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Ischemic compression block attenuates mechanical hyperalgesia evoked from latent myofascial trigger points

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Abstract

The aim of the present study is to test the hypothesis that large-diameter myelinated muscle afferents contribute to the pathophysiology of myofascial trigger points (MTrPs). The ischemic compression blockage (ICB) of large-diameter myelinated muscle afferents was obtained with a 7-cm-wide tourniquet applied around the upper arm proximal to the brachioradialis muscle in 20 healthy subjects. This study consisted of two randomized sessions with an interval of 1 week in between each session. In one session, pressure pain threshold (PPT) and pressure threshold for eliciting referred pain (PTRP) were measured at an MTrP region in the brachioradialis muscle in one forearm. In another session, PPT was measured at a non-MTrP region in the brachioradialis muscle of the contralateral forearm at the time of pre-compression, 20 min following compression, and 10 min after decompression. The results showed that ICB, which mainly blocks large-diameter myelinated muscle afferents, was associated with an increase in PPT and PTRP (all P < 0.001) at MTrP regions but not at non-MTrP regions. These results suggest that large-diameter muscle afferents may be involved in pain and mechanical hyperalgesia at MTrPs.

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References

  • Arendt-Nielsen L, Laursen RJ, Drewes AM (2000) Referred pain as an indicator for neural plasticity. Prog Brain Res 129:343–356

    Article  CAS  PubMed  Google Scholar 

  • Barlas P, Walsh DM, Baxter GD, Allen JM (2000) Delayed onset muscle soreness: effect of an ischaemic block upon mechanical allodynia in humans. Pain 87:221–225

    Article  CAS  PubMed  Google Scholar 

  • Bartel DL, Bicknell VL, Wright TM (1986) The effect of conformity, thickness, and material on stresses in ultra-high molecular weight components for total joint replacement. J Bone Joint Surg Am 68:1041–1051

    CAS  PubMed  Google Scholar 

  • Biro A, Griffin L, Cafarelli E (2007) Reflex gain of muscle spindle pathways during fatigue. Exp Brain Res 177:157–166

    Article  CAS  PubMed  Google Scholar 

  • Chen R, Ashby P (1993) Reflex responses in upper limb muscles to cutaneous stimuli. Can J Neurol Sci 20:271–278

    Google Scholar 

  • Cummings M, Baldry P (2007) Regional myofascial pain: diagnosis and management. Best Pract Res Clin Rheumatol 21:367–387

    Article  PubMed  Google Scholar 

  • Dahlin LB, Shyu BC, Danielsen N, Andersson SA (1989) Effects of nerve compression or ischaemia on conduction properties of myelinated and non-myelinated nerve fibres. An experimental study in the rabbit common peroneal nerve. Acta Physiol Scand 136:97–105

    Article  CAS  PubMed  Google Scholar 

  • Davis KD (1998) Cold-induced pain and prickle in the glabrous and hairy skin. Pain 75:47–57

    Article  CAS  PubMed  Google Scholar 

  • Fern R, Harrison PJ (1994) The contribution of ischaemia and deformation to the conduction block generated by compression of the cat sciatic nerve. Exp Physiol 79:583–592

    CAS  PubMed  Google Scholar 

  • Ge HY, Fernandez-de-las-Penas C, Arendt-Nielsen L (2006) Sympathetic facilitation of hyperalgesia evoked from myofascial tender and trigger points in patients with unilateral shoulder pain. Clin Neurophysiol 117:1545–1550

    Article  PubMed  Google Scholar 

  • Ge HY, Serrao M, Andersen OK, Graven-Nielsen T, Arendt-Nielsen L (2007) Increased H-reflex response induced by intramuscular electrical stimulation at trigger points. J Muscoskel Pain 15(Suppl 13):22

    Google Scholar 

  • Ge HY, Zhang Y, Boudreau S, Yue SW, Laursen RJ (2008) Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points. Exp Brain Res 187:623–629

    Article  PubMed  Google Scholar 

  • Graven-Nielsen T, Mense S, Arendt-Nielsen L (2004) Painful and non-painful pressure sensations from human skeletal muscle. Exp Brain Res 3:273–283

    Article  Google Scholar 

  • Hayashi R, Miyake A, Watanabe S (1988) The functional role of sensory inputs from the foot: stabilizing human standing posture during voluntary and vibration-induced body sway. Neurosci Res 5:203–213

    Article  CAS  PubMed  Google Scholar 

  • Hellström F, Roatta S, Thunberg J, Passatore M, Djupsjöbacka M (2005) Responses of muscle spindles in feline dorsal neck muscles to electrical stimulation of the cervical sympathetic nerve. Exp Brain Res 165:328–342

