Influence of latent trigger points in acute low back pain: a prospective longitudinal study

Authors

  • Marco Aurélio Nemitalla Added Irmandade da Santa Casa de Misericórdia de São Paulo
  • Diego Galace de Freitas Irmandade da Santa Casa de Misericórdia de São Paulo
  • Caroline Added Irmandade da Santa Casa de Misericórdia de São Paulo
  • Claudio Cazarini Junior Irmandade da Santa Casa de Misericórdia de São Paulo
  • Patrícia Maria de Moraes Barros Fucs Irmandade da Santa Casa de Misericórdia de São Paulo

DOI:

https://doi.org/10.11606/issn.2317-0190.v30i2a209429

Keywords:

Trigger Points, Low Back Pain, Rehabilitation

Abstract

Trigger points are muscle nodules that can lead to pain. Low back pain is an important problem of public health and studies point out all the people who suffer from spinal pain present trigger points. Objective: To analyze the pain level of the asymptomatic patients, with acute low back pain, who present latent trigger point, when compared to the pain level of the asymptomatic patients with acute low back pain who did not present latent trigger point. Method: 96 individuals of both genres, aged 18 to 60 years took part in a transversal, evaluator-blind study. Level pain, function, physical activity, kynesiophobia, algometer were analyzed and the gluteus maximus and gluteus medius muscles’ strength of the dominant limb and non-dominant were measured, at the moment the participants were asymptomatic and after developing acute back low pain. For statistical analysis, we considered significant value ≤ 0.05 Results: It was observed significant differences between the groups in relation to pain intensity (p= 0.01), functionality (p= 0.02), algometer (p= 0.05), gluteus maximus muscle dynamometry of the non- dominant limb (p= 0.05) and in the gluteus medius muscle of the dominant limb (p= 0.01) and non-dominant (p= 0.00). Conclusion: Asymptomatic individuals with latent trigger points in the paravertebral lumber muscles present worse pain intensity and other outcomes when it evolves to acute back pain if compared to individuals who don’t present trigger points at the moment they, are considered asymptomatic.

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References

Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-747. Doi: https://doi.org/10.1016/S0140-6736(16)30970-9

Nascimento PR, Costa LO. Low back pain prevalence in Brazil: a systematic review. Cad Saude Publica. 2015;31(6):1141-56. Doi: https://doi.org/10.1590/0102-311X00046114

Added MA, Costa LO, Freitas DG, Fukuda TY, Monteiro RL, Salomão EC, et al. Kinesio taping does not provide additional benefits in patients with chronic low back pain who receive exercise and manual therapy: a randomized controlled trial. J Orthop Sports Phys Ther. 2016;46(7):506-13. Doi: https://doi.org/10.2519/jospt.2016.6590

Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37. Doi: https://doi.org/10.1002/art.34347

Oshima RKA, Vanin AA, Nascimento JP, Kawchuk G, Costa LOP, Costa LDCM. Why do patients with low back pain seek care at emergency department? A cross-sectional study. Braz J Phys Ther. 2022;26(5):100444. Doi: https://doi.org/10.1016/j.bjpt.2022.100444

Oliveira IS, Tomazoni SS, Vanin AA, Araujo AC, Medeiros FC, Oshima RKA, et al. Management of acute low back pain in emergency departments in São Paulo, Brazil: a descriptive, cross-sectional analysis of baseline data from a prospective cohort study. BMJ Open. 2022;12(4):e059605. Doi: https://doi.org/10.1136/bmjopen-2021-059605

Ge HY, Fernández-de-Las-Peñas C, Madeleine P, Arendt-Nielsen L. Topographical mapping and mechanical pain sensitivity of myofascial trigger points in the infraspinatus muscle. Eur J Pain. 2008;12(7):859-65. Doi: https://doi.org/10.1016/j.ejpain.2007.12.005

Chiarotto A, Clijsen R, Fernandez-de-Las-Penas C, Barbero M. Prevalence of Myofascial Trigger Points in Spinal Disorders: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2016;97(2):316-37. Doi: https://doi.org/10.1016/j.apmr.2015.09.021

Dommerholt J, Fernandez-De-Las-Penas C. Trigger point dry needling: an evidence and clinical based approach. 2nd ed. London: Elsevier; 2019.

Malanga GA, Cruz Colon EJ. Myofascial low back pain: a review. Phys Med Rehabil Clin N Am. 2010;21(4):711-24. Doi: https://doi.org/10.1016/j.pmr.2010.07.003

Simons DG, Travell JG. Myofascial pain and dysfunction: the trigger point manual. 3rd ed. Philadelphia: Wolters Kluwer; 2019.

