle-injected WT mice, together with the translocation of bacteria to the PLNs. Interestingly, WT mice treated with broad-spectrum antibiotics (Abx) were fully protected from STZ-induced T1D, which correlated with the abrogation of bacterial translocation to the PLNs. Notably, when Abx-treated STZ-injected WT mice received the NOD2 ligand muramyl dipeptide, both hyperglycemia and the proinflammatory immune response were restored. Our results demonstrate that the recognition of bacterial products by NOD2 inside the PLNs contributes to T1D development, establishing a new putative target for intervention during the early stages of the disease. PMID:27325889

  8. Specifically Formed Corona on Silica Nanoparticles Enhances Transforming Growth Factor β1 Activity in Triggering Lung Fibrosis.

    Science.gov (United States)

    Wang, Zhenzhen; Wang, Chunming; Liu, Shang; He, Wei; Wang, Lintao; Gan, JingJing; Huang, Zhen; Wang, Zhenheng; Wei, Haoyang; Zhang, Junfeng; Dong, Lei

    2017-02-28

    A corona is a layer of macromolecules formed on a nanoparticle surface in vivo. It can substantially change the biological identity of nanomaterials and possibly trigger adverse responses from the body tissues. Dissecting the role of the corona in the development of a particular disease may provide profound insights for understanding toxicity of nanomaterials in general. In our present study, we explored the capability of different silica nanoparticles (SiNPs) to induce silicosis in the mouse lung and analyzed the composition of coronas formed on these particles. We found that SiNPs of certain size and surface chemistry could specifically recruit transforming growth factor β1 (TGF-β1) into their corona, which subsequently induces the development of lung fibrosis. Once embedded into the corona on SiNPs, TGF-β1 was remarkably more stable than in its free form, and its fibrosis-triggering activity was significantly prolonged. Our study meaningfully demonstrates that a specific corona component on a certain nanoparticle could initiate a particular pathogenic process in a clinically relevant disease model. Our findings may shed light on the understanding of molecular mechanisms of human health risks correlated with exposure to small-scale substances.

  9. Saturated fatty acids activate caspase-4/5 in human monocytes, triggering IL-1β and IL-18 release.

    Science.gov (United States)

    Pillon, Nicolas J; Chan, Kenny L; Zhang, Shitian; Mejdani, Marios; Jacobson, Maya R; Ducos, Alexandre; Bilan, Philip J; Niu, Wenyan; Klip, Amira

    2016-11-01

    Obesity is associated with metabolic tissue infiltration by monocyte-derived macrophages. Saturated fatty acids contribute to proinflammatory gene induction in tissue-embedded immune cells. However, it is unknown how circulating monocytes, the macrophage precursors, react to high-fat environments. In macrophages, saturated fatty acids activate inflammatory pathways and, notably, prime caspase-associated inflammasomes. Inflammasome-activated IL-1β contributes to type 2 diabetes. We hypothesized that 1) human monocytes from obese patients show caspase activation, and 2) fatty acids trigger this response and consequent release of IL-1β/IL-18. Human peripheral blood monocytes were sorted by flow cytometry, and caspase activity was measured with a FLICA dye-based assay. Blood monocytes from obese individuals exhibited elevated caspase activity. To explore the nature and consequence of this activity, human THP1 monocytes were exposed to saturated or unsaturated fatty acids. Caspase activity was revealed by isoform-specific cleavage and enzymatic activity; cytokine expression/release was measured by qPCR and ELISA. Palmitate, but not palmitoleate, increased caspase activity in parallel to the release of IL-1β and IL-18. Palmitate induced eventual monocyte cell death with features of pyroptosis (an inflammation-linked cell death program involving caspase-4/5), scored through LDH release, vital dye influx, cell volume changes, and nuclear morphology. Notably, selective gene silencing or inhibition of caspase-4/5 reduced palmitate-induced release of IL-1β and IL-18. In summary, monocytes from obese individuals present elevated caspase activity. Mechanistically, palmitate activates a pyroptotic program in monocytes through caspase-4/5, causing inflammatory cytokine release, additional to inflammasomes. These caspases represent potential, novel, therapeutic targets to taper obesity-associated inflammation.

  10. Manual acupuncture for myofascial pain syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Rong; Li, Xiuxia; Zhou, Shenghu; Zhang, Xiaogang; Yang, Kehu; Li, Xusheng

    2017-08-01

    To assess the efficacy of manual acupuncture (MA) in the treatment of myofascial pain syndrome (MPS). We searched for randomised controlled trials (RCTs) comparing MA versus sham/placebo or no intervention in patients with MPS in the following databases from inception to January 2016: PubMed; Cochrane Library; Embase; Web of Science; and China Biology Medicine. Two reviewers independently screened the literature extracted data and assessed the quality of the included studies according to the risk of bias tool recommended by the Cochrane Handbook (V.5.1.0). Then, a meta-analysis was performed using RevMan 5.3 software. Ten RCTs were combined in a meta-analysis of MA versus sham, which showed a favourable effect of MA on pain intensity after stimulation of myofascial trigger points (MTrPs; standardised mean difference (SMD) -0.90, 95% CI -1.48 to -0.32; p=0.002) but not traditional acupuncture points (p>0.05). Benefit was seen both after a single treatment (SMD -1.05, 95% CI -1.84 to -0.27; p=0.009) and course of eight sessions (weighted mean difference (WMD) -1.96, 95% CI -2.72 to -1.20; p<0.001). We also found a significant increase in pressure pain threshold following MA stimulation of MTrPs (WMD 1.00, 95% CI 0.32 to 1.67; p=0.004). Two of the included studies reported mild adverse events (soreness/haemorrhage) secondary to MA. Through stimulation of MTrPs, MA might be efficacious in terms of pain relief and reduction of muscle irritability in MPS patients. Additional well-designed/reported studies are required to determine the optimal number of sessions for the treatment of MPS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Nitroreductase-triggered activation of a novel caged fluorescent probe obtained from methylene blue.

    Science.gov (United States)

    Bae, Jungeun; McNamara, Louis E; Nael, Manal A; Mahdi, Fakhri; Doerksen, Robert J; Bidwell, Gene L; Hammer, Nathan I; Jo, Seongbong

    2015-08-18

    A near-infrared fluorescent probe based on methylene blue (p-NBMB) was developed for the detection of nitroreductase. Conjugating methylene blue with a p-nitrobenzyl moiety enables it to be activated by nitroreductase-catalyzed 1,6-elimination, resulting in the release of an active methylene blue fluorophore.

