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Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome...
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Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 37884

Special Issue Editor

Prof. Dr. Alba Paris-Alemany

E-Mail Website
Guest Editor
Centro Superior de Estudios Universitarios La Salle, Motion in Brains Research Group, Institute of Neuroscience of the Movement (INCIMOV), Universidad Autónoma de Madrid, 28023 Madrid, Spain
Interests: chronic pain; myofascial pain; orofacial pain; low back pain; headaches; neuropathic pain; temporomandibular disorders; vertebral spine; dizziness; vertigo; rehabilitation; physiotherapy; manual therapy; exercise; biobehavioral physiotherapy; patient education

Special Issue Information

Dear Colleagues,

In this Special Issue, it is intended to review the scientific evidence regarding the updates in the diagnosis and treatment of musculoskeletal soft-tissue disorders.

Conditions such as low back pain, neck and shoulder pain, or disorders are very frequent in the population, and lead to high levels of disability and work absence. Nowadays, the most supported interventions for musculoskeletal disorders are based on conservative management. It is very common to find isolated myofascial pain syndromes or find them associated with other musculoskeletal conditions. There is plenty of evidence that conservative interventions, including exercise, are good options for the management of the pain associated with myofascial trigger points, from manual therapy to therapeutic exercise and other noninvasive or minimally invasive interventions. This Special Issue intends to be set up as a guide to help clinicians prescribe the most effective treatments for their patients. 

Finally, the other topic included in this Special Issue is neuropathies. Neuropathic pain has many ways of presenting and can appear spontaneously or as secondary to other injuries, diseases, or therapeutic interventions; after all, the patient presents with an affection of the nerve function or structure. In this line, any research related to the diagnosis of or therapeutic interventions for neuropathies will be welcome, e.g., from radiculopathies to diabetic neuropathy or neuropathic pain associated with cancer treatments, excluding those neuropathies secondary to nerve sections.

Any original research with a good methodological quality will be of interest, including clinical and basic studies that increase the knowledge about musculoskeletal disorders or neuropathic pain. Additionally, structured reviews of the literature, systematic reviews, and meta-analysis are welcome.

You are more than welcome to send your research if the topic is related to the ones proposed in the present Special Issue.

Prof. Dr. Alba Paris-Alemany
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • musculoskeletal disorders
  • myofascial pain syndrome
  • neck pain
  • low back pain
  • shoulder pain
  • neuropathy
  • diabetic neuropathy
  • conservative treatment
  • rehabilitation