Simons DG. New views of myofascial trigger points: etiology and diagnosis. Arch Phys Med Rehabil. 2008;89(1):157-9. Doi: https://doi.org/10.1016/j.apmr.2007.11.016

Money S. Pathophysiology of Trigger Points in Myofascial Pain Syndrome. J Pain Palliat Care Pharmacother. 2017;31(2):158-9. Doi: https://doi.org/10.1080/15360288.2017.1298688

Barbero M, Schneebeli A, Koetsier E, Maino P. Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care. 2019;13(3):270-6. Doi: https://doi.org/10.1097/SPC.0000000000000445

Roach S, Sorenson E, Headley B, San Juan JG. Prevalence of myofascial trigger points in the hip in patellofemoral pain. Arch Phys Med Rehabil. 2013;94(3):522-6. Doi: https://doi.org/10.1016/j.apmr.2012.10.022

Samani M, Ghaffarinejad F, Abolahrari-Shirazi S, Khodadadi T, Roshan F. Prevalence and sensitivity of trigger points in lumbo-pelvic-hip muscles in patients with patellofemoral pain syndrome. J Bodyw Mov Ther. 2020;24(1):126-130. Doi: https://doi.org/10.1016/j.jbmt.2019.10.012

Costa LC, Maher CG, McAuley JH, Hancock MJ, Herbert RD, Refshauge KM, et al. Prognosis for patients with chronic low back pain: inception cohort study. BMJ. 2009;339:b3829. Doi: https://doi.org/10.1136/bmj.b3829

Costa LO, Maher CG, Latimer J, Ferreira PH, Ferreira ML, Pozzi GC, et al. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best? Spine (Phila Pa 1976). 2008;33(22):2459-63. Doi: https://doi.org/10.1097/BRS.0b013e3181849dbe

Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire--Brazil Roland-Morris. Braz J Med Biol Res. 2001;34(2):203-10. Doi: https://doi.org/10.1590/s0100-879x2001000200007

Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, et al. Questionário Internacional de Atividade Física (IPAQ): estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fis Saúde. 2001;6(2):5-18.

Ghisi GLM, Santos RZ, Felipe TR, Bonin CDB, Pinto EF, Guerra FEF, et al. Validation of the Portuguese version of the tampa scale for kinesiophobia heart (TSK-SV heart). Rev Bras Med Esporte. 2017;23(3):227-31. Doi: https://doi.org/10.1590/1517-869220172303159416

O'Neill S, Kjær P, Graven-Nielsen T, Manniche C, Arendt-Nielsen L. Low pressure pain thresholds are associated with, but does not predispose for, low back pain. Eur Spine J. 2011;20(12):2120-5. Doi: https://doi.org/10.1007/s00586-011-1796-4

Imamura M, Alfieri FM, Filippo TR, Battistella LR. Pressure pain thresholds in patients with chronic nonspecific low back pain. J Back Musculoskelet Rehabil. 2016;29(2):327-336. Doi: https://doi.org/10.3233/BMR-150636

Kollock RO Jr, Onate JA, Van Lunen B. The reliability of portable fixed dynamometry during hip and knee strength assessments. J Athl Train. 2010;45(4):349-56. Doi: https://doi.org/10.4085/1062-6050-45.4.349

Guimarães RP, Alves DPL, Silva GB, Bittar ST, Ono NK, Hon-da E, et al. Tradução e adaptação transcultural do instrumento de avaliação do quadril Harris Hip Score. Acta Ortop Bras. 2010;18(3):142-47. Doi: https://doi.org/10.1590/S1413-78522010000300005

Rabelo NDDA, Lucareli PRG. Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision-making process in patients with patellofemoral pain? Braz J Phys Ther. 2018;22(2):105-109. Doi: https://doi.org/10.1016/j.bjpt.2017.10.002

Tang Y, Li Y, Yang M, Zheng X, An B, Zheng J. The effect of hip abductor fatigue on knee kinematics and kinetics during normal gait. Front Neurosci. 2022;16:1003023. Doi: https://doi.org/10.3389/fnins.2022.1003023

Lluch E, Nijs J, De Kooning M, Van Dyck D, Vanderstraeten R, Struyf F, et al. Prevalence, incidence, localization, and pathophysiology of myofascial trigger points in patients with spinal pain: a systematic literature review. J Manipulative Physiol Ther. 2015;38(8):587-600. Doi: https://doi.org/10.1016/j.jmpt.2015.08.004

Simons DG, Travell JG, Simons LS, Cummings BD. Travell & Simons Myofascial Pain and Dysfunction: the trigger-point manual. 2nd ed. Baltimore: Lippincott, Williams and Wilkins; 1998.

Coelho DM, Barbosa RI, Pavan AM, Oliveira AS, Bevilaqua-Grossi D, Defino HLA. Prevalence of myofascial dysfunction in patients with low back pain. Acta Fisiatr. 2014;21(2):71-74. Doi: https://doi.org/10.5935/0104-7795.20140016

Added MAN, de Freitas DG, Kasawara KT, Martin RL, Fukuda TY. Strengthening the gluteus maximus in subjects with sacroiliac dysfunction. Int J Sports Phys Ther. 2018;13(1):114-120.

Lingutla KK, Pollock R, Ahuja S. Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis. Eur Spine J. 2016;25(6):1924-31. Doi: https://doi.org/10.1007/s00586-016-4490-8

Travell JG, Simons DG. Travell & Simons’ myofascial pain and dysfunction: the trigger point manual. Baltimore: Williams & Wilkins; 1999.

Published

2023-06-30

Issue

Section

Original Article

How to Cite

1.
Added MAN, Freitas DG de, Added C, Cazarini Junior C, Fucs PM de MB. Influence of latent trigger points in acute low back pain: a prospective longitudinal study. Acta Fisiátr. [Internet]. 2023 Jun. 30 [cited 2024 Jun. 4];30(2):97-104. Available from: https://revistas.usp.br/actafisiatrica/article/view/209429