  12. Programmed Cell-to-Cell Variability in Ras Activity Triggers Emergent Behaviors during Mammary Epithelial Morphogenesis

    Directory of Open Access Journals (Sweden)

    Jennifer S. Liu

    2012-11-01

    Full Text Available Variability in signaling pathway activation between neighboring epithelial cells can arise from local differences in the microenvironment, noisy gene expression, or acquired genetic changes. To investigate the consequences of this cell-to-cell variability in signaling pathway activation on coordinated multicellular processes such as morphogenesis, we use DNA-programmed assembly to construct three-dimensional MCF10A microtissues that are mosaic for low-level expression of activated H-Ras. We find two emergent behaviors in mosaic microtissues: cells with activated H-Ras are basally extruded or lead motile multicellular protrusions that direct the collective motility of their wild-type neighbors. Remarkably, these behaviors are not observed in homogeneous microtissues in which all cells express the activated Ras protein, indicating that heterogeneity in Ras activity, rather than the total amount of Ras activity, is critical for these processes. Our results directly demonstrate that cell-to-cell variability in pathway activation within local populations of epithelial cells can drive emergent behaviors during epithelial morphogenesis.

  13. Activated V gamma 9V delta 2 T cells trigger granulocyte functions via MCP-2 release.

    Science.gov (United States)

    Agrati, Chiara; Cimini, Eleonora; Sacchi, Alessandra; Bordoni, Veronica; Gioia, Cristiana; Casetti, Rita; Turchi, Federica; Tripodi, Marco; Martini, Federico

    2009-01-01

    Vgamma9Vdelta2 T cells display a broad antimicrobial activity by directly killing infected cells and by inducing an effective adaptive immune response. The activation of Vgamma9Vdelta2 T cells by aminobisphosphonate drugs such as zoledronic acid (ZOL) results in a massive release of cytokines and chemokines that may induce a bystander activation of other immune cells. The aim of this work was to evaluate the ability of soluble factors released by ZOL-activated Vgamma9Vdelta2 T cells to induce granulocyte activation. We showed that soluble factors released by ZOL-stimulated Vgamma9Vdelta2 T cells activate granulocytes by inducing their chemotaxis, phagocytosis, and alpha-defensins release. Proteomic analysis allowed us to identify a number of cytokines and chemokines specifically released by activated Vgamma9Vdelta2 T cells. Moreover, MCP-2 depletion by neutralizing Ab revealed a critical role of this chemokine in induction of granulocyte alpha-defensins release. Altogether, these data show a Vgamma9Vdelta2-mediated activation of granulocytes through a bystander mechanism, and confirm the wide ability of Vgamma9Vdelta2 T-lymphocytes in orchestrating the immune response. In conclusion, an immune modulating strategy targeting Vgamma9Vdelta2 T cells may represent a key switch to induce an effective and well-coordinated immune response, and can be proposed as a way to strengthen the immune competence during infectious diseases.

  14. B cell activation triggered by the formation of the small receptor cluster: a computational study.

    Directory of Open Access Journals (Sweden)

    Beata Hat

    2011-10-01

    Full Text Available We proposed a spatially extended model of early events of B cell receptors (BCR activation, which is based on mutual kinase-receptor interactions that are characteristic for the immune receptors and the Src family kinases. These interactions lead to the positive feedback which, together with two nonlinearities resulting from the double phosphorylation of receptors and Michaelis-Menten dephosphorylation kinetics, are responsible for the system bistability. We demonstrated that B cell can be activated by a formation of a tiny cluster of receptors or displacement of the nucleus. The receptors and Src kinases are activated, first locally, in the locus of the receptor cluster or the region where the cytoplasm is the thinnest. Then the traveling wave of activation propagates until activity spreads over the whole cell membrane. In the models in which we assume that the kinases are free to diffuse in the cytoplasm, we found that the fraction of aggregated receptors, capable to initiate B cell activation decreases with the decreasing thickness of cytoplasm and decreasing kinase diffusion. When kinases are restricted to the cell membrane - which is the case for most of the Src family kinases - even a cluster consisting of a tiny fraction of total receptors becomes activatory. Interestingly, the system remains insensitive to the modest changes of total receptor level. The model provides a plausible mechanism of B cells activation due to the formation of small receptors clusters collocalized by binding of polyvalent antigens or arising during the immune synapse formation.

  15. Effect of occlusal splints for the management of patients with myofascial pain: a randomized, controlled, double-blind study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Fei-yu; WANG Xiao-geng; DONG Jian; ZHANG Jie-fu; L(U) Ya-lin

    2013-01-01

    Background Occlusal splints have been the preferred modalities in the management of myofascial temporomandibular disorders (TMDs),but now controversy exists in reporting whether they are successful for TMDs treatments.The aim of this study was to give objective evidence to the assessment of treatment effect of occlusal splints for myofascial TMDs patients by clinical assessments and surface electromyography (sEMG) measurements of masseter muscles (MM).Methods Thirty-six patients (12 males and 24 females) aged 16-57 (38±11) years participated in the study.All participants diagnosed with myofascial TMD were randomized into two groups (18 of each).Patients in the first group (A) were treated with occlusal splints for 1 month,while patients in the second group (B) were treated with placebo (non-occluding palatal) splints.Clinical assessments were performed at the beginning of the study and 1 month after treatment.sEMG measurements for MM were performed at mandibular postural position (MPP) and maximum intercuspal contacted position (ICP) 1 month after the treatment.The root mean square (RMS) and the median frequency (MF) as linear indices of sEMG data were used to demonstrate muscle activity and muscle fatigue.Data were analyzed by ANOVA and post hoc SNK test.The differences were considered significant at P <0.05.Results It was found that 89% of group A either completely recovered (39%) or clinically improved (50%),while only 22% of group B had a spontaneous improvement.sEMG analysis showed that at MPP,the mean of RMS value of MM in group A was lower than that of group B,which shows statistical differences (P <0.01).At ICP,the RMS value of MM in group A was higher than that of group B,which shows statistical differences (P <0.01).At MPP,MF value of MM in group A was higher than that of group B (P <0.05).At ICP,MF value of MM was lower than that of group B (P <0.01).Conclusions Occlusal splint could eliminate or improve the signs and symptoms of TMD

  16. Zinc-triggered induction of tissue plasminogen activator by brain-derived neurotrophic factor and metalloproteinases.

    Science.gov (United States)

    Hwang, Ih-Yeon; Sun, Eun-Sun; An, Ji Hak; Im, Hana; Lee, Sun-Ho; Lee, Joo-Yong; Han, Pyung-Lim; Koh, Jae-Young; Kim, Yang-Hee

    2011-09-01

    Tissue plasminogen activator (tPA) is necessary for hippocampal long-term potentiation. Synaptically released zinc also contributes to long-term potentiation, especially in the hippocampal CA3 region. Using cortical cultures, we examined whether zinc increased the concentration and/or activity of tPA. Two hours after a 10-min exposure to 300 μM zinc, expression of tPA and its substrate, plasminogen, were significantly increased, as was the proteolytic activity of tPA. In contrast, increasing extracellular or intracellular calcium levels did not affect the expression or secretion of tPA. Changing zinc influx or chelating intracellular zinc also failed to alter tPA/plasminogen induction by zinc, indicating that zinc acts extracellularly. Zinc-mediated extracellular activation of matrix metalloproteinase (MMP) underlies the up-regulation of brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase (Trk) signaling. Consistent with these findings, co-treatment with a neutralizing antibody against BDNF or specific inhibitors of MMPs or Trk largely reversed tPA/plasminogen induction by zinc. Treatment of cortical cultures with p-aminophenylmercuric acetate, an MMP activator, MMP-2, or BDNF alone induced tPA/plasminogen expression. BDNF mRNA and protein expression was also increased by zinc and mediated by MMPs. Thus, an extracellular zinc-dependent, MMP- and BDNF-mediated synaptic mechanism may regulate the levels and activity of tPA.