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16 pages, 1151 KiB  
Article
Exploring the Interplay of Muscular Endurance, Functional Balance, and Limits of Stability: A Comparative Study in Individuals with Lumbar Spondylosis Using a Computerized Stabilometric Force Platform
by Fareed F. Alfaya, Ravi Shankar Reddy, Mastour Saeed Alshahrani, Ajay Prashad Gautam, Debjani Mukherjee, Zuhair A. Al Salim, Raee S. Alqhtani, Hussain Saleh H. Ghulam, Abdullah Mohammed Alyami, Saeed Al Adal and Abdullah Ali Jabour
Life 2023, 13(10), 2104; https://doi.org/10.3390/life13102104 - 23 Oct 2023
Cited by 3 | Viewed by 2708
Abstract
Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving [...] Read more.
Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45–70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from −0.38 to −0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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13 pages, 888 KiB  
Article
Functional and Neural Correlates Associated with Conditioned Pain Modulation in Patients with Chronic Knee Osteoarthritis Pain: A Cross-Sectional Study
by Marcel Simis, Kevin Pacheco-Barrios, Karen Vasquez-Avila, Ingrid Rebello-Sanchez, Joao Parente, Luis Castelo-Branco, Anna Marduy, Paulo S. de Melo, Marta Imamura, Linamara Battistella and Felipe Fregni
Life 2023, 13(8), 1697; https://doi.org/10.3390/life13081697 - 7 Aug 2023
Cited by 2 | Viewed by 1909
Abstract
Background: In this study, we aimed to assess the factors that predict a dysfunctional conditioned pain modulation (CPM) in chronic knee OA. Methods: This is a cross-sectional analysis of patients with chronic knee OA from a prospective cohort study in Brazil (n = [...] Read more.
Background: In this study, we aimed to assess the factors that predict a dysfunctional conditioned pain modulation (CPM) in chronic knee OA. Methods: This is a cross-sectional analysis of patients with chronic knee OA from a prospective cohort study in Brazil (n = 85). We performed linear and logistic multivariate regression models using the purposeful selection approach to test the relationship between the CPM in both knees (average) as a dependent variable and demographics, clinical, and neurophysiological as independent variables. Results: A significant negative association between WOMAC pain scores and CPM (β: −0.13) was found. This association was modified by the subjects’ race, being stronger in the non-white subjects. In our logistic regression models, pain intensity indexed with the WOMAC pain scale remained a significant association with dichotomized CPM. Furthermore, a significant CPM association with balance, indexed with the Berg Balance score, was evidenced (β: 0.04). Neurophysiological variables showed a significant negative relationship with CPM, such as the relative power of delta oscillations in the frontal area (β: −3.11) and central area (β: −3.23). There was no significant relationship between CPM and the following domains: cognitive, emotion, sleep, opioid receptor polymorphisms, and intrinsic variables of OA disease. There was no association of CPM with TMS-indexed inhibitory markers. Conclusions: These results may indicate that less function of the pain descending inhibitory system in patients with OA is correlated with higher activity-related pain (WOMAC), less balance, and cortical plasticity especially with increased low-frequency (delta) brain oscillations. These associations seem modified by race. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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11 pages, 1574 KiB  
Article
Morphological Changes of the Suboccipital Musculature in Women with Myofascial Temporomandibular Pain: A Case-Control Study
by Daniel Ulman-Macón, César Fernández-de-las-Peñas, Santiago Angulo-Díaz-Parreño, José L. Arias-Buría and Juan A. Mesa-Jiménez
Life 2023, 13(5), 1159; https://doi.org/10.3390/life13051159 - 11 May 2023
Cited by 2 | Viewed by 3043 | Correction
Abstract
Temporomandibular disorder (TMD) is an umbrella term including pain problems involving the cranio-cervical region. It has been suggested that patients with TMD also exhibit cervical spine disturbances. Evidence suggests the presence of morphological changes in the deep cervical muscles in individuals with headaches. [...] Read more.
Temporomandibular disorder (TMD) is an umbrella term including pain problems involving the cranio-cervical region. It has been suggested that patients with TMD also exhibit cervical spine disturbances. Evidence suggests the presence of morphological changes in the deep cervical muscles in individuals with headaches. The objective of this study was to compare the morphology of the suboccipital muscles between women with TMD and healthy controls. An observational, cross-sectional case-control study was conducted. An ultrasound examination of the suboccipital musculature (rectus capitis posterior minor, rectus capitis posterior major, oblique capitis superior, oblique capitis inferior) was conducted in 20 women with myofascial TMD and 20 matched controls. The cross-sectional area (CSA), perimeter, depth, width, and length of each muscle were calculated by a blinded assessor. The results revealed that women with myofascial TMD pain exhibited bilaterally reduced thickness, CSA, and perimeter in all the suboccipital muscles when compared with healthy women. The width and depth of the suboccipital musculature were similar between women with myofascial TMD and pain-free controls. This study found morphological changes in the suboccipital muscles in women with myofascial TMD pain. These changes can be related to muscle atrophy and are similar to those previously found in women with headaches. Future studies are required to investigate the clinical relevance of these findings by determining if the specific treatment of these muscles could help clinically patients with myofascial TMD. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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12 pages, 1773 KiB  
