Association between myofascial trigger point therapy and conditioned pain modulation

Tibor M. Szikszay*, Wacław M. Adamczyk, Gabriela F. Carvalho, Daniel Dolotov, Rika Erdmann, Hauke Heitkamp, Andres Jung, Luisa Luebke, Katharina Rogosch, Kerstin Luedtke

*Corresponding author for this work

Abstract

Introduction: Myofascial trigger point therapy (MTrP) is a widely used therapeutic approach, although the underlying mechanisms remain unclear. Mechanisms discussed include peripheral involvement of muscles as well as central pain modulating processes such as the conditioned pain modulation (CPM). The aim of this study was to investigate whether the analgesic response of MTrP and the analgesic response of CPM correlate in asymptomatic participants in order to identify shared underlying mechanisms of MTrP and CPM. Method: Both, CPM and MTrP protocols consisted of heat-based test stimuli (heat pain thresholds before and after the intervention) and pressure-based (conditioning) stimuli. Asymptomatic participants (n = 94) were randomly assigned to receive either mild, intense or no pressure stimuli (between-group design) to both the fingernail and the MTrP of the infraspinatus muscle (within-group design). Pressure stimuli at both locations (fingernail, MTrP) were applied with a pressure algometer for 120 s and continuously adjusted to maintain a constant pain intensity of mild or intense pain. All thermal stimuli were applied on the lower leg with a thermal stimulator. Results: A significant correlation was shown between the analgesic effect of CPM and MTrP therapy for mild (r = 0.53, p = 0.002) and intensive stimuli (r = 0.73, p < 0.001). 17.3% of the variance of the MTrP effect were explained by CPM after mild stimulation, and 47.1% after intense stimulation. Pain-related characteristics did not explain the variance within the analgesic response using a regression analysis. Conclusions: Between the analgesic responses following MTrP and CPM paradigms, a moderate to strong correlation was observed, suggesting shared underlying mechanisms.

Original languageEnglish
JournalJournal of Bodywork and Movement Therapies
Volume38
Pages (from-to)73-80
Number of pages8
ISSN1360-8592
DOIs
Publication statusPublished - 01.2024

Research Areas and Centers

  • Health Sciences

DFG Research Classification Scheme

  • 206-05 Experimental Models for Investigating Diseases of the Nervous System
  • 206-08 Cognitive and Systemic Human Neuroscience

Cite this