  17. Mp10 and Mp42 from the aphid species Myzus persicae trigger plant defenses in Nicotiana benthamiana through different activities.

    Science.gov (United States)

    Rodriguez, Patricia A; Stam, Remco; Warbroek, Tim; Bos, Jorunn I B

    2014-01-01

    Aphids are phloem-feeding insects that, like other plant parasites, deliver effectors inside their host to manipulate host responses. The Myzus persicae (green peach aphid) candidate effectors Mp10 and Mp42 were previously found to reduce aphid fecundity upon intracellular transient overexpression in Nicotiana benthamiana. We performed functional analyses of these proteins to investigate whether they activate defenses through similar activities. We employed a range of functional characterization experiments based on intracellular transient overexpression in N. benthamiana to determine the subcellular localization of Mp10 and Mp42 and investigate their role in activating plant defense signaling. Mp10 and Mp42 showed distinct subcellular localization in planta, suggesting that they target different host compartments. Also, Mp10 reduced the levels of Agrobacterium-mediated overexpression of proteins. This reduction was not due to an effect on Agrobacterium viability. Transient overexpression of Mp10 but not Mp42 activated jasmonic acid and salicylic acid signaling pathways and decreased susceptibility to the hemibiotrophic plant pathogen Phytophthora capsici. We found that two candidate effectors from the broad-host-range aphid M. persicae can trigger aphid defenses through different mechanisms. Importantly, we found that some (candidate) effectors such as Mp10 interfere with Agrobacterium-based overexpression assays, an important tool to study effector activity and function.

  18. Triggering Klystrons

    Energy Technology Data Exchange (ETDEWEB)

    Stefan, Kelton D.; /Purdue U. /SLAC

    2010-08-25

    To determine if klystrons will perform to the specifications of the LCLS (Linac Coherent Light Source) project, a new digital trigger controller is needed for the Klystron/Microwave Department Test Laboratory. The controller needed to be programmed and Windows based user interface software needed to be written to interface with the device over a USB (Universal Serial Bus). Programming the device consisted of writing logic in VHDL (VHSIC (Very High Speed Integrated Circuits) hardware description language), and the Windows interface software was written in C++. Xilinx ISE (Integrated Software Environment) was used to compile the VHDL code and program the device, and Microsoft Visual Studio 2005 was used to compile the C++ based Windows software. The device was programmed in such a way as to easily allow read/write operations to it using a simple addressing model, and Windows software was developed to interface with the device over a USB connection. A method of setting configuration registers in the trigger device is absolutely necessary to the development of a new triggering system, and the method developed will fulfill this need adequately. More work is needed before the new trigger system is ready for use. The configuration registers in the device need to be fully integrated with the logic that will generate the RF signals, and this system will need to be tested extensively to determine if it meets the requirements for low noise trigger outputs.

  19. Macrophage activation syndrome triggered by coeliac disease: a unique case report.

    Science.gov (United States)

    Palman, J; May, J; Pilkington, C

    2016-12-09

    Macrophage activation syndrome is described as a "clinical syndrome of hyperinflammation resulting in an uncontrolled and ineffective immune response" in the context of an autoinflammatory or rheumatic disease. Current associations of macrophage activation syndrome with autoimmune disease most notably include a host of rheumatological conditions and inflammatory bowel disease. Epidemiological studies have shown that macrophage activation syndrome is precipitated by autoimmune disease more commonly than previously thought. Diagnosing the precipitating factor is essential for effective treatment and prognosis. We report a case of a six year old girl with coeliac disease diagnosed after two episodes of secondary haemophagocytic lymphohistiocytosis. Her condition only responded to treatment once the patient was placed on a gluten free diet. Further immunological testing confirmed anti-transglutaminase and anti-endomysial antibodies, however histological biopsy was deemed inappropriate due to the severity of her condition. She has remained stable with no further episodes of macrophage activation syndrome since commencing a gluten free diet. This case report is the first literature that links macrophage activation syndrome to coeliac disease and highlights the challenge of diagnosing coeliac disease with unusual features such as associated prolonged fever. Clinicians should have a low threshold for screening children with other autoimmune diseases for coeliac disease.

  20. MALT1-ubiquitination triggers non-genomic NF-κB/IKK signaling upon platelet activation.

    Science.gov (United States)

    Karim, Zubair A; Vemana, Hari Priya; Khasawneh, Fadi T

    2015-01-01

    We have recently shown that IKK complex plays an important non-genomic role in platelet function, i.e., regulates SNARE machinery-dependent membrane fusion. In this connection, it is well known that MALT1, whose activity is modulated by proteasome, plays an important role in the regulation of IKK complex. Therefore, the present studies investigated the mechanism by which IKK signaling is regulated in the context of the platelet proteasome. It was found that platelets express a functional proteasome, and form CARMA/MALT1/Bcl10 (CBM) complex when activated. Using a pharmacological inhibitor, the proteasome was found to regulate platelet function (aggregation, integrin activation, secretion, phosphatidylserine exposure and changes in intracellular calcium). It was also found to regulate thrombogenesis and physiologic hemostasis. We also observed, upon platelet activation, that MALT1 is ubiquitinated, and this coincides with the activation of the IKK/NF-κB-signaling pathway. Finally, we observed that the proteasome inhibitor blocks CBM complex formation and the interaction of IKKγ and MALT1; abrogates SNARE formation, and the association of MALT1 with TAK1 and TAB2, which are upstream of the CBM complex. Thus, our data demonstrate that MALT1 ubiquitination is critical for the engagement of CBM and IKK complexes, thereby directing platelet signals to the NF-κB pathway.

