muscle pain week 5

Questions and Answers

What is a characteristic feature of referred muscle pain compared to skin pain?

Referred muscle pain is stronger and more emotional. (correct)

Referred muscle pain has a first/second pain sequence.

Referred muscle pain has clear localization.

Referred muscle pain occurs without a latency.

Which of the following accurately describes the subjective differences between muscle and skin pain?

Muscle pain typically has a first/second pain sequence.

Skin pain is more likely to be cramp-like.

Skin pain has a clearer localization than muscle pain. (correct)

Muscle pain is sharper than skin pain.

Which mechanism is related to the sensitization of trigger points near the sacroiliac joint due to a gastrocnemius injury?

Unmasking of previously silent synapses. (correct)

Decreased release of CGRP.

Desensitization of substance P.

Inactivation of silent synapses.

In terms of objective differences, how does muscle pain differ from skin pain?

Muscle pain exhibits more tonic inhibition by antinociceptive tracts. Signup and view all the answers

Which of the following conditions is NOT typically associated with muscle pain?

Fractures Signup and view all the answers

What is the primary pain sequence observed in acute muscle injury?

No distinct first or second pain sequence. Signup and view all the answers

Which of the following factors contribute to the emotional experience of muscle pain?

Tonic inhibition from the mesencephalon. Signup and view all the answers

What is a risk associated with exercise in individuals with muscle pain due to myopathies?

Increased potassium release leading to kidney failure. Signup and view all the answers

What is the primary concern regarding the trials assessing the efficacy of cold water immersion?

There was a high risk of bias in their design. Signup and view all the answers

What aspect of cold water immersion was found to have insufficient evidence in the trials?

Effectiveness in reducing muscle soreness. Signup and view all the answers

Which of the following is true regarding the studies on antioxidant supplementation?

They involved a high degree of heterogeneity in design. Signup and view all the answers

What common factor affected both categories of interventions (cold water immersion and antioxidants) studied?

They involved a wide variety of exercise types. Signup and view all the answers

What was a notable methodological issue in the trials assessing cold water immersion?

Failure to monitor predefined adverse events. Signup and view all the answers

Which of the following outcomes was not directly associated with the effectiveness of antioxidant supplementation as indicated by the studies?

Consistency in methodological approach across studies. Signup and view all the answers

What was the sample size and gender composition for the study involving cold water immersion?

64 participants, 60 male. Signup and view all the answers

Which factor was cited as a barrier to drawing definite conclusions from the antioxidant studies?

Heterogeneity in types of antioxidant supplements used. Signup and view all the answers

Which chemical factors are likely involved in the pain experienced during ischemia?

K+ ions, adenosine, and lactate Signup and view all the answers

What type of muscle contraction is most commonly associated with delayed onset muscle soreness (DOMS)?

Eccentric contractions Signup and view all the answers

What is a disadvantage of using intramuscular stimulation and recording as a method to measure pain?

It induces muscle twitches. Signup and view all the answers

How does the pain experienced during ischemia depend on the experimental conditions?

It depends on the force, number of repetitions, and duration of ischemia. Signup and view all the answers

What is a characteristic of the visual analogue scale (VAS) for measuring pain?

It functions on a numerical scale ranging from 0 to 10. Signup and view all the answers

What type of pain is most likely to occur due to concentric muscle contractions?

Short-lasting pain, likely due to ischemia Signup and view all the answers

Which type of pain measurement method involves applying controlled pressure?

Mechanical algometers Signup and view all the answers

What does the term 'temporal summation' refer to in the context of pain measurement?

The cumulative effect of repeated pain stimulation over time Signup and view all the answers

What is the delayed onset muscle soreness (DOMS) primarily classified as?

Overexertion-functional type muscle disorder Signup and view all the answers

After how many hours post-exercise do symptoms of DOMS typically onset?

48-72 hours Signup and view all the answers

Which of the following is NOT a symptom of DOMS?

Pain at rest Signup and view all the answers

Which exercise type is more likely to induce DOMS?

Eccentric contractions Signup and view all the answers

What physiological changes are suggested to play a role in DOMS?

Calcium changes affecting titin stiffness Signup and view all the answers

Which statement accurately describes the pain associated with DOMS?

Pain primarily felt during pressure and activity Signup and view all the answers

DOMS is primarily classified in terms of its severity as:

Mild but common Signup and view all the answers

What effect does DOMS have on movement?

