Prevalence of and Referred Pain From Myofascial Trigger Points in the Forearm Muscles in Patients With Lateral Epicondylalgia.

Fernandez-Carnero, Josue PT; Fernandez-de-las-Penas, Cesar PT, PhD; de la Llave-Rincon, Ana Isabel PT; Ge, Hong-You MD, PhD; Arendt-Nielsen, Lars DMSc, PhD

In this study referred pain and pain characteristics evoked from the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum communis, and brachioradialis muscles was investigated in 20 patients with lateral epicondylalgia (LE) and 20-matched controls. Both groups were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The quality and location of the evoked referred pain, and the pressure pain threshold (PPT) at the lateral epicondyle on the right upper extremity (symptomatic side in patients, and dominant-side on controls) were recorded.  The results suggest that in patients with LE, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual elbow and forearm pain, consistent with active TrPs. Lower PPT and larger referred pain patterns suggest that peripheral and central sensitization exists in LE.

Clinical Journal of Pain.    23(4):353-360, May 2007.

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Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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