Investigation on the significance of pressure pain thresholds before and after treatment in female with myofascial chronic pelvic pain / 中国医师进修杂志

Objective To explore the therapeutic effect and clinical significance of pelvic floor rehabilitation technique in female with myofascial chronic pelvic pain (MCPP) by detecting the pressure pain thresholds (PPTs). Methods One hundred healthy female (control group) and 324 female MCPP patients (observation group) from January 2009 to December 2016 were selected. Automatic body surface and vaginal pressure pain detector was applied to detect two groups′PPTs of the 34 spots. The difference of PPTs at each spot was analyzed in two groups. In addition, 51 patients with moderate and severe MCPP were selected to record the changes of PPTs and pain scores before and after the treatment of pelvic floor rehabilitation technique. Results The average PPTs of the abdomen, vulva, pelvic floor and vaginal front and back fornix, bilateral adnexa uteri and sacrouterine ligament in the observation group were significantly lower than those in the control group (P<0.01 or<0.05). The average PPTs of the abdomen, vulva, pelvic floor muscles and vaginal front and back fornix, bilateral adnexa uteri and sacrouterine ligament of 51 MCPP patients after treatment were significantly higher than those before treatment (P<0.01). After treatment, PPTs and pain scores of the pelvic floor muscles, bilateral adnexa uteri, bilateral sacrouterine ligament, bilateral sacral spine ligament and vaginal front and back fornix were negatively correlated (r =- 0.78 to- 0.19, P = 0.01 to 0.04); there was a negative correlation between the PPTs and pain scores of the left and right latissimus dorsi (r=-0.28, P=0.04;r=-0.32, P=0.02). The complete remission rate with the pelvic floor rehabilitation technique in 51 patients with MCPP was 9.8％(5/51), the significant remission rate was 90.2％(46/51), and the total remission rate was 100.0％ (51/51). Conclusions Compared with the normal healthy ones, female with MCPP has lower PPTs in the abdomen, perineum, vagina and pelvic floor. The effect of pelvic floor rehabilitation technique on MCPP is well, which can increase patients′PPTs to reduce pain scores. It is a worthwhile method to treat these diseases.

Avaliação da prevalência de síndrome fibromiálgica em pacientes com DTM e estudo comparativo de aspectos clínicos e do limiar de dor à pressão / Prevalence of Fibromyalgia Syndrome in TMD patients and comparative study of clinical aspects and pressure pain threshold

Introdução: Síndrome Fibromiálgica (SFM) e Disfunção Temporomandibular (DTM) são enfermidades debilitantes que mostram como principal característica a presença de dor crônica podendo compartilhar de aspectos comuns na fisiopatologia e características clínicas. Tem sido associadas à diminuição do limiar de dor à pressão (LDP) devido a mudanças de processamento da dor em nível de sistema nervoso central sendo que a obtenção do LDP pode ser verificada por algometria de pressão. Objetivos: Determinar a prevalência de SFM em pacientes com DTM e comparar características clínicas e o LDP em músculos mastigatórios e ATMs de pacientes com SFM associada ou não a DTM e controles assintomáticos. Metodologia: A prevalência de SFM foi avaliada em 274 pacientes com DTM. O diagnóstico para DTM seguiu os critérios do RDC/TMD e a SFM os critérios da Academia Americana de Reumatologia. O estudo comparativo incluiu 30 mulheres de mesma faixa etária (Grupo SFM+DTM: 15 mulheres e Grupo DTM: 15 mulheres). Os dados foram analisados através dos testes 2-t ou Mann-Whitney para comparação entre pares, e, qui-quadrado ou teste exato de Fischer para variáveis categóricas. Para avaliar o LDP, foram avaliados 57 indivíduos do sexo feminino de mesma raça e faixa etária, divididos em quatro grupos:. Grupo SFM+DTM: 15 indivíduos com SFM e DTM, Grupo DTM: 15 indivíduos com DTM, Grupo SFM: 12 indivíduos com SFM sem dor orofacial nos últimos três meses e Grupo controle: 15 indivíduos assintomáticos sem história de SFM ou DTM. Avaliou-se por algometria o LDP em músculo masseter, temporal, ATMs e ponto controle no leito ungueal do dedo polegar direito. Os dados obtidos foram analisados pelo teste estatístico de Tukey com nível de significância de 5%. Resultados: Observou-se prevalência de 10,58% de SFM em pacientes com DTM. O Grupo SFM+DTM apresentou idade média de 42,8 anos e maior intensidade de dor na primeira consulta. O tipo de DTM e características psicossociais foram semelhantes entre...

Introduction: Fibromyalgia Syndrome (FMS) and Temporomandibular Disorders (TMD) are debilitating diseases that show as main characteristic the presence of chronic pain which may share common aspects on the physiopathology and clinical characteristics. There have been associated with the decrease in pain at the threshold of the pressure (PPT) due to changes in the processing of the pain at the level of central nervous system and the achievement of the PPT can be verified by the algometry of pressure. Aims: The aim was to determine the prevalence of FMS in patients with TMD and compare the clinical characteristics among these patients and compare the PPT in masticatory muscles of patients with SFM associated or not with TMD and asymptomatic controls. Metodology: The prevalence of FMS was evaluated in 274 patients with TMD. The diagnosis for TMD followed the criteria of RDC/TMD and the SFM followed the criteria of the American Academy of Rheumatology. The comparative study included 30 women of the same age range (Group FMS+TMD: 15 women and TMD Group: 15 women). The data was analyzed by 2-t tests or Mann-Whitney test for comparison between pairs, and chi-square or Fischer Exact test for categorical variants. The study of PPT, included 57 female individuals of the same race and age, divided into four groups: FMS+TMD group: 15 people with FMS and TMD, TMD group: 15 people with TMD, FMS group: 12 people without orofacial pain in the last three months and the control group: 15 asymptomatic individuals with no history of FMS or TMD. The PPT was evaluated by algometry in the masseter muscle, temporal, Temporomandibular Joints and control point in the tumb nail bed. The data was analyzed by the Tukey test with statistical significance level of 5%. Results: The prevalence was 10,58% of FMS in patients with TMD. The FMS+TMD group showed greater intensity of pain in the first consultation. The type of TMD and psychosocial characteristics were similar between the groups…

