Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?

AYDOĞ, Ece; Aktas, Ilknur; KÜLCÜ GELER, Duygu; Ozturk, Gulcan

Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?

Gülcan ÖZTÜRK, (Gebze Fatih Devlet Hastanesi, Fiziksel ve Rehabilitasyon Klinik, Kocaeli, Türkiye)

Duygu KÜLCÜ GELER, (Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, Türkiye)

İlknur AKTAŞ, (Sağlık Bakanlığı, Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, Türkiye)

Ece AYDOĞ (Yeditepe Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye)

Türk Osteoporoz Dergisi

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Yıl: 2016 Cilt: 22 Sayı: 1 Sayfa Aralığı: 24 - 28 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?

Öz:

Amaç: Bu çalışmanın amacı boyun ve sırt ağrısı olan hastalarda miyofasiyal tetik nokta ve servikal disk hernisi birlikteliğini araştırmaktır.Gereç ve Yöntem: Bu retrospektif çalışmaya, sadece miyofasiyal tetik noktası olan 30 hasta (grup 1), sadece servikal disk hernisi olan 46 hasta (grup 2), hem miyofasiyal tetik nokta hem servikal disk hernisi olan 147 hasta (grup 3) toplam 223 (151 kadın/72 erkek; yaş ortalaması 38,2±10,1 yıl) hasta dahil edildi. Bulgular: Çalışmaya dahil edilen hastaların 38'inde radikülopati tespit edildi. Bunların 27'sinde miyofasiyal tetik nokta mevcuttu. Grup 2 ve 3 arasında servikal disk hernisi seviyesi (p=0,275) ve derecesi (p=0,188) arasında istatistiksel anlamlı fark yoktu. Grup 1 ve 3 arasında miyofasiyal tetik nokta lokalizasyonu (p=0,684) açısından istatistiksel anlamlı fark yoktu. Grup 3'te servikal disk hernisi ve sinir basısı düzeyine göre miyofasiyal tetik nokta lokalizasyonunda istatistiksel anlamlı fark yoktu. Sonuç: Miyofasiyal tetik nokta ve servikal disk hernisi birlikteliği sıktır. Boyun ve sırt ağrılarının tedavisinde ağrının esas kaynağının miyofasiyal tetik nokta, servikal disk hernisi veya ikisinin birlikteliği olup olmadığı tespit edilmelidir

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Miyofasiyal Tetik Nokta ve Servikal Disk Hernisi Birlikteliği: Hangisi Ağrının Esas Kaynağı?

Öz:

Objective: The aim of this study was to investigate the coexistence of myofascial trigger points (MTrPs) and cervical disc herniations (CDH) in patients with neck and upper back pain.Materials and Methods: In this retrospective study, patients having only MTrPs were defined as group-1, patients having only CDH were defined as group-2, patients having both MTrPs and CDH were defined as Group-3. Two hundred twenty three patients (151 females/72 males; mean age 38.2±10.1 years) were enrolled in this study. There were 30 patients in group 1, 46 patients in group 2, 147 patients in group 3.Results: Thirty eight patients had radiculopathy, 27 of them had MTrP(s). There was no significant difference in terms of CDH level (p=0.275) and degree of herniation (p=0.188) between groups 2 and 3. There was no significant difference in terms of MTrP localisation (p=0.684) between groups 1 and 3. There was no significant difference in terms of MTrP localisations according to CDH level and nerve root compression level in groups 3.Conclusion: MTrP and CDH coexistence is frequent. Management of the pain in the upper back region should be based on whether if the pain originates from MTrP, CDH or both

