Abstract
Gluteal syndrome (GS) mimicking sciatica is a new disease that has been recently recognized and included in the International Classification of Diseases, 11th Revision. The present study examines nociplastic pain involvement in GS and sciatica patients using a new Skorupska protocol (SP) test that provokes amplified vasodilatation in the area of expected muscle-referred pain. A positive test is confirmed if there is (i) a development of autonomic referred pain (AURP) and (ii) an increase in the delta of average temperature (Δ₸°) > 0.3 °C at the end of the stimulation and during the observation SP phases. Chronic GS (n = 20) and sciatica (n = 30) patients were examined. The SP test confirmed muscle-referred pain for (i) all GS patients with 90.6% positive thermograms (Δ₸° 0.6 ± 0.8 °C; maximum AURP 8.9 ± 13.6% (both p < 0.05)) and (ii) those sciatica (n = 8) patients who reported pain sensation during the test with 20.6% positive thermograms (Δ₸° 0.7 ± 0.7 °C; maximum AURP 15.1 ± 17.8% (both p < 0.05)). The remaining sciatica (n = 22) patients did not report pain during the test and presented a Δ₸° decrease and the AURP size below 1%. Conclusion: Amplified vasodilatation suggesting nociplastic pain involvement was confirmed for all GS and sciatica patients who reported painful sensations in the zone typical for gluteus minimus referred pain during the test.
Highlights
The inclusion criteria for sciatica were as follows: diagnosis of sciatica based on a neurological examination, a positive SLR test (>30◦ and
Patients were excluded from the study if they presented with previous back surgery, pregnancy, cauda equina syndrome, complex regional pain syndrome, spinal tumors, scoliosis, coagulant treatment, disseminated intravascular coagulation, diabetes, stroke, epilepsy, infection, inflammatory rheumatologic diseases, or oncological history
Paweł Dobrakoawmskini i5mum of two active trigger points within the gluteus minimus muscle according to Travell and Simons’ diagnostic criteria—i.e., a taut band, spot tenderness, pain recognition, and a limited1 raDnegpaertomfemnt oofvPehmyseiontth.erMapyo,rPeoozvneanr,Ufnoilvleorwsitiynogf MtheedincaelwSceiesntcerse,c6o1-m70m1 Peonzdnaant,ioPonlsa,nd; we considered amdadrtiat.ijooknieall@gdmiaagiln.coomsti(Mc .cJ.r)i;tjearroisal,awsu.zcahwaadszitnhskei@regmpraoil.dcoumct(iJo.Zn.) of the lower leg symptoms ex2peFraiecunltcyeodf Pbhyystihcael EpdautciaetniotnaannddPthhyasitotwheerraepyr,eOcpooglenUizneivderasistyfaofmTeilcihanro, lothgye, 4r5a-r7e5l8yOpole, Pola accessible taut bdtadnydbekc@rigtmeraiol.cno,mand spontaneous referred pain [6]
Summary
Amplified Vasodilloacatteadtiinoonne owf thietthhreiengluttehalemuRscelesf(ei.er.,rgeludteusPmaaixinmuZs, moendiues,ofor minimus) [3]. All of the GS patients had gluteal trigger points and reported pain sensations recognized as the daily complaint during the SP test, which means that they were SP(+). For gluteal syndrome, the inclusion criteria were as follows: diagnosis of active trigger points within the gluteus minimus muscle, a chronic state, and a positive SLR test (>45◦). The inclusion criteria for sciatica were as follows: diagnosis of sciatica based on a neurological examination, a positive SLR test (>30◦ and
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