Autonomic nerve regulation in joint hypermobility patients with myofascial trigger points by Musculoskeletal Interfiber Counterirritant Stimulation (MICS).

Joint hypermobility (JH) conditions suggest dysfunction in the autonomic nervous system (ANS) (dysautonomia), associated with multifactor non-articular local musculoskeletal pain, and remains a complex treatment. This study aims to determine the effects of musculoskeletal interfiber counterirritant stimulation (MICS) as an innovative treatment of myofascial trigger points (MTrPs) on the upper trapezius muscle in JH patients. We evaluate the ANS activity by wavelet transform spectral analysis of heart rate variability (HRV) in sixty women, equally divided: MTrP, MTrP + general joint hypermobility (GJH), and MTrP + joint hypermobility syndrome (JHS). The protocol phases were rest, stimulation, and recovery, with clinical and home treatment for three-days. All groups show a significantly decreased in pain perception during and post-treatment, and an increased parasympathetic ANS activity under MICS in the GJH and JHS groups. The variables low-frequency (LF) vs. high-frequency (HF) showed significant differences during the protocol phases, and the LF/HF ratio maintained a predominance of sympathetic activity (SA) throughout the protocol. The new MICS technique reduces the pain perception and modulates the ANS activity by an increase in vagal tone, and a decrease in sympathetic tone. This modulation was followed by an increase in the HRV in JH patients after treatment with MICS. Clinical Trials: RBR-88z25c5.

Mouth opening, jaw disability, neck disability, pressure pain thresholds, and myofascial trigger points in patients with disc displacement with reduction: A descriptive and comparative study.

OBJECTIVE: To assess jaw and neck function, pressure pain threshold (PPT), and the presence of trigger points (TrPs) in disc displacement with reduction (DDWR) subjects compared to healthy subjects. METHODS: One hundred DDWR subjects and 100 matched controls were studied. Clinical evaluations included demographic data, range of motion, jaw and neck disability, PPT, and muscle TrPs. RESULTS: DDWR subjects have limited pain-free opening limitation (p < 0.001), jaw and neck disability limitation (p < 0.001), and higher presence of active and latent TrPs limitation (p < 0.001) compared to healthy subjects. CONCLUSION: DDWR subjects present a limited pain-free mouth opening, higher jaw and neck disability, lower PPT, and major presence of active and latent TrPs compared to healthy subjects. Cervical spine and TMJ evaluation and treatment should be considered in DDWR patients.

Prevalencia de Dolor Miofascial en Músculos de la Masticación y Cervicales en un Centro Especializado en Trastornos Temporomandibulares y Dolor Orofacial / Prevalence of Myofascial Pain in Masticatory and Neck Muscles in a Specialized Center of Temporomandibular Disorders and Orofacial Pain

El dolor miofascial es una patología muscular regional no inflamatoria que en el territorio craneocervical se encuentra clasificada dentro de los Trastornos Temporomandibulares. Afecta al 95% de las personas con trastornos de dolor crónico y es un hallazgo común en pacientes en tratamiento en centros de dolor. Se revisaron 121 fichas de pacientes atendidos en el policlínico de Trastornos Temporomandibulares y Dolor Orofacial de la Universidad de La Frontera, Temuco-Chile, identificando la prevalencia de dolor miofascial y su asociación con la edad y sexo de los pacientes. El 80,99% de los pacientes presentó dolor miofascial, el músculo masetero fue el más afectado, seguido por los músculos temporal y trapecio superior, siendo frecuente la afectación bilateral y simultánea de diferentes músculos. La presencia de dolor miofascial no se asocia a la edad de los pacientes pero si al sexo de estos, donde las mujeres presentan más frecuentemente esta patología. Es importante realizar un correcto diagnóstico de dolor miofascial en pacientes que acuden por dolor en este territorio y más aún es trascendental tomar conciencia de su elevada prevalencia.

Myofascial pain is a noninflammatory regional muscle pathology, in craniocervical territory it is classified as temporomandibular disorder. Myofascial pain affects 95% of people with chronic pain disorders and is a common finding in pain centers. One hundred twenty-one charts of patients seen at the clinic of Temporomandibular Disorders and Orofacial Pain at the Universidad de La Frontera Temuco-Chile, were reviewed, identifying the prevalence of myofascial pain and its association with age and sex of the patients. In 80.99% of patients myofascial pain was present, the masseter muscle was the most affected, followed by the temporal and upper trapezius muscles, with frequent bilateral and simultaneous involvement of different muscles. The presence of myofascial pain is not associated with patient age but it is associated with the sex of these, where women have this condition more often. It is important to make a correct diagnosis of myofascial pain in patients presenting with pain in this area and it is even more crucial to be aware of its high prevalence.

Changes in Clinical Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study.

Complementary and alternative medicine approaches to treatment for tension-type headache are increasingly popular among patients, but evidence supporting its efficacy is limited. The objective of this study was to assess short term changes on primary and secondary headache pain measures in patients with tension-type headache (TTH) receiving a structured massage therapy program with a focus on myofascial trigger point therapy. Participants were enrolled in an open label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week phases) and follow-up. Twice weekly, 45-minute massage sessions commenced following the baseline phase. A daily headache diary was maintained throughout the study in which participants recorded headache incidence, intensity, and duration. The Headache Disability Index was administered upon study entry and at 3-week intervals thereafter. 18 subjects were enrolled with 16 completing all headache diary, evaluation, and massage assignments. Study participants reported a median of 7.5 years with TTH. Headache frequency decreased from 4.7+/-0.7 episodes per week during baseline to 3.7+/-0.9 during treatment period 2 (P<0.001); reduction was also noted during the follow-up phase (3.2+/-1.0). Secondary measures of headache also decreased across the study phases with headache intensity decreasing by 30% (P<0.01) and headache duration from 4.0+/-1.3 to 2.8+/-0.5 hours (P<0.05). A corresponding improvement in Headache Disability Index was found with massage (P<0.001). This pilot study provides preliminary evidence for reduction in headache pain and disability with massage therapy that targets myofascial trigger points, suggesting the need for more rigorously controlled studies.