Article
Mediation Effect of Pain on the Relationship between Kinesiophobia and Postural Control: Comparison and Correlations in Individuals with Fibromyalgia Syndrome and Asymptomatic Individuals—A Cross-Sectional Study
by Faisal Asiri, Ravi Shankar Reddy, Mastour Saeed Alshahrani, Jaya Shanker Tedla, Snehil Dixit, Adel Alshahrani, Kumar Gular and Abdullah Raizah
Life 2023, 13(1), 175; https://doi.org/10.3390/life13010175 - 6 Jan 2023
Cited by 12 | Viewed by 2332
Abstract
Background: Individuals with fibromyalgia syndrome (FM) usually present with a fear of movement (kinesiophobia), which causes their symptoms to be maintained and exacerbated. Kinesiophobia can significantly impact postural control; ascertaining their association is crucial in evaluating and managing individuals with FM. This study [...] Read more.
Background: Individuals with fibromyalgia syndrome (FM) usually present with a fear of movement (kinesiophobia), which causes their symptoms to be maintained and exacerbated. Kinesiophobia can significantly impact postural control; ascertaining their association is crucial in evaluating and managing individuals with FM. This study aims to (1) compare postural control between individuals with FM and asymptomatic individuals, (2) estimate the relationship between kinesiophobia and postural control in individuals with FM, and (3) evaluate whether pain intensity mediates the association between kinesiophobia and postural control in individuals with FM. Methods: This study enrolled 92 individuals (mean age: 51.52 ± 7.7 years) diagnosed with FM and 106 asymptomatic individuals (mean age: 50.47 ± 6.6 years). The examiners estimated the fear of movement and the intensity of pain utilizing the Tampa scale of kinesiophobia (TSK) scores and the visual analogue scale (VAS), respectively. The postural control variables included anteroposterior (A-P) sway in mm, medio-lateral (M-L) sway in mm, and ellipse area in mm2. Results: The individuals with FM had impaired postural control compared to the asymptomatic individuals (p < 0.001). Kinesiophobia exhibited mild-to-moderate correlations with the postural control variables (nondominant side: A-P sway: r = 0.48, M-L sway: r = 0.49, ellipse area: r = 0.43. Dominant side: A-P sway: r = 0.41, M-L sway: r = 0.33, ellipse area: r = 0.44). The pain intensity significantly mediated the relationship between kinesiophobia and postural control (p < 0.001). Conclusion: Kinesiophobia showed a significant positive relationship with postural control. The individuals with FM with higher TSK scores had decreased postural control. Pain intensity mediated the relationship between kinesiophobia and postural control. These factors must be considered when evaluating and formulating treatment strategies for people with FM. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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16 pages, 878 KiB  
Article
Prediction of Patient Satisfaction after Treatment of Chronic Neck Pain with Mulligan’s Mobilization
by Josué Fernández-Carnero, Hector Beltrán-Alacreu, Alberto Arribas-Romano, Ester Cerezo-Téllez, Juan Nicolás Cuenca-Zaldivar, Eleuterio A. Sánchez-Romero, Sergio Lerma Lara and Jorge Hugo Villafañe
Life 2023, 13(1), 48; https://doi.org/10.3390/life13010048 - 23 Dec 2022
Cited by 13 | Viewed by 3967
Abstract
Chronic neck pain is among the most common types of musculoskeletal pain. Manual therapy has been shown to have positive effects on this type of pain, but there are not yet many predictive models for determining how best to apply manual therapy to [...] Read more.
Chronic neck pain is among the most common types of musculoskeletal pain. Manual therapy has been shown to have positive effects on this type of pain, but there are not yet many predictive models for determining how best to apply manual therapy to the different subtypes of neck pain. The aim of this study is to develop a predictive learning approach to determine which basal outcome could give a prognostic value (Global Rating of Change, GRoC scale) for Mulligan’s mobilization technique and to identify the most important predictive factors for recovery in chronic neck pain subjects in four key areas: the number of treatments, time of treatment, reduction of pain, and range of motion (ROM) increase. A prospective cohort dataset of 80 participants with chronic neck pain diagnosed by their family doctor was analyzed. Logistic regression and machine learning modeling techniques (Generalized Boosted Models, Support Vector Machine, Kernel, Classsification and Decision Trees, Random Forest and Neural Networks) were each used to form a prognostic model for each of the nine outcomes obtained before and after intervention: disability—neck disability index (NDI), patient satisfaction (GRoC), quality of life (12-Item Short Form Survey, SF-12), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI II), pain catastrophizing scale (ECD), kinesiophobia-Tampa scale of kinesiophobia (TSK-11), Pain Intensity Visual Analogue Scale (VAS), and cervical ROM. Pain descriptions from the subjects and pain body diagrams guided the physical examination. The most important predictive factors for recovery in chronic neck pain patients indicated that the more anxiety and the lower the ROM of lateroflexion, the higher the probability of success with the Mulligan concept treatment. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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12 pages, 759 KiB  