    Article  PubMed  Google Scholar 

  • Hong CZ (1994) Persistence of local twitch response with loss of conduction to and from the spinal cord. Arch Phys Med Rehabil 75:12–16

    CAS  PubMed  Google Scholar 

  • Hong CZ, Chen JT, Chen SM, Kuan TS (1997) Sensitive loci in a myofascial trigger point region are related to sensory nerve fibers. Am J Phys Med Rehabil 76:172

    Article  Google Scholar 

  • Kadi F, Waling K, Ahlgren C, Sundelin G, Holmner S, Butler-Browne GS, Thornell LE (1998) Pathological mechanisms implicated in localized female trapezius myalgia. Pain 78:191–196

    Article  CAS  PubMed  Google Scholar 

  • Laursen RJ, Graven-Nielsen T, Jensen TS, Arendt-Nielsen L (1999) The effect of differential and complete nerve block on experimental muscle pain in humans. Muscle Nerve 22:1564–1570

    Article  CAS  PubMed  Google Scholar 

  • Li LT, Ge HY, Yue SW, Arendt-Nielsen L (2009) Nociceptive and non-nociceptive hypersensitivity at latent myofascial trigger points. Clin J Pain 25:132–137

    Article  CAS  PubMed  Google Scholar 

  • Mackenzie RA, Burke D, Skuse NF, Lethlean AK (1975) Fibre function and perception during cutaneous nerve block. J Neurol Neurosurg Psychiatry 38:865–873

    Article  CAS  PubMed  Google Scholar 

  • McNulty WH, Gevirtz RN, Hubbard DR, Berkoff GM (1994) Needle electromyographic evaluation of trigger point response to a psychological stressor. Psychophysiology 31:313–316

    Article  CAS  PubMed  Google Scholar 

  • Passatore M, Filippi GM (1981) On whether there is a direct sympathetic influence on jaw muscle spindles. Brain Res 219:162–165

    Article  CAS  PubMed  Google Scholar 

  • Passatore M, Filippi GM (1982) A dual effect of sympathetic nerve stimulation on jaw muscle spindles. J Auton Nerv Syst 6:347–361

    Article  CAS  PubMed  Google Scholar 

  • Price DE, Alani SM, Wales JK (1991) Effect of aldose reductase inhibition on resistance to ischaemic block in diabetic subjects. Diabetes Care 14:411–413

    Article  CAS  PubMed  Google Scholar 

  • Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, Gerber LH (2008) Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 89:16–23

    Article  PubMed  Google Scholar 

  • Simons DG (2004) Review of enigmatic MTrP as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol 14:95–107

    Article  PubMed  Google Scholar 

  • Simons DG, Mense S (2003) Diagnosis and therapy of myofascial trigger points. Schmerz 17:419–424

    Article  CAS  PubMed  Google Scholar 

  • Smith JE, Wright A (1993) The effect of selective blockade of myelinated afferent neurons on mechanical hyperalgesia in lateral epicondylalgia. Pain Clin 6:9–16

    Google Scholar 

  • Uncini A, Pullman SL, Lovelace RE, Gambi D (1988) The sympathetic skin response: normal values, elucidation of afferent components and application limits. J Neurol Sci 87:299–306

    Article  CAS  PubMed  Google Scholar 

  • Wasner G, Schattschneider J, Binder A, Baron R (2004) Topical menthol—a human model for cold pain by activation and sensitization of C nociceptors. Brain 127:1159–1171

    Article  PubMed  Google Scholar 

  • Yap EC (2007) Myofascial pain—an overview. Ann Acad Med Singap 36:43–48

    PubMed  Google Scholar 

  • Yarnitsky D, Ochoa JL (1989) Sensations conducted by large and small myelinated afferent fibres are lost simultaneously under compression-ischaemia block. Acta Physiol Scand 137:319

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work is supported by the medical science technology development program of Shandong (Grant No. 2009QW009) and the National Natural Science Foundation of China (Grant No. 30872732).

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The authors have no conflicts of interest to report.

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Correspondence to Shou-Wei Yue.

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Y.-H. Wang and X.-L. Ding contributed equally to this work.

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Wang, YH., Ding, XL., Zhang, Y. et al. Ischemic compression block attenuates mechanical hyperalgesia evoked from latent myofascial trigger points. Exp Brain Res 202, 265–270 (2010). https://doi.org/10.1007/s00221-009-2129-2

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  • DOI: https://doi.org/10.1007/s00221-009-2129-2

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