  1. MALT1-ubiquitination triggers non-genomic NF-κB/IKK signaling upon platelet activation.

    Directory of Open Access Journals (Sweden)

    Zubair A Karim

    Full Text Available We have recently shown that IKK complex plays an important non-genomic role in platelet function, i.e., regulates SNARE machinery-dependent membrane fusion. In this connection, it is well known that MALT1, whose activity is modulated by proteasome, plays an important role in the regulation of IKK complex. Therefore, the present studies investigated the mechanism by which IKK signaling is regulated in the context of the platelet proteasome. It was found that platelets express a functional proteasome, and form CARMA/MALT1/Bcl10 (CBM complex when activated. Using a pharmacological inhibitor, the proteasome was found to regulate platelet function (aggregation, integrin activation, secretion, phosphatidylserine exposure and changes in intracellular calcium. It was also found to regulate thrombogenesis and physiologic hemostasis. We also observed, upon platelet activation, that MALT1 is ubiquitinated, and this coincides with the activation of the IKK/NF-κB-signaling pathway. Finally, we observed that the proteasome inhibitor blocks CBM complex formation and the interaction of IKKγ and MALT1; abrogates SNARE formation, and the association of MALT1 with TAK1 and TAB2, which are upstream of the CBM complex. Thus, our data demonstrate that MALT1 ubiquitination is critical for the engagement of CBM and IKK complexes, thereby directing platelet signals to the NF-κB pathway.

  2. Small molecule activators of SIRT1 replicate signaling pathways triggered by calorie restriction in vivo

    Directory of Open Access Journals (Sweden)

    Lavu Siva

    2009-03-01

    Full Text Available Abstract Background Calorie restriction (CR produces a number of health benefits and ameliorates diseases of aging such as type 2 diabetes. The components of the pathways downstream of CR may provide intervention points for developing therapeutics for treating diseases of aging. The NAD+-dependent protein deacetylase SIRT1 has been implicated as one of the key downstream regulators of CR in yeast, rodents, and humans. Small molecule activators of SIRT1 have been identified that exhibit efficacy in animal models of diseases typically associated with aging including type 2 diabetes. To identify molecular processes induced in the liver of mice treated with two structurally distinct SIRT1 activators, SIRT501 (formulated resveratrol and SRT1720, for three days, we utilized a systems biology approach and applied Causal Network Modeling (CNM on gene expression data to elucidate downstream effects of SIRT1 activation. Results Here we demonstrate that SIRT1 activators recapitulate many of the molecular events downstream of CR in vivo, such as enhancing mitochondrial biogenesis, improving metabolic signaling pathways, and blunting pro-inflammatory pathways in mice fed a high fat, high calorie diet. Conclusion CNM of gene expression data from mice treated with SRT501 or SRT1720 in combination with supporting in vitro and in vivo data demonstrates that SRT501 and SRT1720 produce a signaling profile that mirrors CR, improves glucose and insulin homeostasis, and acts via SIRT1 activation in vivo. Taken together these results are encouraging regarding the use of small molecule activators of SIRT1 for therapeutic intervention into type 2 diabetes, a strategy which is currently being investigated in multiple clinical trials.

  3. Direct monitoring of the strand passage reaction of DNA topoisomerase II triggers checkpoint activation.

    Directory of Open Access Journals (Sweden)

    Katherine L Furniss

    Full Text Available By necessity, the ancient activity of type II topoisomerases co-evolved with the double-helical structure of DNA, at least in organisms with circular genomes. In humans, the strand passage reaction of DNA topoisomerase II (Topo II is the target of several major classes of cancer drugs which both poison Topo II and activate cell cycle checkpoint controls. It is important to know the cellular effects of molecules that target Topo II, but the mechanisms of checkpoint activation that respond to Topo II dysfunction are not well understood. Here, we provide evidence that a checkpoint mechanism monitors the strand passage reaction of Topo II. In contrast, cells do not become checkpoint arrested in the presence of the aberrant DNA topologies, such as hyper-catenation, that arise in the absence of Topo II activity. An overall reduction in Topo II activity (i.e. slow strand passage cycles does not activate the checkpoint, but specific defects in the T-segment transit step of the strand passage reaction do induce a cell cycle delay. Furthermore, the cell cycle delay depends on the divergent and catalytically inert C-terminal region of Topo II, indicating that transmission of a checkpoint signal may occur via the C-terminus. Other, well characterized, mitotic checkpoints detect DNA lesions or monitor unattached kinetochores; these defects arise via failures in a variety of cell processes. In contrast, we have described the first example of a distinct category of checkpoint mechanism that monitors the catalytic cycle of a single specific enzyme in order to determine when chromosome segregation can proceed faithfully.

  4. In Vitro Selection for Small-Molecule-Triggered Strand Displacement and Riboswitch Activity.

    Science.gov (United States)

    Martini, Laura; Meyer, Adam J; Ellefson, Jared W; Milligan, John N; Forlin, Michele; Ellington, Andrew D; Mansy, Sheref S

    2015-10-16

    An in vitro selection method for ligand-responsive RNA sensors was developed that exploited strand displacement reactions. The RNA library was based on the thiamine pyrophosphate (TPP) riboswitch, and RNA sequences capable of hybridizing to a target duplex DNA in a TPP regulated manner were identified. After three rounds of selection, RNA molecules that mediated a strand exchange reaction upon TPP binding were enriched. The enriched sequences also showed riboswitch activity. Our results demonstrated that small-molecule-responsive nucleic acid sensors can be selected to control the activity of target nucleic acid circuitry.

  5. Deconstructing complexin function in activating and clamping Ca2+-triggered exocytosis by comparing knockout and knockdown phenotypes.

    Science.gov (United States)

    Yang, Xiaofei; Cao, Peng; Südhof, Thomas C

    2013-12-17

    Complexin, a presynaptic protein that avidly binds to assembled SNARE complexes, is widely acknowledged to activate Ca(2+)-triggered exocytosis. In addition, studies of invertebrate complexin mutants and of mouse neurons with a double knockdown (DKD) of complexin-1 and -2 suggested that complexin maintains the readily releasable pool (RRP) of vesicles and clamps spontaneous exocytosis. In contrast, studies of mouse neurons with a double knockout (DKO) of complexin-1 and -2, largely carried out in hippocampal autapses, did not detect changes in the RRP size or in spontaneous exocytosis. To clarify complexin function, we here directly compared in two different preparations, cultured cortical and olfactory bulb neurons, the phenotypes of complexin DKD and DKO neurons. We find that complexin-deficient DKD and DKO neurons invariably exhibit a ~50% decrease in vesicle priming. Moreover, the DKD consistently increased spontaneous exocytosis, but the DKO did so in cortical but not olfactory bulb neurons. Furthermore, the complexin DKD but not the complexin DKO caused a compensatory increase in complexin-3 and -4 mRNA levels; overexpression of complexin-3 but not complexin-1 increased spontaneous exocytosis. Complexin-3 but not complexin-1 contains a C-terminal lipid anchor attaching it to the plasma membrane; addition of a similar lipid anchor to complexin-1 converted complexin-1 from a clamp into an activator of spontaneous exocytosis. Viewed together, our data suggest that complexin generally functions in priming and Ca(2+) triggering of exocytosis, and additionally contributes to the control of spontaneous exocytosis dependent on the developmental history of a neuron and on the subcellular localization of the complexin.

