Chronic whiplash and central sensitization; an evaluation of the role of a myofascial trigger points in pain modulation.

摘要: it has been established that chronic neck pain following whiplash is associated with the phenomenon of central sensitization, in which injured and uninjured parts body exhibit lowered thresholds due to an alteration processing. furthermore hypothesized peripheral sources nociception muscles may perpetuate sensitization whiplash. hypothesis explored present study was whether myofascial trigger points serve as a modulator subjects pain. controlled case series. outpatient clinic. seventeen patients intractable 10 healthy controls without complaints symptomatic received anesthetic infiltration upper trapezius thigh. Outcome measures: pre post injection cervical range motion, pressure (ppt) over infraspinatus, wrist extensor, tibialis anterior muscles. sensitivity light (photophobia) subjects' perception using visual analog scale (vas) were also evaluated before after injections. only ppt asymptomatic controls. immediate (within 1 minute) alterations motion observed average 3.8 injections 1–2 cc 1% lidocaine into carefully identified points. increased by 49% (p = 0.000) flexion 44% 0.001) extension, 47% 28% < 0.016) right left lateral flexion, 27% 0.002) 45% rotation. found 68% infraspinatus 0.000), 78% extensors 64% 0.002). among 11 photophobia, 2 remained sensitive point 0.033). vas dropped 57%, from 6.1 2.6 0.000). no significant changes control group data suggest tissues. additionally, appears can be immediately reversed, even when long standing although effects resulting anesthesia temporary, possible surgical excision or ablation same offer more permanent solutions for patients. further needed evaluate these other options such