Increased Muscle Tenderness Research Articles

Michigan Splint Versus Superior Repositioning Splint For Management Of TMD’s

The aim of this study is to evaluating the effectiveness of use of Michigan splint in the management of Temporomandibular joint disorders (TMD) in comparison to superior repositioning splint (SRS) as a control group in a one-year follow-up.. Material and methods: Sample was initially constituted by 40 patients, randomly divided into two groups: I- Michigan splints, II- Superior repositioning splints. The whole sample was evaluated by means of TMJ and muscle palpation, mandibular range of motion (ROM), analysis of occlusal contacts, joint sounds inspection and Visual Analogue Scale (VAS) for one year. Results: A significant (after 15 days) improvement in pain report (VAS) and palpation index was found for group II (p²0.01). The occurrence of occlusal alterations as posterior open bite or gross interferences after the splint therapy and increased muscle tenderness were not problems in this study. Similar results in joint noises reduction were observed for the entire sample. Conclusion: It was concluded that use of repositioning splints is a beneficial tool in the management of intra-articular pain and dysfunction, with no risks of irreversible occlusal changes.

Neck and shoulder muscle strength in patients with tension-type headache: A case-control study.

Tension-type headache (TTH) is highly prevalent in the general population, and it is characterized by increased muscle tenderness with increasing headache frequency and intensity. The aim of this case-control study was to compare muscle strength in neck and shoulder muscles in TTH patients and healthy controls by examining maximal voluntary isometric contraction (MVC) during shoulder abduction, neck flexion and extension as well as the extension/flexion strength ratio of the neck. Sixty TTH patients and 30 sex- and age-matched healthy controls were included. Patients were included if they had TTH ≥8 days per month. The MVC neck extensor and flexor muscles were tested with the participant seated upright. MVC shoulder abduction was tested with the individual lying supine. Compared to controls TTH patients had significantly weaker muscle strength in neck extension (p = 0.02), resulting in a significantly lower extension/flexion moment ratio (p = 0.03). TTH patients also showed a tendency toward significantly lower muscle strength in shoulder abduction (p = 0.05). Among the 60 TTH patients, 25 had frequent episodic TTH (FETTH), and 35 had chronic TTH (CTTH). Patients with TTH exhibited decreased muscle strength in the neck extensor muscles, inducing a reduced cervical extension/flexion ratio compared to healthy people.

Pericranial tenderness in chronic tension-type headache: the Akershus population-based study of chronic headache.

BackgroundMost knowledge on chronic tension-type headache (CTTH) is based on data from selected clinic populations, while data from the general population is sparse. Since pericranial tenderness is found to be the most prominent finding in CTTH, we wanted to explore the relationship between CTTH and pericranial muscle tenderness in a population-based sample.MethodsAn age- and gender-stratified random sample of 30,000 persons aged 30-44 years from the general population received a mailed questionnaire. Those with a self-reported chronic headache were interviewed and examined by neurological residents. The questionnaire response rate was 71% and the interview participation rate was 74%. The International Classification of Headache Disorders II was used. Pericranial muscle tenderness was assessed by a total tenderness score (TTS) involving 8 pairs of muscles and tendon insertions. Cross-sectional data from the Danish general population using the same scoring system were used for comparison.ResultsThe tenderness scores were significantly higher in women than men in all muscle groups. The TTS was significantly higher in those with co-occurrence of migraine compared with those without; 19.3 vs. 16.8, p = 0.02. Those with bilateral CTTH had a significantly higher TTS than those with unilateral CTTH. The TTS decreased significantly with age. People with CTTH had a significantly higher TTS compared to the general population.ConclusionsPeople with CTTH have increased pericranial tenderness. Elevated tenderness scores are associated with co-occurrence of migraine, bilateral headache and low age.Whether the increased muscle tenderness is primary or secondary to the headache should be addressed by future studies.

Muscle tenderness and psychiatric comorbidity: a vicious cycle in migraine chronicization.

Muscle tenderness and psychiatric comorbidity: a vicious cycle in migraine chronicization.