  6. Curcumin Triggers p16-Dependent Senescence in Active Breast Cancer-Associated Fibroblasts and Suppresses Their Paracrine Procarcinogenic Effects

    Directory of Open Access Journals (Sweden)

    Siti-Fauziah Hendrayani

    2013-06-01

    Full Text Available Activated cancer-associated fibroblasts (CAFs or myofibroblasts not only facilitate tumor growth and spread but also affect tumor response to therapeutic agents. Therefore, it became clear that efficient therapeutic regimens should also take into account the presence of these supportive cells and inhibit their paracrine effects. To this end, we tested the effect of low concentrations of curcumin, a pharmacologically safe natural product, on patient-derived primary breast CAF cells. We have shown that curcumin treatment upregulates p16INK4A and other tumor suppressor proteins while inactivates the JAK2/STAT3 pathway. This reduced the level of alpha-smooth muscle actin (α-SMA and the migration/invasion abilities of these cells. Furthermore, curcumin suppressed the expression/secretion of stromal cell-derived factor-1 (SDF-1, interleukin-6 (IL-6, matrix metalloproteinase-2 (MMP-2, MMP-9, and transforming growth factor-β, which impeded their paracrine procarcinogenic potential. Intriguingly, these effects were sustained even after curcumin withdrawal and cell splitting. Therefore, using different markers of senescence [senescence-associated β-galactosidase (SA-β-gal activity, Ki-67 and Lamin B1 levels, and bromodeoxyuridine incorporation], we have shown that curcumin markedly suppresses Lamin B1 and triggers DNA damage-independent senescence in proliferating but not quiescent breast stromal fibroblasts. Importantly, this curcumin-related senescence was p16INK4A-dependent and occurred with no associated inflammatory secretory phenotype. These results indicate the possible inactivation of cancer-associated myofibroblasts and present the first indication that curcumin can trigger DNA damage-independent and safe senescence in stromal fibroblasts.

  7. Inferior Frontal Gyrus Activity Triggers Anterior Insula Response to Emotional Facial Expressions

    NARCIS (Netherlands)

    Jabbi, Mbemba; Keysers, Christian

    2008-01-01

    The observation of movies of facial expressions of others has been shown to recruit similar areas involved in experiencing one's own emotions: the inferior frontal gyrus (IFG). the anterior insula and adjacent frontal operculum (IFO). The Causal link bet between activity in these 2 regions, associat

  8. Hormone activities and the cell cycle machinery in immunity-triggered growth inhibition.

    Science.gov (United States)

    Reitz, M U; Gifford, M L; Schäfer, P

    2015-04-01

    Biotic stress and diseases caused by pathogen attack pose threats in crop production and significantly reduce crop yields. Enhancing immunity against pathogens is therefore of outstanding importance in crop breeding. However, this must be balanced, as immune activation inhibits plant growth. This immunity-coupled growth trade-off does not support resistance but is postulated to reflect the reallocation of resources to drive immunity. There is, however, increasing evidence that growth-immunity trade-offs are based on the reconfiguration of hormone pathways, shared by growth and immunity signalling. Studies in roots revealed the role of hormones in orchestrating growth across different cell types, with some hormones showing a defined cell type-specific activity. This is apparently highly relevant for the regulation of the cell cycle machinery and might be part of the growth-immunity cross-talk. Since plants are constantly exposed to Immuno-activating microbes under agricultural conditions, the transition from a growth to an immunity operating mode can significantly reduce crop yield and can conflict our efforts to generate next-generation crops with improved yield under climate change conditions. By focusing on roots, we outline the current knowledge of hormone signalling on the cell cycle machinery to explain growth trade-offs induced by immunity. By referring to abiotic stress studies, we further introduce how root cell type-specific hormone activities might contribute to growth under immunity and discuss the feasibility of uncoupling the growth-immunity cross-talk.

  9. One-way membrane trafficking of SOS in receptor-triggered Ras activation.

    Science.gov (United States)

    Christensen, Sune M; Tu, Hsiung-Lin; Jun, Jesse E; Alvarez, Steven; Triplet, Meredith G; Iwig, Jeffrey S; Yadav, Kamlesh K; Bar-Sagi, Dafna; Roose, Jeroen P; Groves, Jay T

    2016-09-01

    SOS is a key activator of the small GTPase Ras. In cells, SOS-Ras signaling is thought to be initiated predominantly by membrane recruitment of SOS via the adaptor Grb2 and balanced by rapidly reversible Grb2-SOS binding kinetics. However, SOS has multiple protein and lipid interactions that provide linkage to the membrane. In reconstituted-membrane experiments, these Grb2-independent interactions were sufficient to retain human SOS on the membrane for many minutes, during which a single SOS molecule could processively activate thousands of Ras molecules. These observations raised questions concerning how receptors maintain control of SOS in cells and how membrane-recruited SOS is ultimately released. We addressed these questions in quantitative assays of reconstituted SOS-deficient chicken B-cell signaling systems combined with single-molecule measurements in supported membranes. These studies revealed an essentially one-way trafficking process in which membrane-recruited SOS remains trapped on the membrane and continuously activates Ras until being actively removed via endocytosis.

  10. The number of active trigger points is associated with disability and anxiety in tension type headache

    DEFF Research Database (Denmark)

    Palacios-Cena, M.; Ambite-Quesada, S.; Ordas-Bandera, C.

    2015-01-01

    receptor was highly expressed in trigeminal ganglion and dorsal rootganglion. MK-0524 significantly (62%, pp-ERK protein level was observed in the TVS after infusion of PG mix in awake rats. Neuronal activation markers, cFOS and EGR-1, were...

  11. Phosphate-Activated Cyclin-Dependent Kinase Stabilizes G1 Cyclin To Trigger Cell Cycle Entry

    Science.gov (United States)

    Menoyo, S.; Ricco, N.; Bru, S.; Hernández-Ortega, S.; Escoté, X.; Aldea, M.

    2013-01-01

    G1 cyclins, in association with a cyclin-dependent kinase (CDK), are universal activators of the transcriptional G1-S machinery during entry into the cell cycle. Regulation of cyclin degradation is crucial for coordinating progression through the cell cycle, but the mechanisms that modulate cyclin stability to control cell cycle entry are still unknown. Here, we show that a lack of phosphate downregulates Cln3 cyclin and leads to G1 arrest in Saccharomyces cerevisiae. The stability of Cln3 protein is diminished in strains with low activity of Pho85, a phosphate-sensing CDK. Cln3 is an in vitro substrate of Pho85, and both proteins interact in vivo. More interestingly, cells that carry a CLN3 allele encoding aspartic acid substitutions at the sites of Pho85 phosphorylation maintain high levels of Cln3 independently of Pho85 activity. Moreover, these cells do not properly arrest in G1 in the absence of phosphate and they die prematurely. Finally, the activity of Pho85 is essential for accumulating Cln3 and for reentering the cell cycle after phosphate refeeding. Taken together, our data indicate that Cln3 is a molecular target of the Pho85 kinase that is required to modulate cell cycle entry in response to environmental changes in nutrient availability. PMID:23339867