Article
Cervical Joint Position Sense and Its Correlations with Postural Stability in Subjects with Fibromyalgia Syndrome
by Ravi Shankar Reddy, Jaya Shanker Tedla, Snehil Dixit, Abdullah Raizah, Mohammed Lafi Al-Otaibi, Kumar Gular, Irshad Ahmad and Mohamed Sherif Sirajudeen
Life 2022, 12(11), 1817; https://doi.org/10.3390/life12111817 - 7 Nov 2022
Cited by 19 | Viewed by 2952
Abstract
Cervical joint position sense (JPS) and postural stability are vital to maintaining balance and preventing falls in fibromyalgia syndrome (FMS). Impaired cervical JPS may influence postural stability, and understanding the relationship between them can aid in formulating treatment strategies in individuals with FMS. [...] Read more.
Cervical joint position sense (JPS) and postural stability are vital to maintaining balance and preventing falls in fibromyalgia syndrome (FMS). Impaired cervical JPS may influence postural stability, and understanding the relationship between them can aid in formulating treatment strategies in individuals with FMS. This study aims to (1) assess cervical JPS and postural stability between FMS and control group and (2) determine the correlation between cervical JPS and postural stability in the FMS group. This cross-sectional study recruited 92 FMS patients (mean age: 51.52 ± 7.7 yrs.) and 92 healthy controls (mean age: 49.36 ± 6.9 yrs.). A cervical range of motion (CROM) unit was utilized to assess cervical JPS. The postural stability was assessed using an IsoFree force platform, and anterior-posterior (A/P) and medial-lateral (M/L) directions of sway and ellipse area were measured. Cervical JPS and postural stability tests were assessed and compared between FMS and control groups. Cervical JPS was significantly impaired in FMS compared to the control group (p < 0.001). The JPS errors in FMS group were larger in flexion (FMS = 5.5°, control = 2.4°), extension (FMS = 6.4°, control = 3.0°), and rotation in left (FMS = 5.4°, control = 2.2°) and right directions (FMS = 5.1°, control = 2.8°). FMS individuals demonstrated statistically significant impaired postural stability compared to control in both the dominant and non-dominant legs tested (p < 0.001). The cervical JPS test showed moderate to strong positive correlations with postural stability variables. Statistically significant correlations were observed in all the JPS directions tested with all the postural stability variables (A/P and M/L sway and ellipse area). The correlation coefficients ranged between r = 0.37 (moderate) to 0.75 (strong). Cervical JPS and postural stability are impaired in FMS individuals. A moderate to strong relationship existed between JPS and postural stability. Individuals with FMS who had a greater magnitude of cervical JPS errors exhibited more severe postural control deficits. Therefore, cervical JPS and postural stability tests should be incorporated into routine clinical practice when assessing or formulating treatment strategies for patients with FMS. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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9 pages, 830 KiB  
Article
Age and Sex in Back Pain Intensity—Retrospective Study of Conservatory vs. Surgical Discopathy Treatment
by Kamil Koszela and Marta Woldańska-Okońska
Life 2022, 12(11), 1808; https://doi.org/10.3390/life12111808 - 7 Nov 2022
Viewed by 1787
Abstract
(1) Background: The frequency of back pain diagnosis and treatment has markedly increased in recent years. Back pain may be caused by many factors and discopathy is one of them. The aim of the study was to assess the impact of age and [...] Read more.
(1) Background: The frequency of back pain diagnosis and treatment has markedly increased in recent years. Back pain may be caused by many factors and discopathy is one of them. The aim of the study was to assess the impact of age and sex on back pain intensity in rehabilitated patients with discopathy treated conservatively and surgically; (2) Methods: The study included 137 patients: 96 undergoing conservative therapy and 41 after back surgery due to discopathy. VAS and the Laitinen scale were used for pain assessment. All patients underwent a multidirectional rehabilitation program at the Department of Rehabilitation and Physical Medicine of the Medical University in Łódź; (3) Results: No statistically significant effect of age and sex was observed on the level of pain intensity on VAS and the Laitinen scale; (4) Conclusions: Age and sex do not seem to affect back pain intensity in rehabilitated patients treated conservatively and surgically for discopathy. The problem requires further research on a larger group of patients. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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15 pages, 941 KiB  
