Castaldo Matteo, Catena Antonella, Chiarotto Alessandro, Villafañe Jorge H, Fernández-de-Las-Peñas César, Arendt-Nielsen Lars
Poliambulatorio FisioCenter, Collecchio, Parma.
SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
Clin J Pain. 2018 Feb;34(2):95-103. doi: 10.1097/AJP.0000000000000532.
To investigate the association between pain, disability, trigger points (TrPs), and pressure pain thresholds (PPTs) in patients with mechanical neck pain (MNP) or whiplash-associated disorders (WAD).
In total, 46 MNP and 51 WAD patients underwent a physical examination consisting of cervical range of motion, PPTs in the upper trapezius and tibialis anterior muscles, TrPs examination in the upper trapezius, and collection of clinical data including disability, pain intensity, and spontaneous symptomatic pain area.
A significantly moderate positive association between pain and disability was found in both groups (P<0.01). Significantly negative associations between pain intensity and PPT in the upper trapezius (P=0.008 and 0.041), pain and PPT in tibialis anterior (P=0.015 and 0.038), disability and PPT in upper trapezius (both, P=0.006) were also found in both MNP and WAD groups. Individuals with MNP showed significantly positive association between pain area and disability (P=0.034) and negative association between disability and PPT in the tibialis anterior (P=0.003). Patients with active TrPs in the upper trapezius exhibited higher intensity of neck pain, higher neck disability, and lower PPTs than those with latent TrPs in upper trapezius in both groups.
The association between pain, disability, and PPTs is common in patients with neck pain regardless of the origin of neck pain. The presence of active TrPs was related to higher pain intensity and related-disability and lower PPTs.
探讨机械性颈部疼痛（MNP）或挥鞭样损伤相关疾病（WAD）患者的疼痛、功能障碍、触发点（TrP）和压痛阈值（PPT）之间的关联。
总共46例MNP患者和51例WAD患者接受了体格检查，包括颈椎活动范围、斜方肌上部和胫骨前肌的PPT、斜方肌上部的TrP检查，并收集了包括功能障碍、疼痛强度和自发症状性疼痛区域在内的临床数据。
两组中均发现疼痛与功能障碍之间存在显著的中度正相关（P<0.01）。在MNP组和WAD组中，还发现斜方肌上部的疼痛强度与PPT之间存在显著的负相关（P=0.008和0.041），胫骨前肌的疼痛与PPT之间存在显著的负相关（P=0.015和0.038），斜方肌上部的功能障碍与PPT之间存在显著的负相关（两者均为P=0.006）。MNP患者的疼痛区域与功能障碍之间存在显著的正相关（P=0.034），胫骨前肌的功能障碍与PPT之间存在负相关（P=0.003）。在两组中，斜方肌上部有活动性TrP的患者比斜方肌上部有潜伏性TrP的患者表现出更高的颈部疼痛强度、更高的颈部功能障碍和更低的PPT。
无论颈部疼痛的起源如何，疼痛、功能障碍和PPT之间的关联在颈部疼痛患者中都很常见。活动性TrP的存在与更高的疼痛强度、相关功能障碍和更低的PPT有关。
