medigraphic.com
ISSN 1405-8790 (Print)

2009, Number 3

<< Back

Rev Mex Med Fis Rehab 2009; 21 (3)

Cervical miofascial pain syndrome associated to thoracic outlet syndrome, a symptom of the cervical pain

Pérez BMLI, Montes CML, Flores GR, Vázquez JAJ, Díaz BS, Castañeda PN

Language: Spanish
References: 36
Page: 90-94
PDF size: 59.34 Kb.


ABSTRACT

The cervical pain is within the first causes of consultation in rehabilitation, can be originated by postural alterations, cervical sprain, disc herniation, spondiloarthrosis, tension, labor stress, tumoral, inflammatory and congenital processes. For the diagnosis we must include the clinical data, radiological image and electrodiagnosis, being more specific the study of the conduction of the medial cutaneous antebraquial nerve. Objective: To detect the signs and clinical symptoms of the cervical myofascial pain syndrome (CMPS) thoracic outlet syndrome (TOS). Methods: Patients of the Hospital General de Mexico with clinical data of MPS and TOS with a minimum of 3 Simon’s criteria. One evaluated the pain, trigger points, numbness and tingling on the ulnar, median, radial and antebraquial cutaneous medial territories, or in two or more territories; swelling in supraclavicular, hand and forearm; changes of coloration or local temperature; range of neck motion; Adson’s and Wrigth’s tests; migraine and vertigo. Results: 437 patients evaluated in 16 months with CMPS diagnosis, in 43 (9.83%) were associated to TOS, all the patients (100%) presented/displayed cervical pain with trigger points and/or fibrous bands in scalene and/or pectoral minor, numbness and tingling in at least one upper limb (100%), 52% on the nerve ulnar territory. Were not alterations in the electrodiagnosis. Conclusions: CMPS were associated to TOS in 9.3%. More studies are required for confirm the results, and need trials in treatment.


REFERENCES

  1. Salter GC, Roman M, Bland MJ, MacPherson. Acupuncture for chronic neck pain: A pilot for a randomized controlled trial. BMC Musculoskeletal Disorder 2006; 7: 99.

  2. Adams RD, Víctor M, Ropper AH. Principles of neurology. 6a. Edition. McGraw-Hill. Boston. 1997.

  3. Granges G, Litlegohn G, Prevalence of myosfascial pain syndrome in fibromyalgia syndrome and regional pain syndrome: a comparative study. J Musculoskeletal Pain 1993; 1(2): 19-35.

  4. Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Med Clin North Am 2007; 91(2): 229-39.

  5. Howard M, Lee C, Dellon AL. Documentation of brachial plexus compression (in the thoracic inlet) utilizing provocative neurosensory and muscular testing. J Reconstr Microsurg 2003; 19(5): 303-12.

  6. Kuan TS, Hsieh YL, Chen SM, Chen JT, Yen WC, Hong CZ. The myofascial trigger point region: Correlation between the degree of irritability and the prevalence of endplate noise. Am J Phys Med Rehabil 2007; 86(3): 183-9.

  7. Kai Y, Oyama M, Kurose S, Inadome T, Oketani Y, Masuda Y. Neurogenic thoracic outlet syndrome in whiplash injury. J Spinal Disord 2001; 14(6): 487-93.

  8. Simons DG. Clinical and etiological update of myofascial pain from trigger points. J Musculoeskeke Pain 1996; 4: 93-121.

  9. Álvarez DJ, Trigger points: diagnosis and management. Am Fam Physician 2002; 65(4): 65360.

  10. Fernández-de-Las-Penas C, Alonso-Blanco C, Cuadrado ML, Gerwin D, Pareja JA. Myofascial trigger points and their relationship to headache clinical parameters in chronic tension-type headache. Headache 2006; 46(8): 1264-72.

  11. Crotti FM, Carai A, Carai M, Sgaramella E, Sias W. Post-traumatic thoracic outlet syndrome (TOS). Acta Neurochir Suppl 2005; 92: 13-5.

  12. Adson AW, Coffrey JR. Cervical rib: A method of anterior approach for relief of symptoms by division of the scalenus anticus. Ann Surg 1927; 85: 839-857.

  13. Wrigth IS. The neurovascular syndrome produced by hyperabduction of arms. Am Heart J 1955; 29: 1-9.

  14. Caldwell JW, Crane CR, Crusen UL. Nerve conduction studies: An aid in the diagnosis of thoracic outlet syndrome. South Med J 1971; 64(2): 210-2.

