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Trigger point miofasciali nei muscoli masticatori in pazienti con neck pain meccanico cronico | FisioBrain

19/08/16, 12:36

Trigger point miofasciali nei muscoli masticatori in pazienti con


neck pain meccanico cronico
Pubblicato da Samuele Passigli il 18 dicembre 2012 in Terapia Manuale
Samuele Passigli, Fisioterapista OMT
Leziologia del neck pain (NP) meccanico
probabilmente multifattoriale. A causa
delle numerose fibre nocicettive afferenti
che innervano le strutture cervicali,
differenti strutture anatomiche possono
essere la causa dei sintomi del NP, ad
esempio le articolazioni uncovertebrali e
intervertebrali, il tessuto neurale, il disco, i
muscoli o i legamenti. Anche la presenza di trigger point miofasciali (MTrPs) attivi o
latenti, localizzati nella testa, nel collo e nei muscoli della spalla, pu contribuire alla
genesi del NP meccanico. Inoltre, differenti studi hanno riportato che alcuni pazienti
con NP presentano sintomi concomitanti nella regione orofaciale. La diffusione dei
sintomi alla regione trigeminale potrebbe essere connessa alla presenza di MTrPs
latenti nei muscoli masticatori (temporale e massetere). In questo caso, il NP
meccanico cronico potrebbe essere associato ad una sensibilizzazione del complesso
trigeminale che potrebbe avere unimportanza clinica in termini di diffusione dei
sintomi nella regione orofaciale.
De-la-Llave-Rincon AI, Alonso-Blanco C, Gil-Crujera A, Ambite-Quesada S, Svensson

P, Fernndez-de-Las-Peas C. Myofascial trigger points in the masticatory


muscles in patients with and without chronic mechanical neck pain. J Manipulative
Physiol Ther. 2012 Nov;35(9):678-84. doi: 10.1016/j.jmpt.2012.10.008. PubMed PMID:
23206962.
Abstract
OBJECTIVES: The purpose of this study is to describe differences in the presence of
masseter and temporalis muscle trigger points (TrPs) and jaw opening between
individuals with mechanical neck pain and healthy controls.
METHODS: Twenty patients with mechanical neck pain (60% women) without
symptoms in the orofacial region, aged 20 to 37 years old, and 20 matched controls
participated. Temporalis and masseter muscles were examined for the presence of
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Trigger point miofasciali nei muscoli masticatori in pazienti con neck pain meccanico cronico | FisioBrain

19/08/16, 12:36

TrPs in a blinded design. Trigger points were considered active if the subject
recognized the pain as a familiar symptom, whereas the TrPs was considered latent if
the pain was not recognized as a symptom. Jaw opening was assessed with a ruler.
RESULTS: A greater number of TrPs in the masticatory muscles were found in patients
than in controls. None of the patients or healthy controls recognized the referred pain
as familiar; thus, latent rather than active TrPs were found. The distribution of TrPs
between groups was different for the masseter and temporalis muscles. Patients with
neck pain had smaller jaw opening than controls. A negative correlation between active
jaw opening and the number of TrPs within the masticatory muscles was found: the
greater the number of TrPs, the smaller the jaw opening.
CONCLUSIONS: For the subjects in this study, those with mechanical chronic neck
pain had more latent TrPs in the masticatory muscles and reduced jaw opening
compared to healthy controls. These findings may suggest the spread of sensitization
from the cervical segment to the trigeminal brain stem sensory nuclear complex.

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