The Effect of Tart Cherry Juice Blend on Reducing Eccentric Exercise-Induced Muscle Soreness

Tart cherries contain a high level of phytonutrients purported to have antioxidant and anti-inflammatory effects. Limited research has investigated their potential to attenuate the symptoms of delayed onset muscle soreness (DOMS) caused by inflammation resulting from strenuous eccentric exercise. PURPOSE: To assess the effect of tart cherry juice (TCJ) on DOMS by evaluating muscle pain, muscle tenderness, thigh girth, knee range of motion, and quadriceps strength following eccentric exercise. METHODS: Recreationally active males and females (N=29, Age=25.3±6.9 yrs, Height=1.7±0.1 m, Weight=70.1±9.2 kg, BMI=23.3±1.9 kg/m∧2) participated. Baseline data collection measured the right quadriceps muscle for pain, muscle tenderness, thigh girth, passive knee flexion range of motion, and isokinetic knee extension strength. An isokinetic eccentric fatigue protocol of the right quadriceps occurred five days after baseline, and data collection was repeated 24h and 48h post-fatigue. Subjects consumed TCJ or a macronutrient-matched placebo twice per day for the study duration. A two-way mixed ANOVA was utilized to determine differences between groups at 24h and 48h post-fatigue (α=0.05). RESULTS: Compared to baseline, both groups demonstrated increased pain assessed by a Visual Analog Scale (Baseline: 0.5±0.8mm; 24h: 17.1±17.1mm, p<0.001; 48h: 16.2±21.8mm, p=0.002), increased muscle tenderness to force (Baseline: 12.1±4.5kg; 24h: 9.0±3.6kg, p<0.001; 48h: 9.1±4.3kg, p<0.001), and decreased ROM (Baseline: 146.2±7.1°; 48h: 142.7±8.6°, p=0.004). No significant between group differences were demonstrated for the dependent variables at 24 or 48h post-fatigue (p=0.156-0.636). CONCLUSION: Symptoms of DOMS were elicited in both groups at 24h and 48h post-fatigue. Consistent with previous literature, no differences in muscle tenderness or ROM were noted between TCJ and placebo groups. Although research has found that TCJ improved muscle pain and strength compared to placebo, our results showed no significant differences; however, there was a trend for increased strength in the TCJ group at 24h post-fatigue. Future research should further examine the capability of TCJ to suppress symptoms of DOMS following various eccentric fatigue protocols. Supported by the Cherry Marketing Institute.

Central mechanisms of stress-induced headache

Stress is the most commonly reported trigger of an episode of chronic tension-type headache (CTTH); however, the causal significance has not been experimentally demonstrated to date. Stress may trigger CTTH through hyperalgesic effects on already sensitized pain pathways in CTTH sufferers. This hypothesis could be partially tested by examining pain sensitivity in an experimental model of stress-induced headache in CTTH sufferers. Such examinations have not been reported to date. We measured pericranial muscle tenderness and pain thresholds at the finger, head and shoulder in 23 CTTH sufferers (CTH-S) and 25 healthy control subjects (CNT) exposed to an hour-long stressful mental task, and in 23 CTTH sufferers exposed to an hour-long neutral condition (CTH-N). Headache developed in 91% of CTH-S, 4% of CNT, and 17% of CTH-N subjects. Headache sufferers had increased muscle tenderness and reduced pain thresholds compared with healthy controls. During the task, muscle tenderness increased and pain thresholds decreased in the CTH-S group compared with CTH-N and CNT groups. Pre-task muscle tenderness and reduction in pain threshold during task were predictive of the development and intensity of headache following task. The main findings are that stress induced a headache in CTTH sufferers, and this was associated with pre-task muscle tenderness and stress-induced reduction in pain thresholds. The results support the hypothesis that stress triggers CTTH through hyperalgesic effects on already increased pain sensitivity in CTTH sufferers, reducing the threshold to noxious input from pericranial structures.

