Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Aalborg University, Aalborg, Denmark.
J Pain. 2010 May;11(5):491-9. doi: 10.1016/j.jpain.2009.09.017. Epub 2009 Dec 16.
Fatiguing exercise can affect muscle pain sensitivity and muscle hardness, as seen with work-related neck and shoulder pain. Objective methods to assess muscle pain sensitivity are important because the reliability of manual assessment is generally poor. The aim of this study was (1) to compare coexistence of tender points identified by manual palpation and pressure algometry or hardness assessments and (2) to examine the influence of exercise on muscle pain sensitivity and hardness. Fourteen sites in the upper trapezius muscle were selected for assessments in 12 healthy subjects. Pressure pain thresholds and muscle hardness were examined by computer-controlled pressure algometry at baseline, immediately after static or dynamic exercise, and 20 minutes after static or dynamic exercise. Before recording of pressure pain thresholds, the trapezius muscle was examined for tender points by manual palpation. Two sites with low pressure pain thresholds were typical locations for tender points, and these were the least hard sites. However, manually detected tender points were often (29%) not colocalized with most sensitive sites according to the pressure algometry. A heterogeneous distribution of pressure pain sensitivity and muscle hardness was found in the upper trapezius. The short duration of exercise until exhaustion did not change muscle sensitivity or muscle hardness in asymptomatic muscles.
This study confirms clinical findings with heterogeniosity in pain sensitivity and hardness across the upper trapezius muscle. Developments of new techniques that objectively can identify tender points are important, but thus far, manual palpation is best clinical practice.
疲劳运动可影响肌肉疼痛敏感性和肌肉硬度，如与工作相关的颈肩部疼痛。评估肌肉疼痛敏感性的客观方法很重要，因为手动评估的可靠性通常较差。本研究的目的是：（1）比较手动触诊和压力测痛法或硬度评估确定的压痛部位的共存情况；（2）研究运动对肌肉疼痛敏感性和硬度的影响。对 12 名健康受试者的上斜方肌的 14 个部位进行评估。在基线、静态或动态运动后即刻以及静态或动态运动后 20 分钟，使用计算机控制的压力测痛法检查压痛阈值和肌肉硬度。在记录压痛阈值之前，通过手动触诊检查斜方肌的压痛点。两个压力疼痛阈值较低的部位是压痛点的典型位置，也是硬度最低的部位。然而，根据压力测痛法，手动检测到的压痛点往往（29%）与最敏感的部位不同位。在上斜方肌中发现了压力疼痛敏感性和肌肉硬度的不均匀分布。直到精疲力竭的短时间运动并没有改变无症状肌肉的肌肉敏感性或肌肉硬度。
本研究证实了临床发现，即上斜方肌的疼痛敏感性和硬度存在异质性。开发能够客观识别压痛点的新技术很重要，但到目前为止，手动触诊是最佳的临床实践。