  12. Inferior Frontal Gyrus Activity Triggers Anterior Insula Response to Emotional Facial Expressions

    NARCIS (Netherlands)

    Jabbi, Mbemba; Keysers, Christian

    2008-01-01

    The observation of movies of facial expressions of others has been shown to recruit similar areas involved in experiencing one's own emotions: the inferior frontal gyrus (IFG). the anterior insula and adjacent frontal operculum (IFO). The Causal link bet between activity in these 2 regions,

  13. Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative

    Directory of Open Access Journals (Sweden)

    Michael Vincent DeFazio

    2014-05-01

    Full Text Available The composite anterolateral thigh flap with vascularized fascia lata has emerged as a workhorse at our institution for complex Achilles defects requiring both tendon and soft tissue reconstruction. Safe elevation of this flap, however, is occasionally challenged by absent or inadequate perforators supplying the anterolateral thigh. When discovered intraoperatively, alternative options derived from the same vascular network can be pursued. We present the case of a 74-year-old male who underwent composite Achilles defect reconstruction using a segmental rectus femoris myofascial free flap. Following graduated rehabilitation, postoperatively, the patient resumed full activity and was able to ambulate on his tip-toes. At 1-year follow-up, active total range of motion of the reconstructed ankle exceeded 85% of the unaffected side, and donor site morbidity was negligible. American Orthopaedic Foot and Ankle Society and Short Form-36 scores improved by 78.8% and 28.8%, respectively, compared to preoperative baseline assessments. Based on our findings, we advocate for use of the combined rectus femoris myofascial free flap as a rescue option for reconstructing composite Achilles tendon/posterior leg defects in the setting of inadequate anterolateral thigh perforators. To our knowledge, this is the first report to describe use of this flap for such an indication.

  14. Compression on trigger points in the leg muscle increases parasympathetic nervous activity based on heart rate variability.

    Science.gov (United States)

    Takamoto, Kohichi; Sakai, Shigekazu; Hori, Etsuro; Urakawa, Susumu; Umeno, Katsumi; Ono, Taketoshi; Nishijo, Hisao

    2009-05-01

    Massotherapy, the therapeutic use of massage, is used to treat various chronic pain syndromes. One type of massotherapy, pressure stimulus applied over trigger points (TPs), is reported to have excellent therapeutic effects. Its effect is possibly mediated through changes in the autonomic nervous system although little research has been conducted to assess autonomic activity during TP compression. We have investigated how compression applied over TPs affects the autonomic nervous system. Six healthy young adult females whose daily working routine was carried out predominantly in a standing position were enrolled in the study cohort. After a day's work, the subjects were asked to rest supine, and electrocardiograms (ECGs), instantaneous lung volume (ILV) and systolic and diastolic blood pressures (SBP, DBP) were measured before and after pressure application over the TPs in those lower limb muscles where the subjects felt muscle fatigue or discomfort. The subjects were also asked to coordinate breathing with the beeping sounds. The therapeutic effects of TP compression were assessed by a subjective fatigue scale. Parasympathetic nervous activity was also assessed by spectral analysis of heart rate (HR) variability. The transfer function from ILV to HR was evaluated using linear analysis. The results indicated that TP compression (1) decreased HR, SBP and DBP, (2) increased parasympathetic activity, (3) increased the gain from ILV to HR, and (4) improved the fatigue scores. These findings suggest that an increase in parasympathetic nervous activity after the TP compression induced a reduction of fatigue. The therapeutic mechanisms of TP compression to enhance parasympathetic nervous system are discussed.

  15. Activation of the cold-sensing TRPM8 channel triggers UCP1-dependent thermogenesis and prevents obesity

    Institute of Scientific and Technical Information of China (English)

    Shuangtao Ma; Zhenyu Zhu; Li Li; Jian Zhong; Daoyan Liu; Bernd Nilius; Zhiming Zhu; Hao Yu; Zhigang Zhao; Zhidan Luo; Jing Chen; Yinxing Ni; Rongbing Jin; Liqun Ma; Peijian Wang

    2012-01-01

    Brown adipose tissue (BAT) is an energy-expending organ that produces heat.Expansion or activation of BAT prevents obesity and diabetes.Chronic cold exposure enhances thermogenesis in BAT through uncoupling protein 1 (UCP1) activation triggered via a β-adrenergic pathway.Here,we report that the cold-sensing transient receptor potential melastatin 8 (TRPM8) is functionally present In mouse BAT.Challenging brown adipocytes with menthol,a TRPM8 agonist,up-regulates UCP1 expression and requires protein kinase A activation.Upon mimicking long-term cold exposure with chronic dietary menthol application,menthol significantly increased the core temperatures and locomotor activity in wild-type mice; these effects were absent in both TRPM8-/- and UCP1-/- mice.Dietary obesity and glucose abnormalities were also prevented by menthol treatment.Our results reveal a previously unrecognized role for TRPM8,suggesting that stimulation of this channel mediates BAT thermogenesis,which could constitute a promising way to treat obesity.

  16. Nuclear DNA damage-triggered NLRP3 inflammasome activation promotes UVB-induced inflammatory responses in human keratinocytes

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Tatsuya, E-mail: tatsuya.hasegawa@to.shiseido.co.jp; Nakashima, Masaya; Suzuki, Yoshiharu

    2016-08-26

    Ultraviolet (UV) radiation in sunlight can result in DNA damage and an inflammatory reaction of the skin commonly known as sunburn, which in turn can lead to cutaneous tissue disorders. However, little has been known about how UV-induced DNA damage mediates the release of inflammatory mediators from keratinocytes. Here, we show that UVB radiation intensity-dependently increases NLRP3 gene expression and IL-1β production in human keratinocytes. Knockdown of NLRP3 with siRNA suppresses UVB-induced production of not only IL-1β, but also other inflammatory mediators, including IL-1α, IL-6, TNF-α, and PGE{sub 2}. In addition, inhibition of DNA damage repair by knockdown of XPA, which is a major component of the nucleotide excision repair system, causes accumulation of cyclobutane pyrimidine dimer (CPD) and activation of NLRP3 inflammasome. In vivo immunofluorescence analysis confirmed that NLRP3 expression is also elevated in UV-irradiated human epidermis. Overall, our findings indicate that UVB-induced DNA damage initiates NLRP3 inflammasome activation, leading to release of various inflammatory mediators from human keratinocytes. - Highlights: • UVB radiation induces NLRP3 inflammasome activation in human keratinocytes. • NLRP3 knockdown suppresses production of UVB-induced inflammatory mediators. • UVB-induced DNA damage triggers NLRP3 inflammasome activation. • NLRP3 expression in human epidermis is elevated in response to UV radiation.

