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BMC Research Notes

, 7:620

First Online: 09 September 2014Received: 01 October 2013Accepted: 04 September 2014DOI: 10.1186-1756-0500-7-620

Cite this article as: Skorupska, E., Rychlik, M., Pawelec, W. et al. BMC Res Notes 2014 7: 620. doi:10.1186-1756-0500-7-620

Abstract

BackgroundVaried and complicated etiology of low back pain radiating distally to the extremities is still causing disagreement and controversy around the issue of its diagnosis and treatment. Most clinicians believe that the source of that pain is generally radicular. While some of them postulate the clinical significance of the sacroiliac joint syndrome, others demonstrate that almost one in five people with back pain experience symptoms indicative of the neuropathic pain component. To date, neuropathic involvement has not been completely understood, and different mechanisms are thought to play an important role. It has been established that muscle pain myofascial pain e.g. active trigger points from the gluteus minimus, can mimic pain similar to sciatica, especially in the chronic stage. This paper describes patients presenting with radicular sciatica case one and two and sciatica-like symptoms case three. For the first time, intensive short-term vasodilation in the pain area following needle infiltration of the gluteus minimus trigger point was recorded.

Case presentationThree Caucasian, European women suffering from radicular sciatica case one and two and sciatica-like symptoms case three at the age of 57, 49 and 47 respectively underwent infrared camera observation during needle infiltration of the gluteus minimus trigger point. The patients were diagnosed by a neurologist; they underwent magnetic resonance imaging, electromyography, neurography and blood test analysis. Apart from that, the patients were diagnosed by a clinician specializing in myofascial pain diagnosis.

ConclusionIn the examined cases, trigger points-related short-term vasodilation was recorded. Confirmation of these findings in a controlled, blinded study would indicate the existence of a link between the pain of sciatica patients radicular or sciatica-like pain and the activity of the autonomic nervous system. Further studies on a bigger group of patients are still needed.

KeywordsSciatica Trigger points Infrared camera Vasodilation Autonomic phenomenon AbbreviationsCGRPCalcitonin Gen Related Peptide

CRPC-reactive protein

DNDry needling

ESRErythrocyte sedimentation rate

GMGluteus minimus muscle

IRTInfrared thermovision camera

LBPLow back pain

MPSMyofascial pain

MRIMagnetic resonance imaging

NSEExtensive neurological screening examination

TavrAverage temperature

TmaxMaximum temperature

TrPsTrigger points

VASVisual-analogue scale.

Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-7-620 contains supplementary material, which is available to authorized users.

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Autor: Elżbieta Skorupska - Michał Rychlik - Wiktoria Pawelec - Agata Bednarek - Włodzimierz Samborski

Fuente: https://link.springer.com/







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