Pathogenesis and Pathophysiological Mechanisms of Myofascial Trigger Points

肌筋膜激痛点的发病机制和病理生理机制

基本信息

批准号：
8450835
负责人：
Siddhartha Sikdar
金额：
$ 40.3万
依托单位：
GEORGE MASON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-04-01 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8450835
关键词：
Acute Pain Affect Aftercare Area Articular Range of Motion Beds Behavior Biochemical Biological Assay Biomechanics Blood Vessels Blood flow Brief Pain Inventory Characteristics Chronic Chronic Headaches Chronic neck pain Clinical Clinical assessments Complex Contracture Diagnostic Environment Fascia Functional disorder Goals High Prevalence Hypoxia Image Inflammatory Injury Ischemia Lead Low Back Pain Measures Mechanics Methods Modeling Moods Muscle Muscle Contraction Muscle Fibers Myofascial Pain Syndromes Myofascial Trigger Point Neck Neck Pain Needles Neighborhoods Neuropeptides Nociception Nodule Outcome Measure Pain Palpable Palpation Pathogenesis Pathology Patient Self-Report Patients Physical Examination Physical assessment Physiological Physiology Preventive Property Proteins Public Health Questionnaires Research Resistance Rheumatism Role Sampling Site Skeletal Muscle Symptoms System Tactile Techniques Technology Testing Therapeutic Therapeutic Intervention Tissues Translating Trauma Treatment outcome Ultrasonography Work base chronic pain cytokine disability elastography follow-up imaging modality indexing innovation instrument novel physical property pressure programs public health relevance soft tissue trapezius muscle treatment trial trigger point

项目摘要

DESCRIPTION (provided by applicant): Chronic soft-tissue (or myofascial) pain is a significant public health problem. Despite its high prevalence, the underlying mechanisms are poorly understood. In particular, very little is known about the pathophysiology and soft tissue environment of a myofascial trigger point (MTrP). MTrPs are palpable, localized painful nodules in a taut band of skeletal muscle that are a characteristic finding in myofascial pain syndrome (MPS). MTrPs are associated with spontaneous referred pain in symptomatic patients, and are the target for current management strategies for MPS, such as dry needle therapy. Recently, our research group has developed new ultrasound imaging methods to visualize and characterize the physiology and physical properties of the MTrPs and their surrounding soft tissue; and microanalytic techniques to assay the local biochemical milieu. These innovative methodological advances provide a unique opportunity to integrate the physical, physiological and biochemical findings to achieve a more comprehensive understanding of the abnormalities associated with MTrPs (e.g., muscle, fascia, blood vessels); and to correlate these findings with clinical assessments to better understand the role of MTrPs in chronic pain. Our ultimate goal is to develop a working model of the underlying mechanisms of MTrPs and translate the findings to objective clinical outcome measures using office-based technology. The specific aims of the project are: 1) To determine the mechanical tissue properties, vascular physiology and biochemical milieu of the affected soft tissue neighborhood of active MTrPs in patients with chronic neck pain compared to asymptomatic control subjects with/without palpable MTrPs; and 2) To determine the effect of a physical perturbation caused by dry needle therapy, a widely accepted method of treatment, on the soft tissue environment and biochemical milieu of active MTrPs in symptomatic subjects. Our working hypothesis is that MTrPs are sites of muscle injury where local biochemical changes lead to sustained muscle contracture, compression of blood vessels and a local energy crisis that causes tissue hypoxia. This condition perpetuates the release of inflammatory cytokines and nociceptive (pain-inducing) substances. To test this hypothesis, we will correlate ultrasound imaging scores, analyte levels and functional clinical measures in our specific aims. To translate these findings into clinical outcome measures that can be used in an office-based setting, we will adapt a reliable and inexpensive 3D Tactile Imaging instrument for quantifying mechanical soft tissue changes associated with MTrPs.