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Alvarez D, Rockwell P. Trigger points: Diagnosis and management. Am Fam Physician 2002;65:653-60.
Simons DG, Travell JG, Simons LS. Myofascial pain and dysfunction: the trigger point manual. Baltimore: Williams&Wilkins, 1999.
Ruch TC. Pathophysiology of pain. In: Ruch TC, Patton HD, editor. Physiology and biophysics. Philadelphia: Saunders; 1965.p.345- 63.
Mense S. Referral of muscle pain. Am Pain Society J. 1994;3:1-9.
Giamberardino M. Referred muscle pain/hyperalgesia and central sensitisation. J Rehabil Med 2003;41:85-8.
Farasyn A. Referred muscle pain is primarily peripheral in origin: The "barrier-dam" theory. Med Hypotheses 2007;68:144-50.
Trigger Point Formation. Advanced Therapy Instıtute. 2006. Available from: www.advancesintherapy.com/.
Ohnmeiss DD, Vanharanta H, Ekholm J. Degree of disc disruption and lower extremity pain. Spine 1995;22:1600-5.
Rao R. Clinical syndromes of neck pain and cervical radiculopathy. In: Rothman RH, Simeone FA editor. The Spine. Philadelphia: WB Saunders Co; 2006.p.775-84.
Bogduk N. Innervation and pain patterns of the cervical spine. In: Grant R, editor. Physical Therapy of the Cervical and Thoracic Spine. New York: Churchill Livingstone; 2002.p.61-72.
Fernandez-de-Las Penas C Fernandez J, Miangolarra JC. Musculoskeletal disorders in mechanical neck pain: Myofascial trigger points versus cervical joint dysfunctions. A clinical study. J Musculoskel Pain 2005;13:27-35.
Dwyer A, April C, Bogduk N. Cervical zygapophyseal joint pain patterns I: A study in normal volunteers. Spine 1990;15:453-7.
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. Manipulative Physiol Ther 2015;38:587-600.
Slipman CW, Plastaras C, Patel R, Isaac Z, Chow D, Garvan C, et al. Provocative cervical discography symptom mapping. Spine J 2005;5:381-8.
Fernandez-de-Las-Penas C, Alonso-Blanco C, Miangolarra JC. Myofascial trigger points in subjects presenting with mechanical neck pain: A blinded, controlled study. Man Ther 2007;12:29-33.
De Palma MJ, Slipman CW. Treatment of common neck problems. In: Braddom RL editor. Physical Medicine and Rehabilitation 3rd editon. Philadelphia: WB Saunders Co; 2007.p.797-825.
Yunus MB. Fibromyalgia syndrome and myofascial pain syndrome: Clinical features, laboratory tests, diagnosis, and pathophysiologic mechanisms. In: Rachlin ES, editor. Myofascial pain and fibromyalgia: Trigger point management. St Louis: Mosby; 1994.p.3-29.
Cannon DE, Dillingham TR, Miao H, Andary MT, Pezzin LE. Musculoskeletal disorders in referrals for suspected cervical radiculopathy. Arch Phys Med Rehabil 2007;86:1256-9.
Sarı H, Akarırmak Ü, Uludağ M. Active myofascial trigger points might be more frequent in patients with cervical radiculopathy. Eur J Phys Rehabil Med 2012;48:237-44.

APA	Ozturk G, KÜLCÜ GELER D, Aktas I, AYDOĞ E (2016). Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. , 24 - 28.
Chicago	Ozturk Gulcan,KÜLCÜ GELER Duygu,Aktas Ilknur,AYDOĞ Ece Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. (2016): 24 - 28.
MLA	Ozturk Gulcan,KÜLCÜ GELER Duygu,Aktas Ilknur,AYDOĞ Ece Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. , 2016, ss.24 - 28.
AMA	Ozturk G,KÜLCÜ GELER D,Aktas I,AYDOĞ E Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. . 2016; 24 - 28.
Vancouver	Ozturk G,KÜLCÜ GELER D,Aktas I,AYDOĞ E Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. . 2016; 24 - 28.
IEEE	Ozturk G,KÜLCÜ GELER D,Aktas I,AYDOĞ E "Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?." , ss.24 - 28, 2016.
ISNAD	Ozturk, Gulcan vd. "Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?". (2016), 24-28.

APA	Ozturk G, KÜLCÜ GELER D, Aktas I, AYDOĞ E (2016). Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. Türk Osteoporoz Dergisi, 22(1), 24 - 28.
Chicago	Ozturk Gulcan,KÜLCÜ GELER Duygu,Aktas Ilknur,AYDOĞ Ece Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. Türk Osteoporoz Dergisi 22, no.1 (2016): 24 - 28.
MLA	Ozturk Gulcan,KÜLCÜ GELER Duygu,Aktas Ilknur,AYDOĞ Ece Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. Türk Osteoporoz Dergisi, vol.22, no.1, 2016, ss.24 - 28.
AMA	Ozturk G,KÜLCÜ GELER D,Aktas I,AYDOĞ E Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. Türk Osteoporoz Dergisi. 2016; 22(1): 24 - 28.
Vancouver	Ozturk G,KÜLCÜ GELER D,Aktas I,AYDOĞ E Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?. Türk Osteoporoz Dergisi. 2016; 22(1): 24 - 28.
IEEE	Ozturk G,KÜLCÜ GELER D,Aktas I,AYDOĞ E "Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?." Türk Osteoporoz Dergisi, 22, ss.24 - 28, 2016.
ISNAD	Ozturk, Gulcan vd. "Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?". Türk Osteoporoz Dergisi 22/1 (2016), 24-28.