Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 1 , Pages 16-23 , January 2008

Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger Points

  • Jay P. Shah, MD

      Affiliations

    • Rehabilitation Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD
    • Corresponding Author InformationCorrespondence to Jay P. Shah, MD, Rehabilitation Medicine Dept, Clinical Research Center, National Institutes of Health, 10 Center Dr, Rm 1-1469, MSC 1604, Bethesda, MD, 20892
    • ,
  • Jerome V. Danoff, PhD, PT

      Affiliations

    • Rehabilitation Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD
    • Department of Exercise Science, George Washington University, Washington, DC
    • ,
  • Mehul J. Desai, MD

      Affiliations

    • Department of Anesthesiology and Critical Care Medicine, George Washington University, Washington, DC
    • ,
  • Sagar Parikh, BA

      Affiliations

    • Rehabilitation Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD
    • ,
  • Lynn Y. Nakamura, MD

      Affiliations

    • National Rehabilitation Hospital, Washington, DC
    • ,
  • Terry M. Phillips, PhD, DSc

      Affiliations

    • National Institutes of Health, National Institute of Biomedical Imaging and Bioengineering, Ultramicro Analytical Immunochemistry Resource, Bethesda, MD
    • ,
  • Lynn H. Gerber, MD

      Affiliations

    • College of Health and Human Services, Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA.

References 

  1. Simons DG, Travell JG, Simons LS. Travell and Simons’ myofascial pain and dysfunction: the trigger point manual. Vol 1. Upper half of body. Baltimore: Williams & Wilkins; 1999;
  2. Gerwin RD. A study of 96 subjects examined for both fibromyalgia and myofascial pain. J Musculoskeletal Pain. 1995;13(Suppl 1):121–125
  3. Mense S. The pathogenesis of muscle pain. Curr Pain Headache Rep. 2003;7:419–425
  4. Bennett RM. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol. 2007;21:427–445
  5. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point (The importance of the local twitch response). Am J Phys Med Rehabil. 1994;73:256–263
  6. Shah JP, Phillips TM, Danoff JV, Gerber LH. An in vivo micro-analytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol. 2005;99:1977–1984
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  8. Phillips TM, Dickens BF. Analysis of recombinant cytokines in human body fluids by immunoaffinity capillary electrophoresis. Electrophoresis. 1998;19:2991–2996
  9. Phillips TM. Analysis of single-cell cultures by immunoaffinity capillary electrophoresis with laser-induced fluorescence detection. Luminescence. 2001;16:145–152
  10. Phillips TM. Determination of in situ tissue neuropeptides by capillary immunoelectrophoresis. Anal Chim Acta. 1998;372:209–218
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  12. Simons DG. Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol. 2004;14:95–107
  13. Issberner U, Reeh PW, Steen KH. Pain due to tissue acidosis: a mechanism for inflammatory and ischemic myalgia?. Neurosci Lett. 1996;208:191–194
  14. Sluka KA, Kalra A, Moore SA. Unilateral intramuscular injections of acidic saline produce a bilateral, long-lasting hyperalgesia. Muscle Nerve. 2001;24:37–46
  15. Hong CZ, Torigoe Y, Yu J. The localized twitch responses in responsive bands of rabbit skeletal muscle are related to the reflexes at spinal cord level. J Musculoskeletal Pain. 1995;3:15–33
  16. Gerwin RD, Dommerholt J, Shah JP. An expansion of Simons’ integrated hypothesis of trigger point formation. Curr Pain Headache Rep. 2004;8:468–475
  17. Willis WD. Retrograde signaling in the nervous system: dorsal root reflexes. In:  Bradshaw RA,  Dennis EA editor. Handbook of cell signaling. Vol 3:San Diego: Academic/Elsevier Pr; 2003;p. 607–614
  18. Dommerholt J, Mayoral O, Grobli C. Trigger point dry needling. J Man Manipulative Ther. 2006;14:E70–E87
  19. Schafers M, Sorkin LS, Sommer C. Intramuscular injection of tumor necrosis factor-alpha induces muscle hyperalgesia in rats. Pain. 2003;104:579–588
  20. Hoheisel U, Unger T, Mense S. Excitatory and modulatory effects of inflammatory cytokines and neurotrophins on mechanosensitive group IV muscle afferents in the rat. Pain. 2005;114:168–176
  21. Verri WA, Cunha TM, Parada CA, Poole S, Cunha FQ, Ferreira SH. Hypernociceptive role of cytokines and chemokines: targets for analgesic drug development?. Pharmacol Ther. 2006;112:116–138

 Supported by the Intramural Research Program, National Institutes of Health (NIH), the Clinical Center and Office of the Director, NIH.A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit upon the author or 1 or more of the authors. Shah, Danoff, Phillips, and Gerber have filed a patent application for the device used in this study.

PII: S0003-9993(07)01752-2

doi: 10.1016/j.apmr.2007.10.018

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 1 , Pages 16-23 , January 2008

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