描述（由申请人提供）：慢性软组织（或肌筋膜）疼痛是一个重大的公共卫生问题。尽管患病率很高，但基本的机制还是很了解。特别是，关于肌筋膜触发点（MTRP）的病理生理学和软组织环境知之甚少。 MTRP是在骨骼肌绷紧的肌肉带中明显的，局部疼痛的结节，这是肌筋膜疼痛综合征（MPS）的特征发现。 MTRP与有症状的患者自发转介疼痛有关，并且是当前MPS管理策略（例如干针疗法）的目标。最近，我们的研究小组开发了新的超声成像方法，以可视化和表征MTRP及其周围软组织的生理和物理特性。和微分析技术来测定当地的生化环境。这些创新的方法学进步提供了一个独特的机会，可以整合物理，生理和生物化学发现，以更全面地了解与MTRP相关的异常（例如，肌肉，筋膜，筋膜，血管）；并将这些发现与临床评估相关联，以更好地了解MTRP在慢性疼痛中的作用。我们的最终目标是开发MTRP的潜在机制的工作模型，并将发现转化为使用基于办公室技术的客观临床结果指标。该项目的具体目的是：1）确定慢性颈部疼痛患者的活性MTRPS邻居的机械组织特性，血管生理和生化环境与无触觉MTRP的无症状对照受试者相比； 2）确定干针疗法引起的物理扰动的影响，这是一种被广泛接受的治疗方法，对症状受试者的活性MTRP的软化组织环境和生化环境的影响。我们的工作假设是MTRP是肌肉损伤部位，局部生化变化导致持续的肌肉缔合，血管压缩和导致组织缺氧的局部能量危机。这种情况使炎性细胞因子和伤害性（引起疼痛）物质的释放延续。为了检验这一假设，我们将在我们的特定目标中将超声成像评分，分析物水平和功能性临床度量相关联。为了将这些发现转化为可在基于办公室的设置中使用的临床结果指标，我们将适应可靠且廉价的3D触觉成像仪器，以量化与MTRP相关的机械软组织变化。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Ultrasonic tissue characterization of the upper trapezius muscle in patients with myofascial pain syndrome.

肌筋膜疼痛综合征患者上斜方肌的超声组织特征。

DOI：
10.1109/embc.2012.6346938
发表时间：
2012
期刊：
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
影响因子：
0
作者：
Turo,Diego;Otto,Paul;Shah,JayP;Heimur,Juliana;Gebreab,Tadesse;Armstrong,Katherine;Gerber,LynnH;Sikdar,Siddhartha
通讯作者：
Sikdar,Siddhartha

Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.

DOI：
10.1016/j.pmrj.2015.01.024
发表时间：
2015-07
期刊：
PM & R : the journal of injury, function, and rehabilitation
影响因子：
0
作者：
Shah JP;Thaker N;Heimur J;Aredo JV;Sikdar S;Gerber L
通讯作者：
Gerber L

Office-based elastographic technique for quantifying mechanical properties of skeletal muscle.

DOI：
10.7863/jum.2012.31.8.1209
发表时间：
2012-08
期刊：
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
影响因子：
0
作者：
Ballyns JJ;Turo D;Otto P;Shah JP;Hammond J;Gebreab T;Gerber LH;Sikdar S
通讯作者：
Sikdar S

A systematic comparison between subjects with no pain and pain associated with active myofascial trigger points.

DOI：
10.1016/j.pmrj.2013.06.006
发表时间：
2013-11
期刊：
PM & R : the journal of injury, function, and rehabilitation
影响因子：
0
作者：
Gerber LH;Sikdar S;Armstrong K;Diao G;Heimur J;Kopecky J;Turo D;Otto P;Gebreab T;Shah J
通讯作者：
Shah J

Objective sonographic measures for characterizing myofascial trigger points associated with cervical pain.

DOI：
10.7863/jum.2011.30.10.1331
发表时间：
2011-10
期刊：
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
影响因子：
0
作者：
Ballyns JJ;Shah JP;Hammond J;Gebreab T;Gerber LH;Sikdar S
通讯作者：
Sikdar S