Article
Cross-Sectional Comparative Study on Central Sensitization-Psychosocial Associated Comorbidities and Psychological Characteristics in Breast Cancer Survivors with Nociceptive Pain and Pain with Neuropathic Features and without Pain
by Irene de la Rosa-Díaz, Laura Barrero-Santiago, Paz Acosta-Ramírez, Marina Martín-Peces-Barba, Esther Iglesias-Hernández, Bastien Plisset, Nicolás Lutinier, Margot Belzanne, Roy La Touche and Mónica Grande-Alonso
Life 2022, 12(9), 1328; https://doi.org/10.3390/life12091328 - 27 Aug 2022
Cited by 6 | Viewed by 2669
Abstract
The frequency of a high Central Sensitization Inventory (CSI) total score and the prevalence of pain have already been established among breast cancer survivors (BCS). However, the psychological factors’ influence based on the clinical features of pain is still unknown, as well as [...] Read more.
The frequency of a high Central Sensitization Inventory (CSI) total score and the prevalence of pain have already been established among breast cancer survivors (BCS). However, the psychological factors’ influence based on the clinical features of pain is still unknown, as well as BCS characteristics with no pain. Thus, our main aim was to evaluate the presence of a high CSI total score in BCS with pain and compare it with BCS without pain and to evaluate the influence of psychosocial factors. A cross-sectional comparative study was designed to compare BCS with nociceptive pain (n = 19), pain with neuropathic features (n = 19) or no pain (n = 19), classified by the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). CSI, pain catastrophizing, fear of movement, anxiety and depression symptoms were analyzed and compared among the three groups. The CSI total score was higher in both BCS pain groups compared to BCS without pain, but there were no statistical differences between the pain groups. The same observation was made when comparing pain catastrophizing. The neuropathic feature group showed greater levels of fear of movement, anxiety and depression compared to the no pain group. Thus, CS-psychosocial associated comorbidities and pain-catastrophizing thoughts were more prevalent among BCS with pain, regardless of the clinical features of pain. BCS with neuropathic pain features showed greater psychological disturbances. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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3 pages, 1459 KiB  
Correction
Correction: Ulman-Macón et al. Morphological Changes of the Suboccipital Musculature in Women with Myofascial Temporomandibular Pain: A Case-Control Study. Life 2023, 13, 1159
by Daniel Ulman-Macón, César Fernández-de-las-Peñas, Santiago Angulo-Díaz-Parreño, José L. Arias-Buría and Juan A. Mesa-Jiménez
Life 2024, 14(11), 1387; https://doi.org/10.3390/life14111387 - 28 Oct 2024
Viewed by 572
Abstract
Error in Figures [...] Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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7 pages, 3039 KiB  
Case Report
Sciatic Nerve Compression after a Chronic Proximal Hamstring Tear: A Report of Two Cases and a Narrative Review of the Literature
by Michael Gattringer, Georg Schalamon, Hannes Pichler, Franziska Lioba Breulmann, Heinz Buerger, Georg Mattiassich and Martin Bischofreiter
Life 2023, 13(8), 1762; https://doi.org/10.3390/life13081762 - 17 Aug 2023
Cited by 3 | Viewed by 5196
Abstract
Proximal hamstring tears are among the most common injuries afflicting athletes and middle-aged individuals. Sciatic nerve compression after a proximal hamstring injury, which can occur due to scar formation and subsequent irritation or compression of the nerve, is an infrequent but severe complication [...] Read more.
Proximal hamstring tears are among the most common injuries afflicting athletes and middle-aged individuals. Sciatic nerve compression after a proximal hamstring injury, which can occur due to scar formation and subsequent irritation or compression of the nerve, is an infrequent but severe complication with few cases documented in the literature. No evidence is available about the optimal treatment for sciatic nerve symptoms after proximal hamstring injuries. In this case report, we present two cases involving patients primarily treated conservatively at another institution after suffering from a proximal hamstring injury and developing sciatic nerve symptoms over the course of a few months. Both were treated with open neurolysis at our institution without reattachment of the ruptured muscles to the ischial tuberosity due to the chronicity of the injuries. Both patients exhibited neurological symptoms over two years, which recovered after surgery. These two cases show that neurolysis of the sciatic nerve without reattachment of the proximal hamstring muscles is an applicable option for the treatment of chronic proximal hamstring tears with sciatic nerve compression. Further studies will be needed to validate this hypothesis. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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14 pages, 661 KiB  
Hypothesis
Myofascial Pain Syndrome: A Nociceptive Condition Comorbid with Neuropathic or Nociplastic Pain
