title: The relationship between serum trace elements, vitamin B12, folic acid and clinical parameters in patients with myofascial pain syndrome.
abstract: BACKGROUND
  Myofascial pain syndrome (MPS) is characterized by myofascial trigger points in a palpable taut band of skeletal muscle.
  
  
  OBJECTIVE
  We aimed to investigate serum trace elements, vitamin B12, folic acid levels and their correlations with clinical findings and functional status in patients with MPS.
  
  
  METHODS
  Thirty eight patients with at least one trigger point located on shoulder muscles, and at least 6 months duration, were included in this study. The demographic data, disease duration of patients were noted. Serum copper, zinc, magnesium and iron levels, vitamin B12 and folic acid levels were measured. Visual analogue scale (VAS) was implemented to estimate daily severity of pain. Pain pressure threshold of subjects and control groups were assessed by using Fischer's tissue compliancemeter. The Turkish version of the Beck Depression Inventory (BDI) was administered for the presence of any depressive disorder.
  
  
  RESULTS
  The mean age of patients in MPS group and control group were 33.1 and 37.8 years respectively. Serum levels of zinc (p< 0.006) were significantly decreased in patients with MPS. VAS, total myalgic and BDI scores of patients were significantly higher than the control group (Respectively p< 0.000, p< 0.012, p< 0.000). Association between TMS and magnesium, vitamin B12 levels was found statistically significant. BDI score correlated significantly with the serum zinc level (r:-0.548, p< 0.001) and VAS in patients with MPS (r:0.641, p< 0.000).
  
  
  CONCLUSIONS
  According to the results of this study, it was asserted that trace elements, vitamins may play an important role in the pathophysiology of MPS and psychological factors may also have additional effect.
authors.affiliation: Department of First Physical Medicine and Rehabilitation, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey. drmuyesser@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Okumus
authors.forename: E
authors.initials: E
authors.lastname: Ceceli
authors.forename: F
authors.initials: F
authors.lastname: Tuncay
authors.forename: S
authors.initials: S
authors.lastname: Kocaoglu
authors.forename: N
authors.initials: N
authors.lastname: Palulu
authors.forename: Z R
authors.initials: ZR
authors.lastname: Yorgancioglu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003863:Depression / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D005156:Facial Neuralgia / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000097:blood / Q000150:complications*; D006801:Humans; D008297:Male; D014131:Trace Elements / Q000097:blood / Q000172:deficiency*; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications*; D015032:Zinc / Q000172:deficiency
chemical_list: D014131:Trace Elements; D005492:Folic Acid; D015032:Zinc; D014805:Vitamin B 12