Differentiation of active and latent trigger points by thermography.

OBJECTIVE: This study tested whether two distinct thermographic patterns attributed to myofascial trigger points could distinguish between active and latent trigger points. DESIGN: A retrospective chart survey was undertaken with thermographic data divided into two groups: a) increased thermal emission only over the trigger point and b) over the area of pain referral. The criterion standard used in a blinded comparison was physical examination findings separating active from latent trigger points. SETTING: All cases were drawn from a private practice referral center for thermographic evaluation of neck and low back injuries. PATIENTS: A sample of 65 cases showing physical examination findings of trigger points was chosen from 229 consecutive motor vehicle accident case files. RESULTS: There was moderate agreement between the two methods of differentiating active from latent latent trigger points (Kappa = 0.44) with a specificity of 0.70 and a sensitivity of 0.74. When cases in which spinal segmental dysfunction were eliminated, the agreement increased (Kappa = 0.54) with specificity of 0.82 and sensitivity of 0.74. CONCLUSIONS: Thermography may be a useful tool in distinguishing active from latent trigger points, but the thermal imaging of spinal joint dysfunction may be a compounding factor.

Back pain during pregnancy and labor.

A retrospective study of 400 pregnancies and deliveries was undertaken by interview of 170 consecutive female patients presenting to five chiropractic offices in the Niagara Peninsula. Back pain was reported during 42.5% (170) of the pregnancies and 44.7% (179) of the deliveries. There was a statistically significant association between back pain during the two events (p less than .001). Of the 170 pregnancies with reported back pain, 72% (122) also reported back labor. A subsample of 170 painful pregnancies was divided into those that had received manual manipulation and those that had not. The treated group experienced less pain during labor (p less than .001).

Thermographic imaging of myofascial trigger points.

Thermographic findings in two patients suffering from myofascial trigger points are presented. These are shown as discrete foci of increased thermal emission, with corresponding areas of diffuse hyperthermia. These thermal findings correlate highly with the classic locations of specific trigger points and their areas of pain referral, respectively, as described in literature. Not only do these cases describe a thermal pattern that varies somewhat from previous reports, but they also illustrate the previously unreported imaging of areas of pain referral from specific trigger points.

Prevalence of back pain in chiropractors.

An epidemiological survey was made of the prevalence of back pain in a sample of 320 Canadian chiropractors. In addition, demographic, postural and other variables were studied to determine their effect on back pain. The overall prevalence of back pain was 87%. Low back pain was claimed by 74% of responding chiropractors. It was found that male chiropractors complained most frequently of lumbar pain, while among female respondents thoracic pain was most common. No apparent correlation was found between back pain and operating postures or table heights. Yet, 82% of the chiropractors that believed their back pain was aggravated by practice made these kinds of changes to avoid pain.

Back pain in dentists.

An epidemiologic survey was made of the prevalence of back pain in a sample of 172 dentists in the Province of Saskatchewan. In addition, demographic, postural and other variables were studied to determine their effect on back pain. The overall prevalence of back pain in the sample was 57 percent, while the prevalence of low-back pain was 35.5 percent. A significant number of back pain sufferers indicated recurrent or constant pain, and many dentists reported practice as an aggravating factor.