Síndrome de dolor miofascial en pacientes con dismenorrea primaria

Introducción: La dismenorrea primaria se considera uno de los trastornos ginecológicos más prevalente de las mujeres en edad reproductiva, suponiéndoles una merma de su calidad de vida y del desarrollo de su actividad académica y/o profesional, presentándose como la principal causa de absentismo. Es una patología infradiagnosticada e infratratada, con pocas alternativas terapéuticas más allá del tratamiento farmacológico. Existe información limitada sobre los puntos gatillo miofasciales y los síntomas específicos del dolor pélvico crónico, y más concretamente de la dismenorrea. El objetivo de nuestro trabajo fue determinar si las pacientes que sufren de dismenorrea primaria presentan una alteración de la mecanosensibilidad a la presión y unos patrones de dolor, que puedan suponer una mayor presencia de puntos gatillo miofasciales en la musculatura abdominal y del suelo pélvico en mujeres con dismenorrea comparado con aquellas mujeres que no padecen de este problema. Material y método: Se llevó a cabo un estudio descriptivo transversal de casos y controles con una muestra total de 84 participantes, distribuidas en base a si sufrían o no dismenorrea primaria, y si estaban o no bajo algún tratamiento anticonceptivo, y dividida en 4 grupos de 21 mujeres cada uno. Se recogieron datos sobre el dolor, la calidad de vida y la productividad y absentismo laboral; y se realizaron 3 valoraciones, en diferentes fases del ciclo menstrual, para reportar datos sobre el umbral de dolor a la presión, la presencia de puntos gatillo miofasciales y las áreas de dolor referido de estos puntos. Resultados: La prueba ANOVA de una vía mostró diferencias estadísticamente significativas (p < 0,01) entre los grupos, para el dominio de Salud Física y la puntuación total del cuestionario SF-12, y para todos los dominios del cuestionario McGill; pero no se encontraron diferencias significativas en los datos del cuestionario WPAI-GH. Se encuentran datos estadísticamente significativos (p 50%) y siendo superior al 70% en las mujeres con dismenorrea primaria, en la fase menstrual; y del músculo obturador interno (100%) en la fase menstrual. Conclusiones: A penas existen diferencias de mecanosensibilidad musculoesquelética entre mujeres con y sin dismenorrea primaria, pero sí encontramos mayores diferencias, dentro de los grupos, entre las diferentes fases del ciclo menstrual. Existe una mayor prevalencia de PGM activos de los músculos recto abdominal, glúteo mayor, isquiocavernoso y pubococcígeo en la fase menstrual, y una mayor prevalencia de PGM activos del músculo iliococcígeo y de PGM latentes del músculo isquiocavernoso en la fase periovulatoria o intermenstrual, en las mujeres con dismenorrea primaria. Y se observa como aumentan las áreas de dolor a las que refieren los puntos gatillo miofasciales de la musculatura de suelo pélvico en todas las mujeres de estudio, y más notablemente en las que presentan dismenorrea primaria. Palabras clave: dismenorrea primaria, síndrome de dolor miofascial, puntos gatillo miofasciales, mecanosensibilidad, umbral de dolor a la presión

Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study

There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p 50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea.Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería)Fac. de Enfermería, Fisioterapia y PodologíaTRUEpu

Relationship between low back pain and shortened hamstring muscles: a case-control study

[Resumen] Objetivos: Este estudio busca establecer una relación directa entre el dolor lumbar de origen inespecífico y el acortamiento de la musculatura isquiotibial mediante la prueba dedos suelo (Finger-to-floor). Material y métodos: En el presente estudio participaron 54 sujetos: 27 casos y 27 controles (41 mujeres y 13 hombres). Resultados: No se ha encontrado relación entre los casos y los controles en las variables Finger-To-Floor test 1 (FTF1) (rP= 0.079; P>0.570), Finger-To-Floor test 2 (FTF2) (rP= 0.000; p>0.998), Finger-To-Floor test 3 (FTF3) (rP= 0.075; p>0.588) y Finger-To-Floor test total (FTFtotal) (-0.006 (-5.23,5.11);p>0.981). Conclusión: No se encontraron diferencias estadísticamente significativas entre ambos grupos y las respectivas variables.[Abstract] Objectives: This study tries to establish a direct relationship between non specific low-back pain and shortened hamstrings by using fingerto- floor test (FTF). Methods: A sample of 54 subjects divided into 27 cases and 27 controls (41 female and 13 male) was recruited. Results: Regarding outcome measurements, a statically significant relationship between the cases and the control was not found: Finger- To-Floor test 1 (FTF1) (rP= 0.079; P>0.570), Finger-To-Floor test 2 (FTF2) (rP= 0.000; p>0.998), Finger-To-Floor test 3 (FTF3) (rP= 0.075; p>0.588) and Finger-To-Floor test total (FTFtotal) (-0.006 (-5.23,5.11); p>0.981). Conclusion: No statistically significant differences were found between both groups for outcome measuraments

