NIH Clinical Research Studies

Protocol Number: 02-CC-0245

Active Accrual, Protocols Recruiting New Patients

Title:
The Use of Microdialysis/Acupuncture Needle to Assess the Local Tissue Milieu in Active and Latent Myofascial Trigger Points in the Upper Trapezius Muscle in Individuals With and Without Neck Pain
Number:
02-CC-0245
Summary:
Many adults suffer from neck pain of muscle origin (myofascial pain). Treatment depends on accurate diagnosis, which is often difficult. This study proposes to enroll 30 adults (men and women, ages 21 to 65) in three groups:

1. Healthy people without neck pain who have no myofascial trigger points (MTrPs) in the upper trapezius muscle

2. Healthy people without neck pain who have latent MTrPs as identified by palpation (touching) in the upper trapezius muscle

3. Healthy people who have had neck pain for less than three months who have active MTrPs in the upper trapezius muscle

The researchers have treated myofascial pain by inserting an acupuncture needle into the tender part of the upper trapezius muscle. They theorize that the treatment works by physically disrupting the integrity of dysfunctional motor endplates in the muscle. They have devised a hollow needle whose diameter is no larger than that of an acupuncture needle. In this study, they will use the needle to draw small amounts of fluid from the muscle. They will use electrodes to compare the muscle responses of the three groups. They will analyze the chemical contents of the withdrawn fluids, such as electrolytes, muscle metabolites, inflammatory mediators, neurotransmitters, cytokines, and arachidonic acid derivatives. These substances are believed to play a critical role in the biochemistry and pathophysiology of soft tissue pain.

The primary goal of the study is to learn whether this technique can successfully sample these chemicals, and whether the differences in amounts of these chemicals among the three groups will allow the researchers to advance understanding of the nature, diagnosis and treatment of myofascial pain.

Sponsoring Institute:
Warren G. Magnuson Clinical Center (CC)
Recruitment Detail
Type: Active Accrual Of New Subjects
Gender: Male & Female
Referral Letter Required: No
Population Exclusion(s): Children

Eligibility Criteria:
INCLUSION CRITERIA:

A total of 30 adults are expected to be accrued (approximately 50% female) ages 21-65, without pain and those with continuous idiopathic cervical pain of less than 3 months duration.

EXCLUSION CRITERIA:

Fibroymaylgia

Cervical radiculopathy

Atypical facial neuralgia

History of previous trigger point injections in the upper trapezius muscle

History of cervical spine or shoulder surgery

History of bleeding diatheses

Subjects on anticoagulation therapy

If the subject has taken aspirin within 3 days of needling

Tobacco smokers

Other concurrent pain syndromes

On any medications

Subjects who have an inoordinate fear of needles

HEENT infections

Cancer

Special Instructions: Currently Not Provided
Keywords:
Pressure Pain Threshold
MTrP
Musculoskeletal Pain
Soft Tissue Pain
Pathophysiology
Myofascial Pain
Microdialysis
Myofascial Trigger Points
Rehabilitation
Recruitment Keywords:
Muscle Pain
Neck Pain
Healthy Volunteer
HV
Normal Control
Conditions:
Neck Pain
Investigational Drug(s):
None
Investigational Device(s):
None

Contacts:
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citations:
Quintner JL, Cohen ML Referred pain of peripheral nerve origin: an alternative to the "myofascialpain" constructClin J Pain 1994 Sep;10(3):243-51 ReviewPMID: 7833584

Hong CZ Pathophysiology of myofascial trigger pointJ Formos Med Assoc 1996 Feb;95(2):93-104 ReviewPMID: 9064014

Bohr T Problems with myofascial pain syndrome and fibromyalgia syndromeNeurology 1996 Mar;46(3):593-7 Review No abstract availablePMID: 8618650

Active Accrual, Protocols Recruiting New Patients

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