by César Fernández-de-las-Peñas, Jo Nijs, Barbara Cagnie, Robert D. Gerwin, Gustavo Plaza-Manzano, Juan A. Valera-Calero and Lars Arendt-Nielsen
Life 2023, 13(3), 694; https://doi.org/10.3390/life13030694 - 3 Mar 2023
Cited by 16 | Viewed by 6330
Abstract
Myofascial pain syndrome is featured by the presence of myofascial trigger points (TrPs). Whether TrPs are primary or secondary phenomena or if they relate to central or peripheral nervous system disorders is controversial. Referred pain, a cardinal sign of TrPs, is a central [...] Read more.
Myofascial pain syndrome is featured by the presence of myofascial trigger points (TrPs). Whether TrPs are primary or secondary phenomena or if they relate to central or peripheral nervous system disorders is controversial. Referred pain, a cardinal sign of TrPs, is a central phenomenon driven by peripheral input. In 2021, the International Association for the Study of Pain (IASP) proposed a clinical criteria and grading system for classifying patients with pain on nociceptive, neuropathic, or nociplastic phenotypes. Myofascial TrP pain has been traditionally categorized as a nociceptive phenotype; however, increasing evidence supports that this condition could be present in patients with predominantly nociplastic pain, particularly when it is associated with an underlying medical condition. The clinical response of some therapeutic approaches for managing TrPs remains unclear. Accordingly, the ability to classify myofascial TrP pain into one of these phenotypes would likely be critical for producing more successful clinical treatment outcomes by a precision medicine approach. This consensus paper presents evidence supporting the possibility of subgrouping individuals with myofascial TrP pain into nociceptive, nociplastic, or mixed-type phenotype. It is concluded that myofascial pain caused by TrPs is primarily a nociceptive pain condition, is unlikely to be classified as neuropathic or nociplastic, but can be present in patients with predominantly neuropathic or nociplastic pain. In the latter cases, management of the predominant central pain problem should be a major treatment goal, but the peripheral drive from TrPs should not be ignored, since TrP treatment has been shown to reduce sensitization-associated symptomatology in nociplastic pain conditions, e.g., fibromyalgia. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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13 pages, 644 KiB  
Systematic Review
Effect of Different Physical Therapy Interventions on Brain-Derived Neurotrophic Factor Levels in Chronic Musculoskeletal Pain Patients: A Systematic Review
by Silvia Di-Bonaventura, Josué Fernández-Carnero, Luis Matesanz-García, Alberto Arribas-Romano, Andrea Polli and Raúl Ferrer-Peña
Life 2023, 13(1), 163; https://doi.org/10.3390/life13010163 - 5 Jan 2023
Cited by 5 | Viewed by 3072
Abstract
Objective: The main objectives of this review were, firstly, to study the effect of different physiotherapy interventions on BDNF levels, and, secondly, to analyze the influence of physiotherapy on pain levels to subsequently draw conclusions about its possible relationship with BDNF. Background: Based [...] Read more.
Objective: The main objectives of this review were, firstly, to study the effect of different physiotherapy interventions on BDNF levels, and, secondly, to analyze the influence of physiotherapy on pain levels to subsequently draw conclusions about its possible relationship with BDNF. Background: Based on the theory that neurotrophic factors such as BDNF play a fundamental role in the initiation and/or maintenance of hyperexcitability of central neurons in pain, it was hypothesized that the levels of this neurotrophic factor may be modified by the application of therapeutic interventions, favoring a reduction in pain intensity. Methods: A literature search of multiple electronic databases (Pubmed, PsycINFO, Medline (Ebsco), Scopus, WOS, Embase) was conducted to identify randomized control trials (RCTs) published without language restrictions up to and including March 2022. The search strategy was based on the combination of medical terms (Mesh) and keywords relating to the following concepts: “pain”, “chronic pain”, “brain derived neurotrophic factor”, “BDNF”, “physiotherapy”, and “physical therapy”. A total of seven papers were included. Results: There were two studies that showed statistically significant differences in pain intensity reduction and an increase in the BDNF levels that used therapies such as rTMS and EIMS in patients with chronic myofascial pain. However, the same conclusions cannot be drawn for the other physical therapies applied. Conclusions: rTMS and EIMS interventions achieved greater short-term reductions in pain intensity and increased BDNF over other types of interventions in chronic myofascial pain patients, as demonstrated by a moderate amount of evidence. In contrast, other types of physical therapy (PT) interventions did not appear to be more effective in decreasing pain intensity and increasing BDNF levels than placebo PT or minimal intervention, as a low amount of evidence was found. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Interventions for Musculoskeletal disorders, Myofascial Pain Syndrome and Neuropathies)
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