title: The hypoalgesic effect of remote tactile sensory modulation on the mechanical sensitivity of trigger points: A randomized controlled study.
abstract: BACKGROUND
  Sensitivity of the myofascial trigger point (MTrP) can be inhibited by electrical stimulation of remote site. However, it remains unclear whether remote pain control of the MTrP occurs in the same spinal segment or in the supraspinal system.
  
  
  OBJECTIVE
  The aims of this study were to identify whether the remote pain control occurs in the spinal segment corresponding to the MTrP or in the supraspinal system.
  
  
  METHODS
  Test subjects (n = 10) received transcutaneous electrical nerve stimulation for 5 minutes, whereas control subjects (n = 10) received no intervention. The threshold for tactile sensory modulation at the lateral elbow was assessed using Von Frey filaments. The pressure sensitivities of MTrPs in both the infraspinatus and upper trapezius muscles were quantified by algometry. Measurements were performed at baseline and 1 and 15 minutes after the intervention.
  
  
  RESULTS
  Increases of the tactile threshold at the remote site decreased the sensitivity of the MTrP innervated by same spinal segment. However, no changes were observed at MTrP sites innervated by contralateral fibers or those from different spinal segment.
  
  
  CONCLUSIONS
  MTrP sensitivity is more strongly affected by interventions at remote ipsilateral sites in the same spinal segment than by stimulation of extra-segmental sites.
authors.affiliation: Department of Physical Therapy, College of Health Sciences, Korea University, Seoul, South Korea.
authors.forename: Yushin
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Physical Therapy, College of Health Sciences, Korea University, Seoul, South Korea.
authors.forename: Jungjin
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Kinesiology, University of Maryland, College Park, MD, USA.
authors.forename: Jae Kun
authors.initials: JK
authors.lastname: Shim
authors.affiliation: Department of Rehabilitation Medicine, Barunsesang Hospital, Seongnam, South Korea.
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Suh
authors.affiliation: Department of Physical Therapy, College of Health Sciences, Korea University, Seoul, South Korea.
authors.forename: BumChul
authors.initials: B
authors.lastname: Yoon
mesh_terms: D000328:Adult; D004550:Elbow / Q000294:innervation; D004867:Equipment Design; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D009209:Myofascial Pain Syndromes / Q000503:physiopathology / Q000534:rehabilitation*; D017288:Pain Threshold; D010812:Physical Stimulation; D012677:Sensation; D064171:Superficial Back Muscles / Q000294:innervation; D004561:Transcutaneous Electric Nerve Stimulation / Q000295:instrumentation* / Q000379:methods*; D061028:Trigger Points; D055815:Young Adult
keywords: Remote pain control; hypoalgesia; myofascial trigger points; tactile sensory modulation; transcutaneous electrical nerve stimulation