Ultrasound Evaluation of the Abdominal Wall and Lumbar Multifidus Muscles in Participants Who Practice Pilates: A 1-year Follow-up Case Series

Objective The purpose of this study was to describe ultrasound (US) changes in muscle thickness produced during automatic activation of the transversus abdominis (TrAb), internal oblique (IO), external oblique (EO), and rectus abdominis (RA), as well as the cross-sectional area (CSA) of the lumbar multifidus (LM), after 1 year of Pilates practice. Methods A 1-year follow-up case series study with a convenience sample of 17 participants was performed. Indeed, TrAb, IO, EO, and RA thickness, as well as LM CSA changes during automatic tests were measured by US scanning before and after 1 year of Pilates practice twice per week. Furthermore, quality of life changes using the 36-Item Short Form Health Survey and US measurement comparisons of participants who practiced exercises other than Pilates were described. Results Statistically significant changes were observed for the RA muscle thickness reduction during the active straight leg raise test (P = .007). Participants who practiced other exercises presented a larger LM CSA and IO thickness, which was statistically significant (P .05). A direct moderate correlation was observed (r = 0.562, P = .019) between the TrAb thickness before and after a 1-year follow-up. Conclusions Long-term Pilates practice may reduce the RA thickness automatic activation during active straight leg raise. Furthermore, LM CSA and IO thickness increases were observed in participants who practice other exercise types in conjunction with Pilates. Despite a moderate positive correlation observed for TrAb thickness, the quality of life did not seem to be modified after long-term Pilates practice.Sin financiación1.274 JCR (2018) Q3, 46/65 Rehabilitation, 20/27 Integrative & Complementary Medicine; Q4, 80/98 Health Care Sciences & Services0.627 SJR (2018) Q1, 3/9 ChiropracticsNo data IDR 2018UE

Myofascial Trigger Points and Central Sensitization Signs, but No Anxiety, Are Shown in Women with Dysmenorrhea: A Case-Control Study

Background primary dysmenorrhea (PD) is considered to be a cyclic chronic pelvic pain, with its onset in menstrual periods, often accompanied by the presence of myofascial trigger points (MTP). Most MTPs in subjects with chronic pelvic pain are in the inferior part of the abdomen, in the rectus abdominis (RA) area. Central sensitization is closely related to chronic pain processes. Previous studies in women with chronic pelvic pain reported central sensitization signs in their subjects, such as lower pain pressure threshold (PPT). Several authors agree that PPT in the tibialis anterior (TA) muscle, seems to be a reliable reference for signs of central sensitization. Amongst the factors that seem to accompany central sensitization, the presence of anxiety needs to be considered. The aim of the present study was to analyze the existence of hyperalgesic MTPs in RA, central sensitization signs and anxiety in women with PD, in comparison with a control group (CG). Methods: This study was designed following an observational, cross-sectional, case-control model. A total sample of 80 subjects was recruited trough social webs and advertising (PD n = 39) (CG n = 41). PPT in RA and AT was assessed bilaterally through algometry, and anxiety was evaluated through the State&ndash;Trait Anxiety Inventory. Results: Statistically significant differences (p &lt; 0.001) were shown for NRS average and maximum increase, as well as lower bilaterally RA and TA PPT in favor of PD group compared to CG. State or trait STAI did not show any statistically significant differences (p &gt; 0.05) between groups. Conclusions: In this study, women with PD reported symptoms of myofascial pain syndrome and central sensitization, when compared with healthy controls, without any sign of anxiety acting as a confounder for pain sensitivity