title: Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Women with Fibromyalgia Syndrome.
abstract: OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24 comparable healthy women participated. TrPs within the flexor hallucis brevis, adductor hallucis, dorsal interossei, extensor digitorum brevis, and quadratus plantae, as well as external and internal gastrocnemius, were explored. Pressure pain thresholds (PPTs) were assessed in a blind manner over seven locations on each foot. Topographical pressure sensitivity maps of the plantar region were generated using the averaged PPT of each location. RESULTS : The prevalence rate of foot pain was 63% (n = 32). The number of active TrPs for each FMS woman with foot pain was 5 ± 1.5 without any latent TrPs. Women with FMS without foot pain and healthy controls had only latent TrPs (2.2 ± 0.8 and 1.5 ± 1.3, respectively). Active TrPs in the flexor hallucis brevis and adductor hallucis muscles were the most prevalent. Topographical pressure pain sensitivity maps revealed that FMS women with foot pain had lower PPT than FMS women without pain and healthy controls, and higher PPT on the calcaneus bone (P < 0.001). CONCLUSIONS : The presence of foot pain in women with FMS is high. The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in these patients. FMS women suffering foot pain showed higher pressure hypersensitivity in the plantar region than those FMS women without pain.
authors.affiliation: *Alumna de Doctorado, Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Tornero-Caballero
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.|Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Salom-Moreno
authors.affiliation: Department of Psychology, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Cigarán-Méndez
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors.forename: Matilde
authors.initials: M
authors.lastname: Morales-Cabezas
authors.affiliation: Physical Activity and Human Performance group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Pascal
authors.initials: P
authors.lastname: Madeleine
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain cesar.fernandez@urjc.es.|Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-Las-Peñas
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis* / Q000503:physiopathology; D005528:Foot / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology* / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology; D053591:Referred Pain / Q000175:diagnosis* / Q000503:physiopathology; D011312:Pressure / Q000009:adverse effects; D061028:Trigger Points / Q000473:pathology* / Q000503:physiopathology
keywords: Feet; Fibromyalgia Syndrome; Pressure Pain; Sensitization; Trigger Points