  17. The myofascial compartments of the foot: a cadaver study.

    Science.gov (United States)

    Ling, Z X; Kumar, V P

    2008-08-01

    Compartment syndrome of the foot requires urgent surgical treatment. Currently, there is still no agreement on the number and location of the myofascial compartments of the foot. The aim of this cadaver study was to provide an anatomical basis for surgical decompression in the event of compartment syndrome. We found that there were three tough vertical fascial septae that extended from the hindfoot to the midfoot on the plantar aspect of the foot. These septae separated the posterior half of the foot into three compartments. The medial compartment containing the abductor hallucis was surrounded medially by skin and subcutaneous fat and laterally by the medial septum. The intermediate compartment, containing the flexor digitorum brevis and the quadratus plantae more deeply, was surrounded by the medial septum medially, the intermediate septum laterally and the main plantar aponeurosis on its plantar aspect. The lateral compartment containing the abductor digiti minimi was surrounded medially by the intermediate septum, laterally by the lateral septum and on its plantar aspect by the lateral band of the main plantar aponeurosis. No distinct myofascial compartments exist in the forefoot. Based on our findings, in theory, fasciotomy of the hindfoot compartments through a modified medial incision would be sufficient to decompress the foot.

  18. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

    Science.gov (United States)

    Conti, P C R; Costa, Y M; Gonçalves, D A; Svensson, P

    2016-09-01

    There are relevant clinical overlaps between some of the painful temporomandibular disorders (TMD) and headache conditions that may hamper the diagnostic process and treatment. A non-systematic search for studies on the relationship between TMD and headaches was carried out in the following databases: PubMed, Cochrane Library and Embase. Important pain mechanisms contributing to the close association and complex relationship between TMD and headache disorders are as follows: processes of peripheral and central sensitisation which take place in similar anatomical areas, the possible impairment of the descending modulatory pain pathways and the processes of referred pain. In addition, the clinical examination does not always provide distinguishing information to differentiate between headaches and TMD. So, considering the pathophysiology and the clinical presentation of some types of headache and myofascial TMD, such overlap can be considered not only a matter of comorbid relationship, but rather a question of disorders where the distinction lines are sometimes hard to identify. These concerns are certainly reflected in the current classification systems of both TMD and headache where the clinical consequences of diagnosis such as headache attributed to or associated with TMD are uncertain. There are several similarities in terms of therapeutic strategies used to manage myofascial TMD and headaches. Considering all these possible levels of interaction, we reinforce the recommendation for multidisciplinary approaches, by a team of oro-facial pain specialists and a neurologist (headache specialist), to attain the most precise differential diagnosis and initiate the best and most efficient treatment.

  19. Breathing of heliospheric structures triggered by the solar-cycle activity

    Directory of Open Access Journals (Sweden)

    K. Scherer

    Full Text Available Solar wind ram pressure variations occuring within the solar activity cycle are communicated to the outer heliosphere as complicated time-variabilities, but repeating its typical form with the activity period of about 11 years. At outer heliospheric regions, the main surviving solar cycle feature is a periodic variation of the solar wind dynamical pressure or momentum flow, as clearly recognized by observations of the VOYAGER-1/2 space probes. This long-periodic variation of the solar wind dynamical pressure is modeled here through application of appropriately time-dependent inner boundary conditions within our multifluid code to describe the solar wind – interstellar medium interaction. As we can show, it takes several solar cycles until the heliospheric structures adapt to an average location about which they carry out a periodic breathing, however, lagged in phase with respect to the solar cycle. The dynamically active heliosphere behaves differently from a static heliosphere and especially shows a historic hysteresis in the sense that the shock structures move out to larger distances than explained by the average ram pressure. Obviously, additional energies are pumped into the heliosheath by means of density and pressure waves which are excited. These waves travel outwards through the interface from the termination shock towards the bow shock. Depending on longitude, the heliospheric sheath region memorizes 2–3 (upwind and up to 6–7 (downwind preceding solar activity cycles, i.e. the cycle-induced waves need corresponding travel times for the passage over the heliosheath. Within our multifluid code we also adequately describe the solar cycle variations in the energy distributions of anomalous and galactic cosmic rays, respectively. According to these results the distribution of these high energetic species cannot be correctly described on the basis of the actually prevailing solar wind conditions.

    Key words. Interplanetary

  20. Laminin α2-mediated focal adhesion kinase activation triggers Alport glomerular pathogenesis.

    Directory of Open Access Journals (Sweden)

    Duane Delimont

    Full Text Available It has been known for some time that laminins containing α1 and α2 chains, which are normally restricted to the mesangial matrix, accumulate in the glomerular basement membranes (GBM of Alport mice, dogs, and humans. We show that laminins containing the α2 chain, but not those containing the α1 chain activates focal adhesion kinase (FAK on glomerular podocytes in vitro and in vivo. CD151-null mice, which have weakened podocyte adhesion to the GBM rendering these mice more susceptible to biomechanical strain in the glomerulus, also show progressive accumulation of α2 laminins in the GBM, and podocyte FAK activation. Analysis of glomerular mRNA from both models demonstrates significant induction of MMP-9, MMP-10, MMP-12, MMPs linked to GBM destruction in Alport disease models, as well as the pro-inflammatory cytokine IL-6. SiRNA knockdown of FAK in cultured podocytes significantly reduced expression of MMP-9, MMP-10 and IL-6, but not MMP-12. Treatment of Alport mice with TAE226, a small molecule inhibitor of FAK activation, ameliorated fibrosis and glomerulosclerosis, significantly reduced proteinuria and blood urea nitrogen levels, and partially restored GBM ultrastructure. Glomerular expression of MMP-9, MMP-10 and MMP-12 mRNAs was significantly reduced in TAE226 treated animals. Collectively, this work identifies laminin α2-mediated FAK activation in podocytes as an important early event in Alport glomerular pathogenesis and suggests that FAK inhibitors, if safe formulations can be developed, might be employed as a novel therapeutic approach for treating Alport renal disease in its early stages.

  1. Laminin α2-mediated focal adhesion kinase activation triggers Alport glomerular pathogenesis.

    Science.gov (United States)

    Delimont, Duane; Dufek, Brianna M; Meehan, Daniel T; Zallocchi, Marisa; Gratton, Michael Anne; Phillips, Grady; Cosgrove, Dominic

    2014-01-01

    It has been known for some time that laminins containing α1 and α2 chains, which are normally restricted to the mesangial matrix, accumulate in the glomerular basement membranes (GBM) of Alport mice, dogs, and humans. We show that laminins containing the α2 chain, but not those containing the α1 chain activates focal adhesion kinase (FAK) on glomerular podocytes in vitro and in vivo. CD151-null mice, which have weakened podocyte adhesion to the GBM rendering these mice more susceptible to biomechanical strain in the glomerulus, also show progressive accumulation of α2 laminins in the GBM, and podocyte FAK activation. Analysis of glomerular mRNA from both models demonstrates significant induction of MMP-9, MMP-10, MMP-12, MMPs linked to GBM destruction in Alport disease models, as well as the pro-inflammatory cytokine IL-6. SiRNA knockdown of FAK in cultured podocytes significantly reduced expression of MMP-9, MMP-10 and IL-6, but not MMP-12. Treatment of Alport mice with TAE226, a small molecule inhibitor of FAK activation, ameliorated fibrosis and glomerulosclerosis, significantly reduced proteinuria and blood urea nitrogen levels, and partially restored GBM ultrastructure. Glomerular expression of MMP-9, MMP-10 and MMP-12 mRNAs was significantly reduced in TAE226 treated animals. Collectively, this work identifies laminin α2-mediated FAK activation in podocytes as an important early event in Alport glomerular pathogenesis and suggests that FAK inhibitors, if safe formulations can be developed, might be employed as a novel therapeutic approach for treating Alport renal disease in its early stages.