Daily stress and pain sensitivity in chronic tension‐type headache sufferers

AbstractThe aim was to examine interactions between daily stress, pain sensitivity, and headache activity in Chronic Tension‐Type Headache sufferers. We measured daily hassles, pericranial muscle tenderness, pressure pain threshold at finger, headache history (years of headache) and prospective headache activity (in a two‐week clinical diary), in headache sufferers and healthy Controls. Headache sufferers had increased daily hassles scores, increased muscle tenderness, and decreased pain threshold compared to Controls. Daily hassles were correlated with increased muscle tenderness and reduced pain threshold in the CTH group. In regression analyses, daily hassles predicted muscle tenderness when accounting for headache history, headache severity and pain threshold. Muscle tenderness and daily hassles predicted headache severity when accounting for headache history and pain threshold. Muscle tenderness predicted pain threshold when accounting for headache history, headache severity and daily hassles. The results indicate daily stress is related to increased pain sensitivity and headache activity in Chronic Tension‐Type Headache sufferers, accounting for significant variance in these factors additional to that accounted for by clinical factors (headache history and severity). Although only correlational, the results support the proposition that daily stress affects Chronic Tension‐Type Headache through hyperalgesic effects on already sensitized pain pathways in headache sufferers. Copyright © 2007 John Wiley &amp; Sons, Ltd.

Neck pain in chronic whiplash syndrome treated with botulinum toxin. A double-blind, placebo-controlled clinical trial

ObjectivesNeck pain in chronic whiplash syndrome is a major burden for patients, healthcare providers and insurance companies. Randomized data on treatment of botulinum toxin in chronic whiplash syndrome are scarce. We conducted a randomized, placebo-controlled clinical trial to prove efficacy of botulinum toxin for neck pain in chronic whiplash syndrome.Methods40 patients with chronic whiplash syndrome (whiplash associated disorders grade 1 and 2) were randomly assigned to receive botulinum toxin (maximum 100 units) or placebo (saline) in muscles with increased tenderness.ResultsAfter 12 weeks there was no significant difference between the two treatment groups in decrease of neck pain intensity on VAS (−7.0 mm, 95% confidence interval (CI) [−20.7 to +6.7]), mean number of neck pain days (−1%; 95% CI [−15% to +13%]), neck pain hours per day (−0.14; 95% CI [−3.0 to +2.7]), days on which symptomatic treatment was taken (−0.7%; 95% CI [−15% to +13%]) number of analgesics taken per day (−0.14; 95% CI [−0.6 to +0.4]) and total cervical range of motion (−11 degrees; 95% CI [−40 to +17]). There also was no significant difference in patient’s assessment of improvement after week 4, 8 and 12.ConclusionsBotulinum toxin was not proven effective in treatment of neck pain in chronic whiplash syndrome. Increased muscle tenderness alone might not be the major cause of neck pain in whiplash syndrome.

Partial time use of anterior repositioning splints in the management of TMJ pain and dysfunction: a one-year controlled study

This study aimed at evaluating the effectiveness of partial use of anterior repositioning appliances in the management of TMJ pain and dysfunction when compared to stabilization splints and a control group in a one-year follow-up. Sample was initially constituted by 60 patients, randomly divided into three groups: I- stabilization splints, II- repositioning splints and III- no treatment. The whole sample was evaluated by means of TMJ and muscle palpation, mandibular AROM, analysis of occlusal contacts, joint sounds inspection and Visual Analogue Scale (VAS) for one year; 52 patients composed the final sample. A significant (after 15 days) improvement in pain report (VAS) and palpation index was found for group II (p < or = 0.01). The occurrence of occlusal alterations as posterior open bite or gross interferences after the splint therapy and increased muscle tenderness were not problems in this study. Similar results in joint noises reduction were observed for the entire sample. It was concluded that controlled partial use of repositioning splints is a beneficial tool in the management of intra-articular pain and dysfunction, with no risks of irreversible occlusal changes.

Muscle tenderness in pericranial and neck-shoulder region in children with headache. A controlled study.

Increased pericranial muscle tenderness is connected with tension-type headache in adults. In children, the importance of muscle tenderness in the pericranial or neck-shoulder region in the pathogenesis of different types of headache is unknown. The present study evaluated muscle tenderness in the pericranial and neck-shoulder region in children with migraine, those with tension-type headache and those without headache. An unselected population-based questionnaire study concerning headache was carried out in 1135 Finnish schoolchildren aged 12 years. Of them, 183 children were randomly selected for a face-to-face interview and a clinical examination. Muscle tenderness was recorded by manual palpation and dolorimeter. Children with migraine had increased overall tenderness, recorded by manual palpation, compared with those without headache. They also self-reported tenderness in the neck-shoulder region during daily activities more often than the children of the other groups. Muscle tenderness was not associated with paediatric tension-type headache. The mean pressure pain thresholds did not differ among the three groups. However, a negative correlation between the total tenderness score and the dolorimeter score was found in each group. In conclusion, children with migraine had increased muscle tenderness at palpation of the pericranial and neck-shoulder muscles and they also reported pain symptoms in the neck-shoulder region most frequently. Instead, increased pericranial and neck-shoulder muscle tenderness was not associated with tension-type headache in children.

