Presented at the 2013 AAPM Annual Meeting « Back

Prevalence of Myofascial Tender and Trigger Points in Patients Presenting with Cervico-Thoracic and Lumbro-Sacral Spine Related Pain: Preliminary Results

Mehul J. Desai, MD MPH, mdesai@mfa.gwu.edu¹, Emily P. Harmon, BS², Andrew Nava, MD³, (1) GW Spine & Pain Center, Washington, D.C., (2) George Washington University School of Medicine, Washington, D.C., (3) George Washington University, Washington, D.C.

Background: Spinal pathology may predispose to the development of tender (TP) and trigger (TrP) points. To correlate specific spinal diagnoses with associated TP and TrPs, we quantified the prevalence of those points based on referral patterns in patients with cervico-thoracic and lumbro-sacral spine pain. Design/Methods: Following IRB approval, we performed a prospective, observational study of 50 subjects presenting with cervico-thoracic or lumbro-sacral spine pain. Algometery was used to obtain pain-pressure threshold measurements of 10 muscles of the upper extremity (UE) and neck and 6 muscles of the lower extremity (LE). Results: Of patients with cervico-thoracic pain, 61% were found to have TP and/or TrP in specific muscles. Patients with lesions in C3-C4 presented more commonly with both TP and TrP located in the deltoid, trapezius, pectoralis major and triceps brachii; C5-C6 lesions with TP in the latissimus dorsi; C5-C6 lesions with TrP in biceps brachii and pectoralis major; and C6-C7 lesions with TP in the pectoralis major, latissimus dorsi and triceps brachii. Of patients with lumbro-sacral pain, 58% were found to have TP and/or TrP in specific muscles. Patients with lesions in L4-L5 presented more commonly with both TP and TrP located in the gluteus maximus; and L5-S1 lesions with both TP and TrP in the gluteus maximus. The majority of diagnoses included spondylosis, degenerative disc disease, disc bulging, and spinal stenosis. Conclusion: TP and TrP of selected UE and LE muscles appear to correlate to spinal pathology. We expect to enroll a minimum of 100 subjects in this trial.

Funding: None.