Mense / Gerwin Muscle Pain: Diagnosis and Treatment

1. Auflage 2010
ISBN: 978-3-642-05468-6
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 366 Seiten

This edition of the companion volumes Muscle Pain: Understanding the Mech- isms and Muscle Pain: Diagnosis and Treatment is essential reading for those interested in clinical approaches to acute and chronic pain conditions involving muscle tissues and in the mechanisms underlying these conditions. The volumes cover a very important topic in pain medicine, since muscle pain is very common and can often be dif?cult to diagnose and treat effectively. Furthermore, chronic pain involving muscle and other components of the musculoskeletal system increases with age, such that it is a common complaint of those of us who are middle-aged or older. Indeed, as changing population demographics in 'west- nized' countries result in higher proportions of the population living longer and being middle-aged and elderly, chronic muscle pain will likely become even more of a health problem. In the case of acute muscle pain, this can often be very intense, and in the short term can limit or modify the use of components of the musculoskeletal system associated with the sensitive muscle. Chronic muscle pain can also be intense, as well as unpleasant and disabling, and it is in many cases the over-riding symptom of most musculoskeletal disorders that are associated with long-term deleterious changes in musculoskeletal function.

Autoren/Hrsg.

Mense, Siegfried

Gerwin, Robert D.

Inhaltsverzeichnis

1;Foreword;6
2;Preface;8
3;Contents;10
4;Contents to Muscle Pain: Understanding the Mechanisms;12
5;Contributors;14
6;Chapter 1: Introduction;16
6.1;Established Pain Terms (Partly after Merskey and Bogduk 1994; and Loeser and Treede 2008)17
6.1.1;General Terms;17
6.1.2;Diagnostic Terms;18
6.1.2.1;Myofascial Pain;18
6.1.2.2;Fibrositis;18
6.1.2.3;Fibromyalgia;18
6.1.2.4;Myogelosis and ``Muscle Indurations´´;19
6.1.2.5;Nonarticular Rheumatism (Soft Tissue Rheumatism);19
6.1.2.6;Non-Specific Low Back Pain;19
6.1.2.7;Tendomyopathy;19
6.1.2.8;Work-Related Disorders of the Musculoskeletal System;20
6.1.3;Established, but Often Ill-Defined, Terms;20
6.1.3.1;Referred Pain;20
6.2;Importance and Prevalence of Muscle Pain;20
6.3;Gender Differences;21
6.4;Pain Measurement;21
6.5;Aggravating and Perpetuating Factors;22
6.6;Patient History;23
6.7;Examining Patients with Musculoskeletal Pain;23
6.8;Distinguishing Between Different Types of Pain (Local, Projected, Referred, and Central);24
6.8.1;Local Pain and Tenderness;24
6.8.2;Projected Pain;24
6.8.3;Referred Pain and Tenderness;25
6.8.4;Central Pain;25
6.9;References;25
7;Part I: Myofascial Pain Syndrome;27
7.1;Chapter 2: Myofascial Pain Syndrome;28
7.1.1;Introduction;30
7.1.1.1;Trigger Point Manifestations;31
7.1.1.2;Trigger Point Pain;31
7.1.1.3;Current State of Knowledge;32
7.1.2;Clinical Presentation;33
7.1.3;Definition;33
7.1.3.1;Primary Trigger Point Characteristics;33
7.1.3.2;Additional Trigger Point Characteristics;34
7.1.3.3;Trigger Point Identification;36
7.1.3.4;Weakness;37
7.1.3.5;Recruitment;37
7.1.3.6;Reciprocal Inhibition;37
7.1.3.7;Range of Motion;38
7.1.3.8;Functional Adaptation;38
7.1.4;Sensory Changes;38
