Gluteal Trigger Points Found in Most Lumbosacral Radiculopathy Cases

By Anne Harding

March 27, 2015

NEW YORK (Reuters Health) – Most patients with lumbosacral radiculopathy have gluteal trigger points (GTrP), according to new findings.

The findings raise the possibility that treating these trigger points, for example with electrical stimulation, could help ease pain in these patients, although the new study did not address this issue, Dr. Farhad Adelmanesh of McGill University Health Centre in Montreal, Canada, told Reuters Health in a telephone interview.

Lumbosacral radiculopathy, or pain in the low back and legs due to damage to the intravertebral discs, is a frequent cause of lower back pain, Dr. Adelmanesh and his colleagues note in their report. Painful GTrP due to lumbosacral myofascial pain syndrome can mimic this type of pain, they add, and distinguishing between the two can be difficult.

While Dr. Adelmanesh and his team note that they often observe GTrP in patients with lumbosacral radiculopathy, GTrP is not routinely evaluated in these patients.

To better understand the relationship between these two pathologies, the researchers compared the prevalence of GTrP in patients with clinical, electromyographic, and magnetic resonance findings indicating lumbosacral radiculopathy with healthy controls.

They screened 441 patients, 271 of whom met the study’s inclusion criteria. Two-hundred seven (76.4%) had GTrP, versus three of the 152 healthy volunteers (1.9%). Among patients with one-sided pain, 74.6% had ipsilateral GTrP.

The findings were published March 12 in the American Journal of Physical Medicine & Rehabilitation.

The investigators also found that just one of the 14 patients with no pain, but leg weakness and parasthesias, had a positive GTrP, versus 82.5% of patients with right-sided pain and 79.5% of those with left-sided pain.

“Taken together, these findings support the clinical observation of the authors of this study that GTrPs are common among patients with radicular pain and that they are directly associated with this pain condition,” Dr. Adelmanesh and his colleagues write.

Based on the findings, Dr. Adelmanesh said, evaluating lumbosacral radiculopathy for GTrP can be a useful diagnostic tool, as well as offering a potential treatment approach.

The authors reported no conflicts of interest.

SOURCE: http://bit.ly/1BOosnc

Am J Phys Med Rehabil 2015.

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