Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger Points

Spennende studie som viser biokjemiske endringer i triggerpunkter i trapezius. Nevner at bl.a. pH var lavere i ømme områder.  Noe som kanskje er et problem med denne studien er at nålen ble stående i 1 minutt før de tok sine prøver. Kanskje vil nålen i seg selv også øke betennelsesfaktorer lokalt i løpet av den tiden. Men uansett tok de sine prøver der det var en twitchrespons, og de fikk statistiske forskjeller i normal muskel vs triggerpunktdelen av muskelen.

http://www.sciencedirect.com/science/article/pii/S0003999307017522

Hele studien: http://www.archives-pmr.org/article/S0003-9993(07)01752-2/fulltext

We followed a predetermined sampling schedule; first in the trapezius muscle and then in normal gastrocnemius muscle, to measure pH, bradykinin, substance P, calcitonin gene-related peptide, tumor necrosis factor alpha, interleukin 1β (IL-1β), IL-6, IL-8, serotonin, and norepinephrine, using immunocapillary electrophoresis and capillary electrochromatography.

Within the trapezius muscle, concentrations for all analytes were higher in active subjects than in latent or normal subjects (P<.002); pH was lower (P<.03).

At all times within the gastrocnemius, the active group had higher concentrations of all analytes than did subjects in the latent and normal groups (P<.05); pH was lower (P<.01).

Subjects with active MTPs in the trapezius muscle have a biochemical milieu of selected inflammatory mediators, neuropeptides, cytokines, and catecholamines different from subjects with latent or absent MTPs in their trapezius.

The needle was kept stationary in situ for 1 minute, after which collection of the sample commenced. Five minutes after insertion, the needle was advanced into the muscle until an LTR was obtained in the active and latent subjects. Again, this was confirmed by surface electromyography. Depth of penetration was estimated to be between 0.5 and 1.0cm.

Analyte concentrations in the trapezius combining previous and current data. Collection for (A) pH and (B) SP.

 

Analyte concentrations in the trapezius for (A) CGRP and (B) bradykinin.

Analyte concentrations in the trapezius for (A) TNF-α and (B) IL-1β.

Analyte concentrations in the trapezius for (A) IL-6 and (B) IL-8.

Analyte concentrations in the trapezius for (A) 5-HT and (B) norepinephrine.

 

There is a unique biochemical milieu of substances associated with pain and inflammation in the vicinity of an active MTP in the upper trapezius that includes elevated concentrations of protons, SP, CGRP, bradykinin, TNF-α, IL-1β, IL-6, IL-8, 5-HT, and norepinephrine. Concentrations of analytes from the milieu of the upper trapezius differ quantitatively from a remote uninvolved site in the medial gastrocnemius muscle. Furthermore, compared with the other groups, subjects with active MTPs in the trapezius had elevated levels of inflammatory mediators, neuropeptides, catecholamines, and cytokines in the gastrocnemius muscle. This suggests that elevations of biochemicals associated with pain and inflammation may not be limited to localized areas of active MTPs.

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