Visceral Manipulation Decreases Pain, Increases Cervical Mobility and Electromyographic Activity of the Upper Trapezius Muscle in Non-Specific Neck Pain Subjects with Functional Dyspepsia: Two Case Reports

Andréia C O Silva, Claudia S Oliveira, Daniela A Biasotto-Gonzalez, Marco A Fumagalli, Fabiano Politti, Andréia C O Silva, Claudia S Oliveira, Daniela A Biasotto-Gonzalez, Marco A Fumagalli, Fabiano Politti

Abstract

Background and purpose: The lack of clear knowledge about the etiology of nonspecific neck pain (NS-NP) strengthens the need for other mechanisms, still poorly described in the literature, to be investigated. Therefore, a quantitative analysis of two cases of NS-NP in subjects with functiona dyspepsia was conducted in order to verify the immediate and seven-day postintervention effects of visceral manipulation (VM) to the stomach and liver on neck pain, cervical range of motion (ROM), and electromyographic (EMG) activity of the upper trapezius muscle.

Case description: Case A was an 18-year-old female with a complaint of nonspecific neck pain for one year, with reported pain on waking, momentary intermittent pain, and occasional symptoms of paresthesia in the upper limbs. Case B was a 25-year-old female with a complaint of cervical pain for one year, accompanied by pain in the unilateral temporomandibular joint, and medial thoracic region. Both cases presented functional dyspepsia.

Outcomes: The results demonstrated (subjects A and B, respectively) a general increase in cervical ROM (range: 12.5% to 44.44%) and amplitude of the EMG signal (immediately postintervention: 57.62 and 20.78; post seven days: 53.54% and 18.83%), and an increase in muscle fiber conduction velocity immediately postintervention (4.44% and 7.44%) and a decrease seven days postintervention (25.25% and 21.18%). For pain, a decrease was observed immediately postintervention (23.07% and 76.92%) and seven days postintervention (100% for both subjects).

Discussion: A single VM provided important clinical improvement in neck pain, cervical spine range of motion, and EMG activity of the upper trapezius muscle, immediately and seven days postintervention in two NS-NP subjects with functional dyspepsia.

Keywords: electromyography; functional dyspepsia; muscle pain; neck pain; visceral manipulation.

Conflict of interest statement

CONFLICT OF INTEREST NOTIFICATION The authors report no conflicts of interest. The authors are wholly responsible for the content of the article.

Figures

Figure 1
Figure 1
Visceral manipulation in stomach (A) and liver (B).
Figure 2
Figure 2
Flow sequence diagram of data recording. EMG = electromyography; T1 = before visceral manipulation (baseline); T2 = after EMG recording; T3 = immediately post visceral manipulation; T4 = after EMG recording; T5 = seven days after the visceral manipulation; ROM = range of motion, T6 = after EMG recording.

