Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.
Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark.
Pain Med. 2017 Dec 1;18(12):2485-2491. doi: 10.1093/pm/pnx130.
Previous studies suggest that trigger points (TrPs) contribute to migraine pain, but no data is available on the effects of TrPs on pressure pain sensitivity. Our objective was to investigate the association between the number of TrPs and widespread pressure hypersensitivity in women with episodic migraines.
Ninety-five women with episodic migraines participated. Clinical features of migraines, that is, intensity, duration, frequency, and onset, were collected. Active and latent TrPs were bilaterally explored in the temporalis, masseter, suboccipital, sternocleidomastoid, upper trapezius, and splenius capitis musculature. Pressure pain thresholds (PPTs) were assessed over the trigeminal area (i.e., temporalis muscle), extratrigeminal (i.e., C5/C6 zygapophyseal joint), and a distant pain-free point (i.e., tibialis anterior muscle).
Active TrPs in the temporalis and upper trapezius muscles were the most prevalent. The number of active but not latent TrPs was significantly and negatively associated with PPTs: the higher the number of active TrPs, the lower the widespread PPT and the more generalized sensitization.
This study found that the number of active but not latent TrPs in head and neck and shoulder muscles was associated with widespread pressure hypersensitivity in women with episodic migraines, suggesting a potential contribution of active TrPs as contributors for sensitization processes in migraines.
既往研究提示触发点(TrPs)与偏头痛疼痛有关,但尚无 TrPs 对压痛敏度影响的数据。本研究旨在调查发作性偏头痛女性的 TrPs 数量与广泛压痛敏化之间的相关性。
95 例发作性偏头痛女性参与本研究。收集偏头痛的临床特征,即强度、持续时间、频率和发作起始。双侧颞肌、咬肌、枕下肌、胸锁乳突肌、上斜方肌和头夹肌中探查活动性和潜伏性 TrPs。评估三叉神经分布区(即颞肌)、三叉神经分布区以外(即 C5/C6 关节突关节)和远离疼痛区的压痛阈(PPT)。
颞肌和上斜方肌的活动性 TrPs 最为常见。活动性 TrPs 数量与 PPT 呈显著负相关,但潜伏性 TrPs 数量与 PPT 无相关性:活动性 TrPs 数量越多,广泛 PPT 值越低,且敏化越广泛。
本研究发现头颈部和肩部肌肉的活动性 TrPs 数量与发作性偏头痛女性的广泛压痛敏化相关,提示活动性 TrPs 可能作为偏头痛敏化过程的促成因素之一。