  15. Sanders RJ, Monsour JW, Baer SB. Transaxilary first rib. Resection fot the thoracic outlet syndrome. Arch Surg 1968; 97: 1014-23.

  16. Capistrant TD. Thoracic outlet syndrome in whiplash injury. Ann Surg 1977; 185(2): 175-8.

  17. Liu JE, Tahmoush AJ, Roos DB, Schwartzman RJ. Shoulder-arm pain from cervical bands and scalene muscle anomalies. J Neurol Sci 1995; 128(2): 175-80.

  18. Esenyel M, Caglar N, Aldemir T. Treatment of myofascial pain. Am J Phys Med Rehabil 2000; 79(1): 48-52.

  19. Gross AR, Goldsmith C, Hoving JL, Haines T, Peloso P, Aker P, Santaguida P, Myers C. Conservative management of mechanical neck disorders: A systematic review. J Rheumatol 2007; 34: 1083-102.

  20. Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Med Clin North Am 2007; 91(2): 229-39.

  21. Majlesi J, Unalan. High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: a randomized, double-blind, case-control study. Ach Phys Med Rehabil 2004; 85(5): 833-6.

  22. Kroeling P, Gross AR, Goldsmith CH. Cervical Overview Group. A cochrane review of electrotherapy for mechanical neck disorders. Spine 2005; 30(21): E641-8.

  23. Kay TM, Gross A, Goldsmith C, Santaguida PL, Hoving J, Bronfort G; Cervical review Group. Exercises for mechanical neck disorders. Cochrane Database Syst Rev 2005; (3): CD 0 4250.

  24. Martin-Santos JM. Artrosis (2). Espondiloartrosis. Coxartrosis. Gonartrosis. Artrosis de manos. Otras localizaciones. Medicina 2005; 9(32): 2108-2116.

  25. Magnusson T. Extracervical symptoms after whiplash trauma. Cephalalgia 1994; 14(3): 223-7.

  26. Kroeling P, Gross AR, Goldsmith CH; Cervical Overview Group. A Cochrane review of electrotherapy for mechanical neck disorders. Spine 2005; 30(21): E641-8.

  27. Gillard J, Pérez-Cousin M, Hachulla E, Remy J, Hurtevent JF, Vinckier L, Thevenon A, Duquesnoy B. Diagnosing thoracic outlet syndrome: contribution of provocative tests, ultrasonography, electrophysiology, and helical computed tomography in 48 patients. Joint Bone Spine 2001; 68(5): 416-24.

  28. Endo K, Ichimaru K, Komagata M, Yamamoto K. Cervical vertigo and dizziness after whiplash injury. Eur Spine 2006: 886-90.

  29. Álvarez GBA, Reyes-Sánchez AA. Esguince cervical. Propuesta de tratamiento. Acta Ortopédica Mexicana 2009; 23(2): 103-108.

  30. Treleaven J, Jull G, Sterling M. Dizziness and unsteadiness following whiplash injury: Characteristic features and relationship with cervical joint position error. J Rehabil Med 2003; 35(1): 36-43.

  31. Koknel TG. Thoracic outlet syndrome. Agri 2005; 17(2): 5-9.

  32. Le Forestier N, Moulonguet A, Maisonobe T, Leger JM, Bouche P. True neurogenic thoracic outlet syndrome: electrophysiological diagnosis in six cases. Muscle Nerve 1998; 21(9): 1129-34.

  33. Cuevas-Trisan RL, Cruz-Jiménez M. Provocative F waves may help in the diagnosis of thoracic outlet syndrome: a report of three cases. Am J Phys Med Rehabil 2003; 82(9): 712-5.

  34. Kimura I, Ayar DR. Sensory nerve conduction study in the medial antebrachial cutaneous nerve. Tohoku J Exp Med 1984; 142(4): 461-6.

  35. Seror P. Medial antebrachial cutaneous nerve conduction study, a new tool to demonstrate mild lower brachial plexus lesions. A report of 16 cases. Clin Neurophysiol 2004; 115(10): 2316-22.

  36. Rousseff R, Tzvetanov P, Valkov I. Utility (or futility?) of electrodiagnosis in thoracic outlet syndrome. Electromyogr Clin Neurophysiol 2005; 45(3): 131-3.




2020     |     www.medigraphic.com