Effect of muscle strengthening on perceived pain and static knee angles in young subjects with patellofemoral pain syndrome

The purpose of this pilot study was to determine the effects of strength training of the knee muscles on perceived pain and static knee angles in young subjects with patellofemoral pain syndrome (PFPS). Ten pa-tients, 100% female (mean age, 18.2\ub13.8 years), with unilateral PFPS (anterior knee pain for at least 3 months), received muscle strengthen-ing of the hip and knee (10 sessions over a period of 3 weeks). The out-come measures were perceived pain (visual analogue scale, VAS) and static knee angles (knee rotation measurer). All measures were collect-ed at pre-, postintervention, and at 1-month follow-up (VAS). Muscle strengthening reduced perceived pain after intervention in 90.8% in subjects and this result was maintained at 1-month follow-up (all, P=0.001). Regarding changes in static knee angles, no significant im-provements were found in internal and external rotation; valgus and varus; flexion and recurvatum (all, P>0.05). There was no significant difference between the symptomatic and healthy sides (all, P>0.05). Analyses of the correlation coefficients indicated no significant associ-ations between changes in perceived pain and static knee angles. The current study found that muscle strengthening addressed to the symp-tomatic knee reduced pain; however, perceived pain was not associat-ed with static knee angles in young subjects with unilateral PFPS

An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

<p>Abstract</p> <p>Background</p> <p>Neck-shoulder pain conditions, e.g., chronic trapezius myalgia, have been associated with sensory disturbances such as increased sensitivity to experimentally induced pain. This study investigated pain sensitivity in terms of bilateral pressure pain thresholds over the trapezius and tibialis anterior muscles and pain responses after a unilateral hypertonic saline infusion into the right legs tibialis anterior muscle and related those parameters to intensity and area size of the clinical pain and to psychological factors (sleeping problems, depression, anxiety, catastrophizing and fear-avoidance).</p> <p>Methods</p> <p>Nineteen women with chronic non-traumatic neck-shoulder pain but without simultaneous anatomically widespread clinical pain (NSP) and 30 age-matched pain-free female control subjects (CON) participated in the study.</p> <p>Results</p> <p>NSP had lower pressure pain thresholds over the trapezius and over the tibialis anterior muscles and experienced hypertonic saline-evoked pain in the tibialis anterior muscle to be significantly more intense and locally more widespread than CON. More intense symptoms of anxiety and depression together with a higher disability level were associated with increased pain responses to experimental pain induction and a larger area size of the clinical neck-shoulder pain at its worst.</p> <p>Conclusion</p> <p>These results indicate that central mechanisms e.g., central sensitization and altered descending control, are involved in chronic neck-shoulder pain since sensory hypersensitivity was found in areas distant to the site of clinical pain. Psychological status was found to interact with the perception, intensity, duration and distribution of induced pain (hypertonic saline) together with the spreading of clinical pain. The duration and intensity of pain correlated negatively with pressure pain thresholds.</p

Diagnostico clínico de artrosis en la articulación temporomandibular asociado a un síndrome de dolor miofascial: Análisis de un caso

A case report of a 70 year-old patient with bilateral orofacial pain and local pain in the right temporomandibular joint (TMJ). The physical examination shows a decrease in the articular range of motion, a soft end feel, crepitation and trigger points activated at the jaw and neck muscles. The image study confirmed TMJ osteoarthrosis and it was concluded that the symptoms were primarily produced by myofascial pain syndrome. A precise differential diagnoses is important in order to orientate the treatment stages.Se presenta un caso de una paciente de 70 años que presenta dolor orofacial simétrico y dolor local a nivel de la articulación temporomandibular (ATM) derecha. La exploración clínica muestra disminución del rango de movimiento articular, un end feel blando, crepitación a la auscultación, y puntos gatillos miofasciales (PGMs) a nivel de la musculatura masticatoria y del cuello. El estudio radiológico confirma artrosis en la ATM y se termina concluyendo que la sintomatología es provocada, principalmente, por el síndrome de dolor miofascial. Se reafirma la importancia de realizar un diagnóstico diferencial preciso para orientar adecuadamente las pautas del tratamiento