7.1.5;Electrophysiology of the Trigger Point: Spontaneous Electrical Activity (Endplate Noise) ;39
7.1.6;Etiology of Myofascial Trigger Points;41
7.1.6.1;Generation of the Taut Band;41
7.1.6.2;Muscle Overuse Syndromes and Myofascial Pain Syndrome;41
7.1.6.3;The Neuromuscular Junction: The Role of the Neuromuscular Junction in Trigger Point Formation;41
7.1.6.4;Peripheral Nerve Sensitization in Myofascial Pain Syndrome;43
7.1.6.5;Hypoxia and Ischemia;43
7.1.6.6;Biochemistry of the Trigger Point Region;44
7.1.7;Muscle Pathology;46
7.1.8;Central Sensitization;50
7.1.8.1;Central Pathways;50
7.1.8.2;Referred Pain;51
7.1.9;Muscle Stress and Overuse;53
7.1.9.1;Muscle Overuse Syndromes;53
7.1.9.2;Postural Stresses;56
7.1.10;Pain Initiation in Myofascial Pain Syndrome;56
7.1.10.1;Inflammatory Pain Models;56
7.1.10.2;Acid-Sensing Ion Channels;57
7.1.10.3;Serotonergic Mechanisms;57
7.1.10.4;Calcitonin Gene-Related Peptide;58
7.1.10.5;Spinal Modulation of Pain;58
7.1.11;Epidemiology of Myofascial Pain;59
7.1.11.1;Prevalence Studies;59
7.1.11.2;Gender Differences;59
7.1.11.3;Hypermobility;60
7.1.12;Diagnosis of Myofascial Pain Syndrome;60
7.1.12.1;Reliability of Manual Identification of Trigger Points;60
7.1.12.2;Consensus Studies and Systematic Reviews;62
7.1.12.3;Objective Criteria;63
7.1.12.4;Pain from Bone and Tendon;64
7.1.13;Differential Diagnosis;65
7.1.13.1;Differential Diagnostic Considerations;65
7.1.13.2;Trigger Point-Initiating Factors;65
7.1.13.3;Fibromyalgia;66
7.1.13.4;Other Disorders to Consider;66
7.1.13.5;Viscerosomatic Disorders;66
7.1.13.6;Other Causes of Referred Pain;67
7.1.13.7;Mechanical Dysfunction;67
7.1.14;Treatment;67
7.1.14.1;Treatment Principles;67
7.1.14.2;Manual Inactivation of Trigger Points;68
7.1.14.3;Noninvasive, Non-Manual Treatment Techniques;70
7.1.14.4;Invasive Treatment of Myofascial Trigger Points;70
7.1.14.5;Botulinum Toxin;73
7.1.15;Perpetuating Factors;74
7.1.15.1;Introduction to Perpetuating Factors;74
7.1.15.2;Iron Insufficiency;74
7.1.15.3;Hypothyroidism;75
7.1.15.4;Iron Status and Thyroid Function;76
7.1.15.5;Vitamin D Deficiency;77
7.1.15.6;Statins;78
7.1.15.7;Structural and Mechanical Factors;79
7.1.16;Selected Specific Clinical Syndromes;79
7.1.16.1;Headache;79
7.1.16.2;Fibromyalgia;80
7.1.16.3;Endometriosis and Other Pelvic Viscerosomatic Pain Syndromes;81
7.1.16.4;Radiculopathy;82
7.1.16.5;Thoracic Outlet Syndrome;83
7.1.17;Conclusion;84
7.1.18;References;84
7.2;Chapter 3: Morphology of Myofascial Trigger Points: What Does a Trigger Point Look Like?;97
7.2.1;Introduction and Historical Remarks;98
7.2.2;Normal Histology and Structure of Skeletal Muscle;100
7.2.2.1;The Striation;100
7.2.2.2;The Motor Unit;100
7.2.2.3;The Neuromuscular Junction;102
7.2.3;Morphological Features of a Trigger Point;104
7.2.4;Animal Experiments Aiming at the Production of Myofascial Trigger Points;108
7.2.5;Morphology of the Tender Points of the Fibromyalgia Syndrome ;111
7.2.6;References;112
8;Part II: Fibromyalgia Syndrome;115
8.1;Chapter 4: Fibromyalgia Syndrome: Clinical Aspects and Management;116
8.1.1;Definitions and Terms;118
8.1.1.1;Fibromyalgia;118
8.1.1.2;Regional Pain Syndrome;118
8.1.2;Prevalence;118
8.1.3;Impact;119
8.1.4;Symptoms;120
8.1.4.1;Pain;120
8.1.4.2;Fatigue;120
8.1.4.3;Sleep Disturbance;121
