Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Pain Med. 2019 Jul 1;20(7):1379-1386. doi: 10.1093/pm/pnz020.
The presence of trigger points (MTrPs) and pressure pain sensitivity has been well documented in subjects with neck and back pain; however, it has yet to be examined in people with upper thoracic spine pain. The purpose of this study was to investigate the presence of MTrPs and mechanical pain sensitivity in individuals with upper thoracic spine pain.
Seventeen subjects with upper thoracic spine pain and 17 pain-free controls without spine pain participated. MTrPs were examined bilaterally in the upper trapezius, rhomboid, iliocostalis thoracic, levator scapulae, infraspinatus, and anterior and middle scalene muscles. Pressure pain thresholds (PPTs) were assessed over T2, the C5-C6 zygapophyseal joint, the second metacarpal, and the tibialis anterior.
The numbers of MTrPs between both groups were significantly different (P < 0.001) between patients and controls. The number of MTrPs for each patient with upper thoracic spine pain was 12.4 ± 2.8 (5.7 ± 4.0 active TrPs, 6.7 ± 3.4 latent TrPs). The distribution of MTrPs was significantly different between groups, and active MTrPs within the rhomboid (75%), anterior scalene (65%), and middle scalene (47%) were the most prevalent in patients with upper thoracic spine pain. A higher number of active MTrPs was associated with greater pain intensity and longer duration of pain history.
This study identified active MTrPs and widespread pain hypersensitivity in subjects with upper thoracic spine pain compared with asymptomatic people. Identifying proper treatment strategies might be able to reduce pain and improve function in individuals with upper thoracic spine pain. However, future studies are needed to examine this.
触发点（MTrPs）和压痛敏感受已在颈背部疼痛患者中得到充分证实；然而，在上胸段脊柱疼痛患者中尚未进行过研究。本研究旨在调查上胸段脊柱疼痛患者中 MTrPs 和机械性疼痛敏感受的存在情况。
17 例上胸段脊柱疼痛患者和 17 例无脊柱疼痛的无症状对照者参与了研究。双侧上斜方肌、菱形肌、胸髂肋肌、肩胛提肌、肩胛下肌、前中斜角肌的 MTrPs 进行了检查。在 T2、C5-C6 关节突关节、第二掌骨和胫骨前肌评估压痛阈值（PPTs）。
两组之间的 MTrPs 数量存在显著差异（P<0.001）。每位上胸段脊柱疼痛患者的 MTrPs 数量为 12.4±2.8（5.7±4.0 个活跃 TrPs，6.7±3.4 个潜伏 TrPs）。上胸段脊柱疼痛患者与对照组之间 MTrPs 的分布存在显著差异，且活跃的 MTrPs 在菱形肌（75%）、前斜角肌（65%）和中斜角肌（47%）中的分布最为普遍。活跃的 MTrPs 数量较多与疼痛强度较大和疼痛病史较长有关。
与无症状者相比，本研究在上胸段脊柱疼痛患者中发现了活跃的 MTrPs 和广泛的疼痛敏感受。确定适当的治疗策略可能能够减轻上胸段脊柱疼痛患者的疼痛并改善其功能。然而，需要进一步的研究来检验这一点。
