Association between muscle trigger points, ongoing pain, function, and sleep quality in elderly women with bilateral painful knee osteoarthritis.
OBJECTIVE
The objectives of this study were to investigate if referred pain elicited by active trigger points (TrPs) reproduced the symptoms in individuals with painful knee osteoarthritis (OA) and to determine the relationship between the presence of active TrPs, intensity of ongoing pain, function, quality of life, and sleep quality in individuals with painful knee OA.


METHODS
Eighteen women with bilateral painful knee OA, aged 79 to 90 years, and 18 matched controls participated. Muscle TrPs were bilaterally explored in several muscles of the lower extremity. Trigger points were considered active if the elicited referred pain reproduced knee symptoms, and TrPs were considered latent if the elicited pain did not reproduce symptoms. Pain was collected with a numerical pain rate scale (0-10), function was assessed with Western Ontario and McMaster Universities, quality of life was assessed with the Medical Outcomes Study Short Form 36 questionnaire, and sleep quality was determined with the Pittsburgh Sleep Quality Index.


RESULTS
Women with knee OA exhibited a greater number of active TrPs (mean, 1 ± 1; P < .001) but similar number of latent TrPs (mean, 4 ± 2) than healthy women (mean, 4 ± 3; P = .613). A greater number of active TrPs were associated with higher intensity of ongoing pain (r = 0.605; P = .007). Higher intensity of ongoing knee pain was associated with lower physical function (P < .05).


CONCLUSIONS
The referred pain elicited by active TrPs in the lower extremity muscles contributed to pain symptoms in painful knee OA. A higher number of active TrPs was associated with higher intensity of ongoing knee pain.
Physical Therapist, Residencia de Mayores de Guadaira, Alcalá de Guadaira, Sevilla, Spain.
Anabel
A
Alburquerque-García
Physical Therapist, Department of Psychology, Social and Anthropology, University of Salamanca, Salamanca, Spain.
Daiana P
DP
Rodrigues-de-Souza
Professor, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, University Rey Juan Carlos, Alcorcón Madrid, Spain.
César
C
Fernández-de-las-Peñas
Professor, Department of Nursing and Physical Therapy, University of Salamanca, Salamanca, Spain. Electronic address: pacoalbu@usal.es.
Francisco
F
Alburquerque-Sendín
D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D010147:Pain Measurement; D011788:Quality of Life; D012890:Sleep / Q000502:physiology*; D061028:Trigger Points / Q000503:physiopathology*
Disability Evaluation; Myofascial Pain Syndrome; Osteoarthritis; Sleep; Trigger Points