8.1.4.4;Stiffness and Exercise Myalgia;121
8.1.4.5;Cognitive Disturbance;121
8.1.4.6;Abnormal Sensations;121
8.1.4.7;Vascular Disturbances;122
8.1.5;Signs;122
8.1.5.1;Tenderness;122
8.1.5.2;Muscle Tightness;123
8.1.5.3;Other Signs;123
8.1.6;Diagnosis;124
8.1.6.1;Clinical Presentation;124
8.1.6.2;Investigations;125
8.1.7;Comorbidities;126
8.1.7.1;Chronic Fatigue Syndrome;127
8.1.7.2;Irritable Bowel Syndrome;127
8.1.7.3;Irritable Bladder Syndrome;127
8.1.7.4;Regional Pain Syndromes;127
8.1.7.5;Restless Legs Syndrome;127
8.1.7.6;Multiple Chemical Sensitivities;128
8.1.8;Personality, Mood, and Psychology;128
8.1.8.1;Personality;128
8.1.8.2;Depression;130
8.1.8.3;Anxiety;130
8.1.8.4;Distress;131
8.1.9;Triggers;131
8.1.9.1;Trauma;131
8.1.9.2;Infection;132
8.1.9.3;Chronic Illness;132
8.1.9.4;Stress;132
8.1.10;Basic Management;132
8.1.10.1;Assessment;133
8.1.10.2;Management Setting;133
8.1.10.3;Lifestyle Factors;134
8.1.10.4;Stress Factors;134
8.1.11;Nonpharmacological Management;135
8.1.11.1;Accurate Diagnosis;135
8.1.11.2;Education;135
8.1.11.3;The Importance of Patient Involvement;136
8.1.11.4;Exercise;136
8.1.11.5;Psychological Approaches;137
8.1.11.5.1;Cognitive Behavioral Therapy;138
8.1.11.5.2;Operant Behavioral Therapy;138
8.1.11.6;Other Nonpharmacological Therapies;138
8.1.12;Pharmacological Management;139
8.1.12.1;General Approaches;139
8.1.12.2;Analgesics: Opioid and Nonopioid;139
8.1.12.3;Non-Steroidal Anti-inflammatory Drugs;140
8.1.12.4;Pain System Modulators;141
8.1.12.4.1;General Considerations;141
8.1.12.4.2;Tricyclic Antidepressants;141
8.1.12.4.3;Serotonin and Norepinephrine Reuptake Inhibitors;141
8.1.12.4.4;Balanced Dual Reuptake Inhibitors;142
8.1.12.4.5;Monoamine Oxidase Inhibitors;143
8.1.12.4.6;Selective Serotonin Reuptake Inhibitors;143
8.1.12.4.7;Serotonin Receptor Antagonists;143
8.1.12.4.8;Dopamine Receptor Modulators;143
8.1.12.4.9;N-Methyl-d-aspartate Receptor Antagonists;143
8.1.12.4.10;Alpha-2-Delta Ligands;144
8.1.12.5;Agents for Sleep;144
8.1.12.6;Combination Therapies;145
8.1.13;Other Technology;145
8.1.14;Treatment Plan Checklist;146
8.1.15;Conclusion;146
8.1.16;References;147
8.2;Chapter 5: Gender, Genetics, and Other Risk Factors Increasing Vulnerability to Fibromyalgia;153
8.2.1;Introduction;154
8.2.2;Gender;154
8.2.3;Triggers;155
8.2.4;Familial Factors;157
8.2.5;Genetic Factors;158
8.2.5.1;Human Leukocyte Antigen;158
8.2.5.2;Monoaminergic Systems;158
8.2.5.3;Catechol-O-Methyltransferase Pathway;158
8.2.5.4;Serotonin-Related Genes;161
8.2.5.5;Serotonin Transporter Gene;161
8.2.5.6;Serotonin Receptor Genes;162
8.2.5.7;Monoamine Oxidase;162
8.2.5.8;Dopamine-Related Genes;162
8.2.5.9;Other Genes;163
8.2.6;Conclusion;163
8.2.7;References;164
9;Part III: Other Muscle Pain Syndromes ;168
9.1;Chapter 6: Low Back Pain of Muscular Origin;169
9.1.1;Introduction;170
9.1.2;Epidemiology;171
9.1.3;Etiology;173
9.1.3.1;Predisposing Factors;173
9.1.3.2;Mechanical;173
9.1.3.3;Comorbid Disorders;174
9.1.3.4;Psychological Factors;174
9.1.3.5;Occupational Factors;174
9.1.3.6;Sex, Gender, and Age Factors;175
9.1.4;Clinical Myofascial Low Back Pain Syndromes;176
9.1.4.1;Quadratus Lumborum Muscle;179
9.1.4.2;Abdominal Muscles;181
9.1.4.3;Iliopsoas;182
9.1.4.4;Gluteus Medius;185
9.1.4.5;Erector Spinae;185