References

    1. Merskey H, Bogduk N. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. Seattle, WA: IASP Press; 1994.
    1. Binder A. The diagnosis and treatment of nonspecific neck pain and whiplash. Eur Medicophysica. 2007;43(1):79–89.
    1. Strandring S. Gray’s Anatomy. 41st ed. Amsterdam, The Netherlands: Elservier; 2016.
    1. Barral J-P, Mercier P. Visceral Manipulation, rev. ed. Seattle, WA: Eastland Press; 2006.
    1. Shoja MM, Oyesiku NM, Griessenauer CJ, Radcliff V, Loukas M, Chem JJ, et al. Anastomoses between lower cranial and upper cervical nerves: a comprehensive review with potential significance during skull base and neck operations, Part I: trigeminal, facial, and vestibulocochlear nerves. Clin Anat. 2014;27(1):118–130. doi: 10.1002/ca.22340.
    1. Brun R, Kuo B. Functional dyspepsia. Ther Adv Gastroenterol. 2010;3(3):145–164. doi: 10.1177/1756283X10362639.
    1. Markel Feldt C, Carriere B. The Pelvic Floor. 1st ed. New York: Thieme Medical Pub; 2006.
    1. Tozzi P, Bongiorno D, Vitturini C. Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and improves renal mobility. J Bodyw Mov Ther. 2012;16(3):381–391. doi: 10.1016/j.jbmt.2012.02.001.
    1. Hymel GM. Research Methods for Massage and Holistic Therapies. St. Louis, MO: Elsevier Mosby; 2006. (Mosby’s Massage Career Development Series).
    1. Rome Foundation. Guidelines–Rome III Diagnostic criteria for functional gastrointestinal disorders. J Gastrointest Liver Dis. 2006;15(3):307–312.
    1. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399–2404. doi: 10.1016/j.pain.2011.07.005.
    1. McLean L, Chislett M, Keith M, Murphy M, Walton P. The effect of head position, electrode site, movement and smoothing window in the determination of a reliable maximum voluntary activation of the upper trapezius muscle. J Electromyogr Kinesiol. 2003;13(2):169–180. doi: 10.1016/S1050-6411(02)00051-2.
    1. Farina D, Merletti R. Methods for estimating muscle fibre conduction velocity from surface electromyographic signals. Med Biol Eng Comput. 2004;42(4):432–445. doi: 10.1007/BF02350984.
    1. Giamberardino MA, Affaitati G, Lerza R, Lapenna D, Costantini R, Vecchiet L. Relationship between pain symptoms and referred sensory and trophic changes in patients with gallbladder pathology. Pain. 2005;114(1–2):239–249. doi: 10.1016/j.pain.2004.12.024.
    1. McSweeney TP, Thomson OP, Johnston R. The immediate effects of sigmoid colon manipulation on pressure pain thresholds in the lumbar spine. J Bodyw Mov Ther. 2012;16(4):416–423. doi: 10.1016/j.jbmt.2012.02.004.
    1. Vecchiet L, Vecchiet J, Giamberardino MA. Referred muscle pain: clinical and pathophysiologic aspects. Curr Rev Pain. 1999;3(6):489–498. doi: 10.1007/s11916-999-0077-y.
    1. Cervero F, Jänig W. Visceral nociceptors: a new world order? Trends Neurosci. 1992;15(10):374–378. doi: 10.1016/0166-2236(92)90182-8.
    1. Euchner-Wamser I, Sengupta JN, Gebhart GF, Meller ST. Characterization of responses of T2–T4 spinal cord neurons to esophageal distension in the rat. J Neurophysiol. 1993;69(3):868–883. doi: 10.1152/jn.1993.69.3.868.
    1. Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. J Multidiscip Healthc. 2013;6:281–291. doi: 10.2147/JMDH.S45443.
    1. Paoletti S. The Fasciae: Anatomy, Dysfunction and Treatment. 1st ed. Seattle, WA: Eastland Press; 2006.
    1. Falla D, Farina D. Muscle fiber conduction velocity of the upper trapezius muscle during dynamic contraction of the upper limb in patients with chronic neck pain. Pain. 2005;116(1–2):138–145. doi: 10.1016/j.pain.2005.03.038.
    1. de Silva ACO, Biasotto-Gonzalez DA, Dos Santos DM, De Melo NC, Fidelis de Paula Gomes CA, Ferreira Amorim C, Politti F. Evaluation of the immediate effect of auricular acupuncture on pain and electromyographic activity of the upper trapezius muscle in patients with nonspecific neck pain: a randomized, single-blinded, sham-controlled, crossover study. Evid-Based Complement Altern Med. 2015;2015 doi: 10.1155/2015/523851. 523851.
    1. Ge H-Y, Arendt-Nielsen L, Farina D, Madeleine P. Gender-specific differences in electromyographic changes and perceived pain induced by experimental muscle pain during sustained contractions of the upper trapezius muscle. Muscle Nerve. 2005;32(6):726–733. doi: 10.1002/mus.20410.
    1. Madeleine P, Leclerc F, Arendt-Nielsen L, Ravier P, Farina D. Experimental muscle pain changes the spatial distribution of upper trapezius muscle activity during sustained contraction. Clin Neurophysiol. 2006;117(11):2436–2445. doi: 10.1016/j.clinph.2006.06.753.
    1. Falla D, Farina D. Neuromuscular adaptation in experimental and clinical neck pain. J Electromyogr Kinesiol. 2008;18(2):255–261. doi: 10.1016/j.jelekin.2006.11.001.
    1. Kadi F, Waling K, Ahlgren C, Sundelin G, Holmener G, Butler-Browne GS, Thornell L-E. Pathological mechanisms implicated in localized female trapezius myalgia. Pain. 1998;78(3):191–196. doi: 10.1016/S0304-3959(98)00126-2.
    1. Lindman R, Hagberg M, Angqvist KA, Söderlund K, Hultman E, Thornell LE. Changes in muscle morphology in chronic trapezius myalgia. Scand J Work Environ Health. 1991;17(5):347–355. doi: 10.5271/sjweh.1693.

Source: PubMed

3
Předplatit