  2. Activation and interruption of the reproduction of Varroa destructor is triggered by host signals (Apis mellifera).

    Science.gov (United States)

    Frey, Eva; Odemer, Richard; Blum, Thomas; Rosenkranz, Peter

    2013-05-01

    The reproductive cycle of the parasitic mite Varroa destructor is closely linked to the development of the honey bee host larvae. Using a within colony approach we introduced phoretic Varroa females into brood cells of different age in order to analyze the capacity of certain stages of the honey bee larva to either activate or interrupt the reproduction of Varroa females. Only larvae within 18 h (worker) and 36 h (drones), respectively, after cell capping were able to stimulate the mite's oogenesis. Therewith we could specify for the first time the short time window where honey bee larvae provide the signals for the activation of the Varroa reproduction. Stage specific volatiles of the larval cuticle are at least part of these activation signals. This is confirmed by the successful stimulation of presumably non-reproducing mites to oviposition by the application of a larval extract into the sealed brood cells. According to preliminary quantitative GC-MS analysis we suggest certain fatty acid ethyl esters as candidate compounds. If Varroa females that have just started with egg formation are transferred to brood cells containing host larvae of an elder stage two-thirds of these mites stopped their oogenesis. This confirms the presence of an additional signal in the host larvae allowing the reproducing mites to adjust their own reproductive cycle to the ontogenetic development of the host. From an adaptive point of view that sort of a stop signal enables the female mite to save resources for a next reproductive cycle if the own egg development is not sufficiently synchronized with the development of the host. The results presented here offer the opportunity to analyze exactly those host stages that have the capacity to activate or interrupt the Varroa reproduction in order to identify the crucial host signals.

  3. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    NARCIS (Netherlands)

    Bron, Carel; Dommerholt, J.; Stegenga, Boudewijn; Wensing, M.; Oostendorp, R.A.B.

    2011-01-01

    Background: Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols.

  4. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    NARCIS (Netherlands)

    Bron, Carel; Dommerholt, J.; Stegenga, Boudewijn; Wensing, M.; Oostendorp, R.A.B.

    2011-01-01

    Background: Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols.

  5. Helicobacter pylori CagA triggers expression of the bactericidal lectin REG3γ via gastric STAT3 activation.

    Directory of Open Access Journals (Sweden)

    Kai Syin Lee

    Full Text Available BACKGROUND: Most of what is known about the Helicobacter pylori (H. pylori cytotoxin, CagA, pertains to a much-vaunted role as a determinant of gastric inflammation and cancer. Little attention has been devoted to potential roles of CagA in the majority of H. pylori infected individuals not showing oncogenic progression, particularly in relation to host tolerance. Regenerating islet-derived (REG3γ encodes a secreted C-type lectin that exerts direct bactericidal activity against Gram-positive bacteria in the intestine. Here, we extend this paradigm of lectin-mediated innate immunity, showing that REG3γ expression is triggered by CagA in the H. pylori-infected stomach. METHODOLOGY/PRINCIPAL FINDINGS: In human gastric mucosal tissues, REG3γ expression was significantly increased in CagA-positive, compared to CagA-negative H. pylori infected individuals. Using transfected CagA-inducible gastric MKN28 cells, we recapitulated REG3γ induction in vitro, also showing that tyrosine phosphorylated, not unphosphorylated CagA triggers REG3γ transcription. In concert with induced REG3γ, pro-inflammatory signalling downstream of the gp130 cytokine co-receptor via the signal transducer and activator of transcription (STAT3 and transcription of two cognate ligands, interleukin(IL-11 and IL-6, were significantly increased. Exogenous IL-11, but not IL-6, directly stimulated STAT3 activation and REG3γ transcription. STAT3 siRNA knockdown or IL-11 receptor blockade respectively abrogated or subdued CagA-dependent REG3γ mRNA induction, thus demonstrating a requirement for uncompromised signalling via the IL-11/STAT3 pathway. Inhibition of the gp130-related SHP2-(Ras-ERK pathway did not affect CagA-dependent REG3γ induction, but strengthened STAT3 activation as well as augmenting transcription of mucosal innate immune regulators, IL-6, IL-8 and interferon-response factor (IRF1. CONCLUSIONS/SIGNIFICANCE: Our results support a model of CagA-directed REG3

  6. Effectiveness comparison between Thai traditional massage and Chinese acupuncture for myofascial back pain in Thai military personnel: a preliminary report.

    Science.gov (United States)

    Kumnerddee, Wipoo

    2009-02-01

    The objective of this randomized comparative study was to provide preliminary data of comparative effectiveness of Thai traditional massage (TTM) and Chinese acupuncture for the treatment of myofascial back pain in young military personnel. Eighteen Thai military personnel, aged ranging from 20-40 years were randomly divided into TTM and acupuncture groups. Each group received 5 sessions of massage or acupuncture during a 10-day period. The Thai version McGill Pain Questionnaire, 100-mm, visual analog scale (VAS) and summation of pain threshold in each trigger point measured by pressure algometer were assessed at day 0, 3, 8 and 10. At the end of treatment protocols, McGill scores decreased significantly in TTM and acupuncture groups (p = 0.024 and 0.002, respectively). VAS also decreased significantly (p = 0.029 and 0.003, respectively). However, the pain pressure threshold increased significantly in the acupuncture group but not in the TTM group (p = 0.006 and 0.08, respectively). When outcomes were compared between the two groups, no significant difference was found in the VAS (p = 0.115) and pain pressure threshold (p = 0.116), whereas the acupuncture group showed significantly lower McGill scores than the TTM group (p = 0.039). In conclusion, five sessions of Thai traditional massage and Chinese acupuncture were effective for the treatment of myofascial back pain in young Thai military personnel. Significant effects in both groups begin after the first session. Acupuncture is more effective than Thai traditional massage when affective aspect is also evaluated.

  7. The lack of autophagy triggers precocious activation of Notch signaling during Drosophila oogenesis

    Directory of Open Access Journals (Sweden)

    Barth Julia MI

    2012-12-01

    Full Text Available Abstract Background The proper balance of autophagy, a lysosome-mediated degradation process, is in