The Association of Active Trigger Points with Lumbar Disc Lesions

Abstract

Objective: To seek indication for an association between trigger points [TrPs] and lumbar disc lesions as evidenced by the myotomal level of the disc lesion.

Methods: Sixty subjects, 44 men and 16 women, ranging from 22 to 61 years-old who had lumbar disc prolapse [location confirmed with magnetic resonance imaging] were recruited to the cross-sectional study from consecutive sampling. All patients were referred from the Department of Orthopaedic and Accident Surgery Unit I. Subjects with disc prolapse who were scheduled for surgery in the following week participated in this study. They were given a complete physical therapy examination including an assessment of soft tissue pain and dysfunction. The clinical diagnosis of TrPs and myofascial pain syndrome were made according to the criteria by Travell and Simons.

Results: The majority of the patients with LL Vdisc prolapse had active TrPs in the tibialis anterior. Subjects with LL Vand LS lesions had active TrPs in the gluteus medius and gastrocnemius. Subjects with LL Vdisc prolapse had active TrPs in the extensor hallucis longus and tibialis anterior.

Conclusions: This study affirms that there is a possibility of a myofascial pain syndrome component when there is lumbar disc disease, and it also corresponds to the same myotome level of the lesion.

KEYWORDS:

• Myofascial pain syndrome
• lumbar disc disease
• low back pain
• sciatica
• trigger points