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Muscle Tenderness (muscle + tenderness)
Kinds of Muscle Tenderness Selected AbstractsPericranial injection of botulinum toxin type A (Dysport®) for tension-type headache , A multicentre, double-blind, randomized, placebo-controlled studyEUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2008A. Straube Increasingly, botulinum type A toxin is used to influence pathologically increased muscle activity in conditions such as dystonia and spasticity. Studies have also assessed its efficacy in tension-type headache, where muscle tenderness may be increased. We undertook a prospective, multicentre, randomized, double-blind, placebo-controlled trial. Patients received injections of Dysport® (total dose of 420 or 210 units) or saline placebo in 18 sites on the head and neck. Of 125 patients treated, 118 were included in the intention-to-treat dataset. No significant differences between each verum group and placebo were seen for the primary efficacy parameter , change in the number of headache-free days at 4,8 weeks after injection compared with 4 weeks before injection. The groups receiving 420 or 210 units of Dysport experienced 2.60 and 2.87 more headache-free days respectively, compared with 1.93 more headache-free days for the placebo group (P = 0.66 versus 420 units; P = 0.52 versus 210 units). Treatment with 420 units of Dysport was associated with significant improvements compared with placebo for two secondary efficacy parameters: mean change in headache duration from baseline to weeks 8,12 (P < 0.05) and improved global physician and patient assessment scores (P < 0.05). Further studies should address the possible value of multiple injections with extended observation periods, dose optimization, and whether duration of headache history and number of previous treatments are predictors of patient response. [source] Side-to-side differences in pressure pain thresholds and pericranial muscle tenderness in strictly unilateral migraineEUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2008C. Fernández-de-las-Peñas Previous studies dealing with pressure pain sensitivity or muscle tenderness in migraine have shown conflicting results. Our aim was to explore the differences in mechanical pain sensitivity and pericranial muscle tenderness between patients with unilateral migraine and healthy controls, and to analyse side-to-side differences in both study groups. Pressure pain thresholds (PPT) at cephalic and neck points, plus local and total tenderness scores were blindly assessed in 25 patients with strictly unilateral migraine and 25 healthy subjects. For PPT in the neck there were significant differences between groups (F = 47.029; P < 0.001) and sides (F = 6.363; P < 0.01), and a significant interaction between group and side (F = 5.201; P = 0.02), while PPT in the cephalic point showed differences between groups (F = 11.774; P < 0.001), but not sides (F = 2.838; P = 0.1). The total tenderness score showed significant differences between groups (F = 6.800; P < 0.01) and sides (F = 17.699; P < 0.001), along with a significant interaction between group and side (F = 14.420; P < 0.001). Patients had lower PPT and increased pericranial tenderness on the symptomatic side as compared with the non-symptomatic side and to either side in controls (P < 0.001), whereas no significant differences were identified between the non-symptomatic side and controls (P > 0.9). In migraine patients, PPT levels and muscle tenderness scores were negatively correlated (P < 0.001). The enhancement of local tenderness scores was related to hyperesthesia of specific muscles (sternocleidomastoid, suboccipital, and temporalis) rather than a generalized pericranial tenderness. Future studies should investigate the neuro-physiological basis for the laterality of allodynic and hyperalgesic responses in unilateral migraine. [source] Dynamic Assessment of Abnormalities in Central Pain Transmission and Modulation in Tension-type Headache SufferersHEADACHE, Issue 2 2000Jonathan D. Neufeld PhD Objective.,To examine and compare central pain processing and modulation in young tension-type headache sufferers with that of matched healthy controls using an induced headache "challenge" paradigm. Background.,Recent research has suggested that abnormalities in central pain processing and descending pain modulation may contribute to chronic tension-type headache. These abnormalities, if they contribute to headache pathogenesis, should be present in young adult tension-type headache sufferers. Recent research using static measures of physiological variables, such as muscle tenderness and exteroceptive suppression, has identified chronic muscle tenderness as a characteristic of young tension-type headache sufferers, but other central nervous system functional abnormalities may require a dynamic "challenge" to be observed. Methods.,Twenty-four young women meeting the International Headache Society diagnostic criteria for tension-type headache (headache-prone) and a matched group of 24 healthy women who reported fewer than 10 problem headaches per year (control) participated in a double-blind, placebo-controlled, crossover study. Subjects completed jaw clenching and a placebo condition on different days in counterbalanced order. Pericranial muscle tenderness, pressure-pain thresholds on the temporalis, and exteroceptive suppression periods were assessed before and after each procedure. Head pain was