Avaliação da prevalência de síndrome fibromiálgica em pacientes com DTM e estudo comparativo de aspectos clínicos e do limiar de dor à pressão / Prevalence of Fibromyalgia Syndrome in TMD patients and comparative study of clinical aspects and pressure pain threshold

Introdução: Síndrome Fibromiálgica (SFM) e Disfunção Temporomandibular (DTM) são enfermidades debilitantes que mostram como principal característica a presença de dor crônica podendo compartilhar de aspectos comuns na fisiopatologia e características clínicas. Tem sido associadas à diminuição do limiar de dor à pressão (LDP) devido a mudanças de processamento da dor em nível de sistema nervoso central sendo que a obtenção do LDP pode ser verificada por algometria de pressão. Objetivos: Determinar a prevalência de SFM em pacientes com DTM e comparar características clínicas e o LDP em músculos mastigatórios e ATMs de pacientes com SFM associada ou não a DTM e controles assintomáticos. Metodologia: A prevalência de SFM foi avaliada em 274 pacientes com DTM. O diagnóstico para DTM seguiu os critérios do RDC/TMD e a SFM os critérios da Academia Americana de Reumatologia. O estudo comparativo incluiu 30 mulheres de mesma faixa etária (Grupo SFM+DTM: 15 mulheres e Grupo DTM: 15 mulheres). Os dados foram analisados através dos testes 2-t ou Mann-Whitney para comparação entre pares, e, qui-quadrado ou teste exato de Fischer para variáveis categóricas. Para avaliar o LDP, foram avaliados 57 indivíduos do sexo feminino de mesma raça e faixa etária, divididos em quatro grupos:. Grupo SFM+DTM: 15 indivíduos com SFM e DTM, Grupo DTM: 15 indivíduos com DTM, Grupo SFM: 12 indivíduos com SFM sem dor orofacial nos últimos três meses e Grupo controle: 15 indivíduos assintomáticos sem história de SFM ou DTM. Avaliou-se por algometria o LDP em músculo masseter, temporal, ATMs e ponto controle no leito ungueal do dedo polegar direito. Os dados obtidos foram analisados pelo teste estatístico de Tukey com nível de significância de 5%. Resultados: Observou-se prevalência de 10,58% de SFM em pacientes com DTM. O Grupo SFM+DTM apresentou idade média de 42,8 anos e maior intensidade de dor na primeira consulta. O tipo de DTM e características psicossociais foram semelhantes entre...

Introduction: Fibromyalgia Syndrome (FMS) and Temporomandibular Disorders (TMD) are debilitating diseases that show as main characteristic the presence of chronic pain which may share common aspects on the physiopathology and clinical characteristics. There have been associated with the decrease in pain at the threshold of the pressure (PPT) due to changes in the processing of the pain at the level of central nervous system and the achievement of the PPT can be verified by the algometry of pressure. Aims: The aim was to determine the prevalence of FMS in patients with TMD and compare the clinical characteristics among these patients and compare the PPT in masticatory muscles of patients with SFM associated or not with TMD and asymptomatic controls. Metodology: The prevalence of FMS was evaluated in 274 patients with TMD. The diagnosis for TMD followed the criteria of RDC/TMD and the SFM followed the criteria of the American Academy of Rheumatology. The comparative study included 30 women of the same age range (Group FMS+TMD: 15 women and TMD Group: 15 women). The data was analyzed by 2-t tests or Mann-Whitney test for comparison between pairs, and chi-square or Fischer Exact test for categorical variants. The study of PPT, included 57 female individuals of the same race and age, divided into four groups: FMS+TMD group: 15 people with FMS and TMD, TMD group: 15 people with TMD, FMS group: 12 people without orofacial pain in the last three months and the control group: 15 asymptomatic individuals with no history of FMS or TMD. The PPT was evaluated by algometry in the masseter muscle, temporal, Temporomandibular Joints and control point in the tumb nail bed. The data was analyzed by the Tukey test with statistical significance level of 5%. Results: The prevalence was 10,58% of FMS in patients with TMD. The FMS+TMD group showed greater intensity of pain in the first consultation. The type of TMD and psychosocial characteristics were similar between the groups…

Relationships Between Pressure Pain Thresholds and Clinical Symptoms in Acupuncture and Moxibustion Therapy. A Case of Osteoarthritis of the Knee Joints / 全日本鍼灸学会雑誌

The tender points treatment has been widely used for both treatment and diagnosis, but there have been very few studies that have examined its diagnostic usefulness. Thus, the purpose of this study was to clarify the diagnostic importance of tender points. The subject was a patient who had osteoarthritis of the knee of Meiji University of Oriental Medicine Hospital. The relationship between pressure pain thresholds (PPTs) and symptoms in osteoarthritis of the knee (painful knee motion) were evaluated with the Japanese Orthopaedic Association scale (JOA scale), a knee scale and the subject's knee pain diary (starting pain, flexion pain, walking pain and total pain Wong-Baker faces pain rating scale). After 40 acupuncture treatments, improvement was noted in the symptoms and PPTs. The changes in PPTs were related to the symptoms of the knee (flexion and walking pain). This suggests that changes in PPTs (around the knee) are a useful indicator for evaluating knee pain.