Trigger points--ultrasound and thermal findings

Abstract

Rationale: Muscle pain can be elicited by any irritation of the nociceptors in the muscle or central sensitization in the central nervous system. The most frequently described muscle pain syndromes are myofascial pain syndrome and fibromyalgia syndrome. Myofascial pain syndrome has a more localized manifestation, the trigger points.

Objective: If there is a correlation between the clinical findings, the ultrasound examination and the thermal pattern of trigger points exist.

Material and method: The presence of trigger points can be identified by using clinical criteria. An ultrasound examination was performed to evaluate the trigger point dimensions. The ultrasound showed an ellipsoidal hypoechogenic area in the muscle. A thermography of the low back region was performed in order to observe the thermal pattern of the area.

Results: Trigger points are represented by a higher temperature area surrounded by a cooler area, probably caused by a deficit in the blood flow around those points.

Discussion: Infrared thermography could be a great asset for the monitoring of neuromusculoskeletal disorders and their dynamics, as well as an important aid for the initial diagnosis of conditions associated with tissue temperature alterations.

Keywords: muscle pain; muscle ultrasound; myofascial pain syndrome; thermography; trigger points.

Figures

Fig. 1

Ultrasound examination of a trigger point

Fig. 2

Thermal image of patient no. 2, initial and five days after the injection procedure

Fig. 3

Thermal reading corresponding to L1, for patient no. 2, initial and five days after the injection procedure

Fig. 4

3D representation of the thermal readings corresponding to R1 region for patient no. 2, initial and five days after the injection procedure