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Original Research Article
Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Patients with Chronic Nonspecific Low Back Pain
Article first published online: 15 AUG 2013
Wiley Periodicals, Inc
Volume 14, Issue 12, pages 1964–1970, December 2013
How to Cite
Iglesias-González, J. J., Muñoz-García, M. T., Rodrigues-de-Souza, D. P., Alburquerque-Sendín, F. and Fernández-de-las-Peñas, C. (2013), Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Patients with Chronic Nonspecific Low Back Pain. Pain Medicine, 14: 1964–1970. doi: 10.1111/pme.12224
1) No funds were received for this study; 2) no financial benefits are derived to the authors from this study; 3) data from this study have not been presented in any other form.
- Issue published online: 11 DEC 2013
- Article first published online: 15 AUG 2013
- Low Back Pain;
- Trigger Points;
- Myofascial Pain;
To investigate the difference in the presence of trigger points (TrPs) between patients with chronic nonspecific low back pain (LBP) and healthy people, and to determine the relationship of TrPs with the intensity of ongoing pain, disability, and sleep quality.
A cross-sectional study.
The role of TrPs in LBP has not been determined.
Forty-two patients with nonspecific LBP (50% women), aged 23–55 years old, and 42 age- and sex-matched controls participated.
TrPs were bilaterally explored within the quadratus lumborum, iliocostalis lumborum, psoas, piriformis, gluteus minimus, and gluteus medius muscles in a blinded design. TrPs were considered active if the subject recognized the local and referred pain as familiar symptoms, and TrPs were considered latent if the pain was not recognized as a familiar symptom. Pain measures were collected with a numerical pain rate scale, disability was assessed with the Roland–Morris questionnaire, and sleep quality was determined with the Pittsburgh Sleep Quality Index.
Patients with nonspecific LBP exhibited a greater disability and worse sleep quality than healthy controls (P < 0.001). Patients with nonspecific LBP exhibited a mean of 3.5 ± 2.3 active TrPs. Further, patients with nonspecific LBP showed a greater (P < 0.001) number of latent TrPs (mean: 2.0 ± 1.5) than healthy controls (mean: 1.0 ± 1.5). Active TrPs in the quadratus lumborum, iliocostalis lumborum, and gluteus medius muscles were the most prevalent in patients with nonspecific LBP. A greater number of active TrPs was associated with higher pain intensity (rs = 0.602; P < 0.001) and worse sleep quality (rs = 0.338; P = 0.03).
The local and referred pain elicited by active TrPs in the back and hip muscles contributes to pain symptoms in nonspecific LBP. Patients had higher disability and worse sleep quality than controls. The number of active TrPs was associated with pain intensity and sleep quality. It is possible that a complex interaction among these factors is present in patients with nonspecific LBP.