Jimbo Shizuo, Atsuta Yuji, Kobayashi Tetsuya, Matsuno Takeo
Department of Orthopaedic Surgery, Rishiri Island Central Hospital, Hokkaido, Japan.
J Orthop Sci. 2008 Mar;13(2):101-6. doi: 10.1007/s00776-007-1209-z. Epub 2008 Apr 8.
Neck pain (katakori) is a common symptom in adult Japanese people. However, the pathophysiological aspect of this condition has not been well documented to date. The purpose of this study was to investigate the effects of tender point dry needling to the trapezius muscles and the resultant changes in muscular hemodynamics.
"Neck pain" patients were defined as those complaining of dull pain or discomfort mainly along the trapezius muscles without serious spinal or shoulder disorders. We used near-infrared spectroscopy to monitor the changes of oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) of the trapezius muscles and a Visual Analogue Scale (VAS) to assess subjective neck pain intensity. Experiment I: Nine subjects with "neck pain" and four control subjects were recruited. Total hemoglobin (Hb) and SdO2 [= oxyHb/(oxyHb + deoxyHb)] were measured before and immediately after needling for 15 min. We compared these parameters and VAS before and immediately after needling. Experiment II: Thirteen subjects with "neck pain" were instructed to perform isometric contraction of their trapezius muscles for 1 min; the half-recovery time of SdO2 (defined as T(R)) was measured. After that, all subjects underwent needling. On the next day, we repeated the measurements of T(R) after the same voluntary contraction of the trapezius muscle in the same patients. We compared T(R) and VAS before and on the day after needling.
Experiment I: All subjects with "neck pain" reported significant pain relief (P = 0.0147) measured by VAS immediately after needling, but total Hb and SdO2 exhibited no significant change after needling. Experiment II: T(R) was shortened on the day after needling in 10 of 13 patients (P = 0.0043), and neck pain was decreased in 12 patients (P = 0.0158).
After dry needling, total Hb and SdO2 did not change in real time, but T(R) was shortened on the next day. These results showed that the shortening of T(R) would provide a measure by which to assess the effectiveness of treatment for neck pain.
颈部疼痛（肩凝症）是成年日本人的常见症状。然而，迄今为止，这种病症的病理生理学方面尚未得到充分记录。本研究的目的是调查斜方肌激痛点干针疗法的效果以及由此导致的肌肉血流动力学变化。
“颈部疼痛”患者定义为主要沿斜方肌主诉钝痛或不适且无严重脊柱或肩部疾病的患者。我们使用近红外光谱监测斜方肌的氧合血红蛋白（oxyHb）和脱氧血红蛋白（deoxyHb）的变化，并使用视觉模拟评分法（VAS）评估颈部主观疼痛强度。实验一：招募了9名“颈部疼痛”受试者和4名对照受试者。在针刺15分钟前后测量总血红蛋白（Hb）和血氧饱和度（SdO2）[= oxyHb /（oxyHb + deoxyHb）]。我们比较了针刺前后的这些参数和VAS。实验二：指示13名“颈部疼痛”受试者进行斜方肌等长收缩1分钟；测量SdO2的半恢复时间（定义为T(R)）。之后，所有受试者接受针刺。第二天，在同一患者斜方肌进行相同的自主收缩后，我们重复测量T(R)。我们比较了针刺前后的T(R)和VAS。
实验一：所有“颈部疼痛”受试者在针刺后立即通过VAS测量报告疼痛明显缓解（P = 0.0147），但针刺后总Hb和SdO2无明显变化。实验二：13名患者中有10名在针刺后第二天T(R)缩短（P = 0.0043），12名患者颈部疼痛减轻（P = 0.0158）。
干针疗法后，总Hb和SdO2没有实时变化，但第二天T(R)缩短。这些结果表明，T(R)的缩短将提供一种评估颈部疼痛治疗效果的方法。