Causes painful limitation in movement Signup and view all the answers

What was the primary outcome evaluated in the studies on high-dose antioxidants?

Severity and duration of DOMS Signup and view all the answers

Which aspect of the studies on high-dose antioxidant supplementation raised concerns about their validity?

High risk of bias due to selective reporting Signup and view all the answers

What was a significant finding regarding the reduction of soreness after antioxidant supplementation?

No reduction in soreness beyond 72 hours Signup and view all the answers

How many studies investigated adverse effects related to high-dose antioxidant supplementation?

9 studies Signup and view all the answers

What conclusion was made regarding the effect size of high-dose antioxidant supplementation on soreness?

Weak evidence suggesting no effect on soreness Signup and view all the answers

Which demographic was primarily involved in the randomized trials assessing antioxidant supplementation?

961 male participants Signup and view all the answers

What potential limitation was noted concerning the assessment of subjective recovery in the studies?

Lack of testing for subjective recovery Signup and view all the answers

What type of study designs were included in the 50 studies evaluating antioxidants?

Randomised and quasi-randomised studies Signup and view all the answers

Study Notes

Referred Muscle Pain

Referred pain often correlates to same dorsal horn neuron activation, occurring with latency.
Gastrocnemius injuries can lead to sensitive trigger points near the sacroiliac joint through mechanisms like sensitization involving substances like substance P and CGRP.

Differences between Muscle and Skin Pain

Subjective Differences:
- Muscle pain lacks the first/second pain sequence found in skin pain.
- Muscle pain is described as cramp-like and pressing, often with difficult localization, while skin pain is sharp with clear localization.
- Muscle pain features a stronger referred pain component compared to skin pain, which has minimal referred sensation.
- Emotionally, muscle pain is harder to tolerate and suppress.
Objective Differences:
- Muscle pain does not elicit a flexor reflex, contrasting with pronounced reflexes seen in skin pain.
- Unmyelinated afferent axons in muscle have minor effects on spinal cord neurons compared to the significant impact of skin pain.
- Muscle pain activates the anterior cingulate cortex more strongly.
- Muscle pain experiences strong tonic inhibition from antinociceptive descending tracts, unlike skin pain.

Muscle Pain as a Symptom

Potential serious diseases indicated by muscle pain include:
- Myopathies (genetic or drug-induced)
- Myositis (autoimmune or infectious)
- Rheumatological diseases
In severe cases, exercise may lead to muscle tissue decay, risking kidney failure due to myoglobin and potassium release.

Measuring Pain

Visual Analog Scale (VAS) employs a numerical scale from 0 to 10 but lacks qualitative assessment.

Experimental Procedures Inducing Muscle Pain

Ischemia:
- Involves a tourniquet and voluntary muscle contraction; pain results from exertion levels, repetitions, and ischemia duration.
- Unclear mechanisms with suspected chemical factors like potassium ions, adenosine, and lactate.
Exercise:
- Concentric contractions lead to short-lasting pain due to ischemia.
- Eccentric contractions cause Delayed Onset Muscle Soreness (DOMS), peaking 24-48 hours post-exercise.
Electrical Methods:
- Intramuscular stimulation (microneurography) accurately measures referred pain but can induce muscle twitches.
Mechanical Methods:
- Use of pressure algometers can activate both muscle and skin.

Delayed Onset Muscle Soreness (DOMS)

Characterized as an overexertion-induced disorder, particularly after eccentric exercise.
Symptoms include:
- Delayed onset (48-72 hours post-exercise) and reduced force production.
- Pain at pressure or movement, increased muscle tone, and local swelling.
Classified as mild but impactful on professional training.

Physiological Mechanisms of DOMS

Pathophysiology remains partly understood; involves mechanical factors and potential calcium changes.
Active interventions for recovery may include cold immersion, infrared therapy, and active recovery methods.

Antioxidant Supplementation Research

Investigated for their potential role in reducing DOMS severity and duration, with numerous studies conducted.
Weak results showing slight soreness reduction at intervals (6, 24, 48, 72 hours), but negligible effects at 96 hours.
High risk of bias present in studies due to design shortcomings, indicating limited evidence on effectiveness for soreness reduction or subjective recovery.

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Description

This quiz examines the concepts of referred muscle pain and its relationship to functional testing, particularly within the context of Duus’ Topical Diagnosis in Neurology. It includes information on trigger points and findings from recent clinical studies to aid in understanding these conditions.