Presented at the 2013 AAPM Annual Meeting « Back

A Controlled Study of the Relationship Between the Gluteal Trigger Point and Lumbosacral Radiculopathy

Farhad Adelmanesh, MD, farhadadelmanesh@yahoo.com¹, Ali Jalali, MD¹, Gholam Reza Raissi¹, Seyed Mostafa Jazayeri Shooshtari, MD², Seyed Mehdi Ketabchi, MD¹, (1) Tehran University of Medical Sciences, Tehran, Iran, (2) Iranian Board of PM&R, Shiraz, Fars, Iran

Introduction: Based on our clinical experience, many patients with lumbosacral radiculopathy will have trigger points on their gluteal area. The objective of this study was to quantify and compare the presence of the gluteal trigger point (GTrP) between patients with lumbosacral radiculopathy and healthy volunteers. Materials and methods: In a multistage sampling method from September 2010 to February 2012, all the patients with history, symptoms, signs, electromyographic and MRI findings consistent with lumbosacral radiculopathy, referred to a tertiary multidisciplinary pain clinic, were examined for the presence of GTrP. Age- and sex-matched clusters of healthy hospital staff were selected as the control group. Presence of pain in the upper outer quadrant of the gluteal region in response to 2-9 kg/cm2 of pressure administered by means of an algometer was considered as a positive GTrP. This cross sectional study was approved by the ethical committee of the University. Results: Prevalence of GTrP was 76.4% in 271 patients versus 1.9% in 152 healthy volunteers (p <0.001). Monte Carlo test revealed significant correlation between the side of GTrP and the side of patients’ pain (p <0.001). Cross tabulation between the side of pain and GTrP was assessed and revealed Phi=0.684 and Cramer’s V =0.679. Conclusions: The prevalence of GTrP is higher in patients with lumbosacral radiculopathy. There is a direct correlation between the side of the patients’ pain and side of GTrP. The diagnostic significance of GTrP as a sign in lumbosacral radiculopathy, and its value in pain management of these patients should be evaluated. References: 1) Harden RN, Bruehl SP, Gass S et al. Signs and symptoms of the myofascial pain syndrome: a national survey of pain management providers. Clinical Journal of Pain 2000;16:64-72. 2) Alvarez DJ, Rockwell PG. Trigger points: Diagnosis and management. American family physician 2002;65:653-660. 3) Hong C-Z. Muscle pain syndromes. In: Braddom RL, Chan L, Harrast MA editors. Physical Medicine and Rehabilitation. Philadelphia: Saunders, 2011. P. 971.

Funding: None

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