PainSci commentary on Ge 2008: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
It’s possible that trigger points irritate muscles enough to cause cramping. In this experiment, 14 brave volunteers allowed injection of an irritant into their trigger points to see if it would cause cramping. It did!
Latent trigger points were identified with electromyography, and EMG was also used to monitor for cramps before, during, and after the injection of glutamate. For comparison, they also injected saline solution, and injected a control point in healthy muscle.
Injection of both glutamate and saline caused more pain in trigger points than the control points, and glutamate hurt more than saline solution. Glutamate caused cramping in nearly everyone (92%) when injected into trigger points. Saline solution and control points caused no cramping at all.
The authors reasonably concluded that “latent MTrPs could be involved in the genesis of muscle cramps.”
~ Paul Ingraham
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
The aim of this present study is to test the hypothesis that nociceptive stimulation of latent myofascial trigger points (MTrPs) increases the occurrence of local muscle cramps. Nociceptive muscle stimulation was obtained by a bolus injection of glutamate (0.1 ml, 0.5 M) into a latent MTrP and a control point (a non-MTrP) located in the right or left gastrocnemius medialis muscles in 14 healthy subjects. A bolus of isotonic saline (0.9%, 0.1 ml) injection served as a control. The injections were guided by intramuscular electromyography (EMG) showing resting spontaneous electrical activity at a latent MTrP and no such activity at a non-MTrP. Intramuscular and surface EMG activities in the gastrocnemius medialis muscle were recorded pre-, during-, and post-injection for a period of 8 min to monitor the occurrence of muscle cramps, which are characterized by a brief episodic burst of high levels of EMG activity. The results showed that glutamate and isotonic saline injections into the latent MTrPs induced higher peak pain intensity than into the non-MTrPs (both P < 0.05). Glutamate injection induced higher peak pain intensity than isotonic saline injection into either latent MTrPs or non-MTrPs (both P < 0.05). Muscle camps were observed in 92.86% of the subjects following glutamate injection into the latent MTrPs, but not into the non-MTrPs (P < 0.001). No muscle cramps were recorded following isotonic saline injection into either the latent MTrPs or the non-MTrPs. These results suggest that latent MTrPs could be involved in the genesis of muscle cramps. Focal increase in nociceptive sensitivity at MTrPs constitutes one of the mechanisms underlying muscle cramps.
- “Microscopic features and transient contraction of palpable bands in canine muscle,” D G Simons and W C Stolov, Am J Phys Med, 1976.
- “Endplate potentials are common to midfiber myofacial trigger points,” David G Simons, Chang-Zern Hong, and Lois Statham Simons, Am J Phys Med Rehabil, 2002.
- “Accelerated muscle fatigability of latent myofascial trigger points in humans,” Hong-You Ge, Lars Arendt-Nielsen, and Pascal Madeleine, Pain Med, 2012.
- “Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study,” Cristina Emöke Erika Müller, Maria Fernanda Montans Aranha, and Maria Beatriz Duarte Gavião, Ultrason Imaging, 2015.
- “Assessment of myofascial trigger points (MTrPs): a new application of ultrasound imaging and vibration sonoelastography,” Siddhartha Sikdar, Jay P Shah, Elizabeth Gilliams, Tadesse Gebreab, and Lynn H Gerber, Conf Proc IEEE Eng Med Biol Soc, 2008.
- “Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome,” Jay P Shah and Elizabeth A Gilliams, Journal of Bodywork & Movement Therapies, 2008.
- “Ability of magnetic resonance elastography to assess taut bands,” Qingshan Chen, Jeffrey Basford, and Kai-Nan An, Clin Biomech (Bristol, Avon), 2008.
- “Identification and quantification of myofascial taut bands with magnetic resonance elastography,” Qingshan Chen, Sabine Bensamoun, Jeffrey R Basford, Jeffrey M Thompson, and Kai-Nan An, Archives of Physical Medicine & Rehabilitation, 2007.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- No long-term effects after a three-week open-label placebo treatment for chronic low back pain: a three-year follow-up of a randomized controlled trial. Kleine-Borgmann 2022 Pain.
- Exercise and education versus saline injections for knee osteoarthritis: a randomised controlled equivalence trial. Bandak 2022 Ann Rheum Dis.
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
- A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Yousef 2013 Anaesthesia.
- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.