9.1.4.6;Posterior Serratus Inferior Muscle;188
9.1.5;Functional Consequences of Myofascial Trigger Points (see Chap.2);188
9.1.6;Treatment;190
9.1.6.1;Treatment Evaluation Schema;190
9.1.6.2;Nonpharmacological;190
9.1.6.2.1;Physiotherapy;191
9.1.6.2.2;Electrical Stimulation;192
9.1.6.2.3;Interventional Treatment;193
9.1.6.2.3.1;Botulinum Toxin;193
9.1.6.2.3.2;Trigger Point Dry Needling and Injections;193
9.1.6.3;Pharmacological Treatment;194
9.1.6.3.1;Muscle Relaxants;196
9.1.6.3.2;Opioids;196
9.1.7;Conclusion;197
9.1.8;References;197
9.2;Chapter 7: Masticatory Muscle Pain;201
9.2.1;The Masticatory Muscle Pain;202
9.2.2;Epidemiology;203
9.2.3;Comorbidity;204
9.2.3.1;Headache;204
9.2.3.2;Neck Pain;204
9.2.3.3;Fibromyalgia;205
9.2.4;Etiology and Risk Factors;205
9.2.4.1;Gender and Age;206
9.2.4.2;Stress and Psychological Factors;206
9.2.4.3;Genetic Factors;207
9.2.4.4;Parafunction;208
9.2.5;Pathophysiology of Localized Muscle Pain;210
9.2.6;Trigger Points and Masticatory Muscle Pain;212
9.2.7;Sensory and Motor Consequences of Masticatory Muscle Pain;215
9.2.7.1;Somatosensory Alterations;215
9.2.7.2;Motor Alterations;216
9.2.8;Summary on Masticatory Muscle Pain;217
9.2.9;Diagnosis;217
9.2.10;Management;220
9.2.10.1;Treatment of Acute or Persistent Masticatory Muscle Pain;220
9.2.10.2;Patient Education and Self-control;221
9.2.10.3;Physiotherapy;221
9.2.10.4;Pharmacological Treatment;222
9.2.10.5;Relaxation Therapy;222
9.2.10.6;Occlusal Appliances;223
9.2.11;Management of the Chronic Masticatory Muscle Pain;223
9.2.11.1;Cognitive-Behavioral Therapy;224
9.2.11.2;Pharmacological Treatment;224
9.2.12;References;225
9.3;Chapter 8: Inflammatory Myopathies;236
9.3.1;Background;237
9.3.2;Polymyositis and Dermatomyositis;237
9.3.2.1;Epidemiology;237
9.3.2.2;Etiology and Pathogenesis;239
9.3.2.3;Clinical Features;240
9.3.2.4;Muscle;241
9.3.2.5;Joints;241
9.3.2.6;Skin;242
9.3.2.7;Respiratory Tract System;242
9.3.2.8;Gastrointestinal Tract;243
9.3.2.9;Heart;243
9.3.2.10;Diagnosis;243
9.3.2.11;Autoantibodies in Inflammatory Myopathies;244
9.3.3;Treatment;246
9.3.3.1;Pharmacological Treatment;246
9.3.3.2;Physical Exercise;247
9.3.3.3;Prognosis;247
9.3.4;Inclusion Body Myositis;248
9.3.4.1;Clinical and Laboratory Features;248
9.3.4.2;Muscle Biopsy;248
9.3.4.3;Etiology and Pathogenesis;249
9.3.4.4;Treatment and Prognosis;250
9.3.5;Conclusions;250
9.3.6;References;250
9.4;Chapter 9: Whiplash Injury, Muscle Pain and Motor Dysfunction;254
9.4.1;Introduction;255
9.4.1.1;Whiplash Mechanisms;256
9.4.2;Classifications;263
9.4.3;Chronic Symptoms After Whiplash Injury;265
9.4.4;Muscles and Motor Function;270
9.4.5;Sensory Aspects of Whiplash;276
9.4.6;Clinical Management;279
9.4.7;References;280
9.5;Chapter 10: Brain Imaging of Muscle Pain;296
9.5.1;Introduction;297
9.5.2;The Pain Matrix: A Short Introduction Based on Acute Nociceptive Stimulation;297
9.5.3;How Does the Representation of Muscle Pain Differ from Cutaneous Nociceptive Inputs in the Brain?;300
9.5.4;Acute Nociceptive Stimulation in Patients with Chronic Musculoskeletal Pain;301
9.5.5;Nociceptive Processing in Chronic Muscle Pain;308
9.5.6;Structural Changes in Patients with Chronic Muscle Pain;310
9.5.7;Conclusions and Outlook;311
9.5.8;References;312
10;Glossary ;317
11;Index;366