recorded for 12 to16 hours following each condition. Results.,Headache-prone subjects were more likely than controls to experience headaches after both the jaw clenching and placebo procedures, but neither group was significantly more likely to experience headaches following jaw clenching than placebo. In pretreatment measurements, headache-prone subjects exhibited greater muscle tenderness than controls, but pressure-pain detection thresholds and exteroceptive suppression periods did not differ in the two groups. Control subjects showed increases in muscle tenderness and exteroceptive suppression periods following both the clenching and placebo procedures, whereas headache-prone subjects exhibited no significant changes in any of the physiological measures following either experimental manipulation. Conclusions.,These results confirm previous findings indicating abnormally high pericranial muscle tenderness in young tension headache sufferers even in the headache-free state. In addition, the results suggest that the development of headaches following noxious stimulation is more strongly related to headache proneness and associated abnormalities in central pain transmission or modulation (indexed by pericranial muscle tenderness and exteroceptive suppression responses) than muscle strain induced by jaw clenching. [source] The prevalence of temporomandibular disorders in patients with psoriasis with or without psoriatic arthritisJOURNAL OF ORAL REHABILITATION, Issue 11 2005E. DERVIS summary, Psoriasis is a chronic, genetic, non-contagious skin disorder that appears in many different forms and can affect any part of the body, including the nails and scalp. It may affect the quality of life by causing psychosocial stress. Psoriatic arthritis (PA) is considered to be a spondyloarthropathy, and has spinal and peripheral joint involvement associated with psoriasis. The purpose of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with psoriasis without PA and in patients with PA and compare with a healthy group. Signs and symptoms of TMD were evaluated by means of Helkimo's Anamnestic (Ai) and Dysfunction indices (Di). In the present study, patients with psoriasis without arthritis did not report TMD signs and symptoms significantly more often than healthy subjects. A statistically significant increase was found in patients with PA when compared with psoriasis patients without arthritis and healthy patients in Di. In patients with PA, muscle tenderness on palpation, temporomandibular joint sounds and stiffness/tiredness in jaws in the morning were the most frequent findings. It is concluded that the signs and symptoms of TMD in PA is caused mainly by related joint involvement that directly affects the masticatory system. [source] The diagnostic value of pressure algometry in myofascial pain of the jaw musclesJOURNAL OF ORAL REHABILITATION, Issue 1 2000M. Farella Recent evidence suggests that evaluation of muscle tenderness in temporomandibular disorders (TMDs) patients might be improved by the use of pressure algometry; nevertheless, the evaluation of the diagnostic value of this tool has received little attention. The aim of this study was to assess the diagnostic value of pressure algometry in myofascial pain of the jaw muscles, by calculation of sensitivity (Se), specificity (Sp) and positive predictive values (PPV). Pressure pain thresholds (PPTs) of masseter and anterior temporalis muscles were assessed in 40 female myogenous TMD patients and 40 age-matched female controls. PPTs were significantly lower (P<0·001) in TMD patients than in control subjects for both masseter and temporalis muscles, being 40,50% of the control values. Setting a cutoff value 1 s.d. below the mean PPT values of control subject, sensitivity and specificity were 0·67 and 0·85, respectively, for the masseter muscle and 0·77 and 0·87, respectively, for the temporalis muscle. When taking into account the prevalences of myofascial pain in the general population and in TMD clinics, the PPV ranged from 0·5 to 0·7. As a result of the low PPV, pressure algometry has strong limitations when used as a solitary diagnostic tool. [source] Importance of Pelvic Muscle Tenderness Evaluation in Women with Chronic Pelvic PainPAIN MEDICINE, Issue 2 2010Mary Lourdes Lima De Souza Montenegro MD Abstract Objective., To determine the prevalence of pelvic muscle tenderness in women with chronic pelvic pain (CPP) and to assess the importance of evaluating muscle tenderness in such women. Design., Observational study of 48 healthy female volunteers and 108 women with CPP, who were clinically evaluated for pelvic muscle tenderness by two researchers blinded to all clinical data. Results., The frequency of clinically detected pelvic muscle tenderness was significantly higher in women with CPP than in healthy volunteers (58.3% vs 4.2%, P < 0.001). Among women with CPP, those with pelvic muscle tenderness had higher Beck Depression Index scores (22 [6,42] vs 13 [3,39], P = 0.02) and higher rates of dyspareunia (63.5% [40/63] vs 28.9% [13/45], P < 0.004) and constipation (46.0% [29/63] vs 26.7% [12/45], P = 0.05) than those without pelvic muscle tenderness. Conclusion., Tenderness of pelvic muscles was highly prevalent among women with CPP and was associated with higher BDI scores and higher rates of dyspareunia and constipation. Determination of pelvic muscle tenderness may help in identifying women who require more intense treatment for CPP. [source] | ||||||||||