Ultrasound Assessment of Myofascial Trigger Points

Summary

Musculoskeletal pain represents a significant burden on individuals and the healthcare system in Spain, where 20% of adults experience pain, and 7% suffer from it daily. Myofascial pain syndrome (MPS), one of the most frequent causes of musculoskeletal pain, affects over 85% of the general population at some point. MPS is characterized by local or referred pain and the presence of myofascial trigger points (MTrPs). Despite advancements in diagnostic technologies, the evaluation of MTrPs still largely relies on manual palpation due to the absence of conclusive findings for their objective identification.

Ultrasound presents a promising alternative as a widely available, cost-effective, and non-invasive diagnostic tool for MTrPs. While prior studies on ultrasound for MTrP detection have shown variable sensitivity and specificity (ranging from 33% to 100%), no consensus has been reached on a standardized ultrasound methodology for reliable clinical use. The ability to accurately identify MTrPs through ultrasound could shift the current paradigm, facilitating earlier diagnosis and preventing the chronicity of musculoskeletal pain, thus improving patient care and reducing healthcare costs.

This study aims to evaluate ultrasound as a potential gold standard for MTrP diagnosis and characterization. By exploring optimal ultrasound modes (B-mode, Doppler), we aim to standardize a highly reliable inter-examiner diagnostic protocol that can be easily applied in clinical practice using accessible technology, such as portable wireless ultrasound devices. Specific objectives include: 1) developing ultrasound exploration protocols for MTrP detection; 2) evaluating vibration parameters for enhanced MTrP visualization; 3) characterizing MTrPs through ultrasound by analyzing size, shape, location, and echotextural features; and 4) validating proposed protocols by correlating them with manual palpation and clinical measures.

This research will contribute significantly to understanding MTrPs, providing innovative diagnostic tools and protocols that will improve the precision and effectiveness of musculoskeletal pain assessment. The findings may also have important clinical implications for MTrP-related conditions, enhancing patient care and quality of life.

Conditions

• Myofascial Pain
• Myofascial Trigger Points
• Musculoskeletal Pain

Interventions

DIAGNOSTIC_TEST

Ultrasound imaging

Both groups of participants-those with myofascial and/or musculoskeletal pain and those without musculoskeletal alterations-will undergo a standardized intervention focused on the application of vibratory stimuli, alongside real-time ultrasound imaging. Vibratory stimuli will be applied directly to the region of interest, specifically over the identified MTrP in participants with active myofascial pain. In participants without musculoskeletal alterations, the stimuli will be applied either over a latent MTrP or in a randomly selected area of the gastrocnemius medialis muscle, ensuring a consistent methodology across both groups. Simultaneously, real-time ultrasound imaging will be performed to capture detailed images of the muscle tissue during the application of vibratory stimuli. Imaging will be conducted in two planes (longitudinally and transversely).

Sponsors & Collaborators

• Universidad de Zaragoza

  lead OTHER

Principal Investigators

• Pablo Herrero Gallego · Universidad de Zaragoza

• Eva María Gómez Trullén · Universidad de Zaragoza

Eligibility

Min Age

18 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-12-02

Primary Completion

2025-07-01

Completion

2025-07-01

Countries

• Spain

Study Locations