Pressure pain threshold and needle acupuncture in chronic tension-type headache – a double-blind placebo-controlled study

In order to examine the role of muscular mechanisms in chronic tension-type headache a study with needle acupuncture was performed. Needle acupuncture could be of therapeutic value because it has shown some positive effects in myofascial pain syndromes. We performed a double-blind, placebo-controlled study with 39 patients (mean age 49.0 years, SD=14.8) fulfilling the International Headache Society criteria for chronic tension-type headaches. Participants were randomly assigned to verum or placebo condition. Six weeks after end of treatment no significant differences between placebo and verum could be observed with respect to visual analogue scale and frequency of headache attacks. Nevertheless, pressure pain thresholds significantly increased for the verum group. The findings of our study support the hypothesis that peripheral mechanisms – such as increased muscle tenderness – only play a minor role in the pathogenesis of chronic tension-type headache.

Five‐year longitudinal study of adolescents with intact and restored dentitions: signs and symptoms of temporomandibular dysfunction and functional recordings

Signs and symptoms of temporomandibular dysfunction (TMD) and functional recordings were re-examined in subjects, 19-21 years of age, 5 years after the first examination. Thirty-seven subjects had restored dentitions at both examinations (group F), 13 subjects with previously intact dentitions had had fillings in their teeth during the follow-up period (group FI), and 14 subjects had intact dentitions at both examinations (group I). In agreement with the first examination, the subjects with restored dentitions had a higher degree and frequency of TMD than the subjects with intact teeth. Most of the symptoms were mild, but more severe symptoms were reported by the subjects in group F, and female subjects in group F had more signs than male subjects. The subjects who had received fillings during the follow-up period (group FI) constituted a group intermediate between group F and group I with regard to signs and symptoms of TMD. Frequent parafunction and more attrition were more common in group F. Together with the finding of increased muscle tenderness, this indicates more functional activity in restored dentitions. Correlation analysis did not reveal any relationship between occlusal factors and TMD. The findings of this study are consistent with those of the earlier investigation. Dental filling therapy appears to be an aetiological factor in TMD worthy of more consideration and more extensive research.

COMPARISON OF STRUCTURAL CHANGES IN BOVINE LONG AND SEMITENDINOSUS MUSCLES DURING COOKING

ABSTRACTStructural characteristics of aged (10 days) bovine longissimus and semitendinosus muscles as affected by thermal treatment were evaluated with scanning electron microscopy (SEM) and transmission electron microscopy PEM). Steaks were oven roasted at 177°C to internal temperatures of either 63, 68, or 73°C. At 63°C both muscle samples exhibited coagulation and denaturation of the perimy‐sium and sarcolemma and progressively increased to near complete coagulation and denaturation at 73°C. Well‐defined myofibrillar surface features were present in semitendinosus samples at 63°C and increased sarcomere denaturation and shrinkage were observed at the higher temperatures. Whereas, the overall topographical features of longissimus myofibrils were not well‐defined and exhibited a granular appearance even at 63°C. TEM of samples heated to 63°C revealed less distinct myofibrils in longissimus than in semitendinosus samples. Disintegration of filaments in the I‐band and shrinkage of filaments in the A‐band occurred at 63°C. Increased disintegration of actin filaments in the I‐band at the junction of the Z‐disc and shrinkage and disruption of the A‐band material occurred as temperatures were increased. Z‐disc material remained intact with some evidence of disruption at the higher temperatures. Although progressive disruption of muscle fiber ultrastructure occurred as steaks were heated to higher internal temperatures, these changes did not result in increased muscle tenderness. Instead the samples became progressively less tender as internal temperatures were increased likely due to the shrinkage and hardening of filamentous material in the A‐bands. Increased disintegration of filaments in the I‐band as temperature was increased apparently did not contribute to an improvement in tenderness.