title: Intensive vasodilatation in the sciatic pain area after dry needling.
abstract: BACKGROUND
  Short-term vasodilatation in the pain area after dry needling (DN) of active trigger points (TrPs) was recorded in several cases of sciatica. Moreover, the presence of TrPs in sciatica patients secondary to primary lesion was suggested. Still, it is not known how often they occur and if every TrPs can provoke vasomotor reactions. The purpose of this study was to evaluate the prevalence of active TrPs among subacute sciatica patients and the response to DN under infrared thermovision (IRT) camera control.
  
  
  METHODS
  Fifty consecutive Caucasian patients (mean age 41.2 ± 9.1y) with subacute sciatica were diagnosed towards gluteus minimus TrPs co-existence. Based on TrPs confirmation, patients were divided into two groups: TrPs-positive and TrPs-negative, than DN under IRT control was performed. Skin temperature changes and the percentage size of vasomotor reactions in the pain area were evaluated if present.
  
  
  RESULTS
  The prevalence of active TrPs was 32.0%. Every TrPs-positive presented vasodilatation dependent on TrPs co-diagnosis (r = 0.72 p < 0.000) and pain recognition during DN (r = 0.4 p < 0.05). The size of vasodilatation in TrPs-positive subjects was: post-DN 12.3 ± 4.0% and post-observation 22.1 ± 6.1% (both p = 0.000) versus TrPs-negative: post-DN 0.4 ± 0.3% and post-observation 0.4 ± 0.2%. A significant temperature increase in the thigh and calf was confirmed for TrPs-positive subjects only (both p < 0.05). Post-DN and post-observation temperatures were as follows: average (thigh:1.2 ± 0.2°C; 1.4 ± 0.2°C, both p < 0.05 and calf: 0.4 ± 0.2°C; 0.4 ± 0.3°C, both p < 0.05) and maximum (thigh 1.4 ± 0.3°C 1.6 ± 0.3°C; both p < 0.05).
  
  
  CONCLUSIONS
  The presence of active TrPs within the gluteus minimus muscle among subacute sciatica subjects was confirmed. Every TrPs-positive sciatica patient presented DN related vasodilatation in the area of referred pain. The presence of vasodilatation suggests the involvement of sympathetic nerve activity in myofascial pain pathomechanism. Although the clinical meaning of TrPs in subacute sciatica patients is possible, further studies on a bigger group of patients are still required.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12614001060639. Registered 3 October 2014.
authors.affiliation: Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Fredry 10, 61-701, Poznań, Poland. skorupska@ump.edu.pl.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Skorupska
authors.affiliation: Department of Virtual Engineering, Poznan University of Technology, Plac Marii Skłodowskiej-Curie 5, 60-965, Poznań, Poland. rychlik.michal@poczta.fm.
authors.forename: Michał
authors.initials: M
authors.lastname: Rychlik
authors.affiliation: Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Fredry 10, 61-701, Poznań, Poland. samborskiw@o2.pl.
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Samborski
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D001315:Australia; D002081:Buttocks / Q000503:physiopathology; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009209:Myofascial Pain Syndromes / Q000503:physiopathology*; D009339:Needles; D009520:New Zealand; D010146:Pain; D010147:Pain Measurement; D053591:Referred Pain / Q000503:physiopathology*; D012585:Sciatica / Q000503:physiopathology*; D012881:Skin Temperature; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D061028:Trigger Points; D014664:Vasodilation