Evaluation of Neuropathic Pain Component in Myofascial Pain Syndrome; Its Effect on Emosyonel Status, Sleep and Quality of Life

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Tuba Erdem Sultanoğlu
Safinaz Ataoğlu
Kübranur Demir
Rümeysa Samanci


Objective: The aim of this study was to evaluate the neuropathic pain component in patients with myofascial pain syndrome, and to examine the effects of neuropathic pain on emotional status, sleep and quality of life.

Material and Methods: 73 patients with MPS in their neck or upper back region admitted to the tertiary university hospital were included. Questionnaires were administrated to the patients via face-to-face interviews, and included sociodemographic variables. The patients were evaluated for neuropathic component by DN4 questionnaires, and pain by visual analog scale (VAS). Validated questionnaires measuring emosyonel status, sleep quality and quality of life were used.

Results: Of the 73 patients, 48 (65.8%) were female and 25 (34.2%) were male. The mean age of all recruited patients was 38.2±10.6 years. According to the DN4 scale 56.2% of the patients had neuropathic pain. MPS patients were divided into two groups as those with and without neuropathic pain. VAS, BDI, and PSQI scores were significantly higher among MPS patients with neuropathic pain than among MPS patients without neuropathic pain (p<0.01).The patients with neuropathic pain had lower scores for all the parameters of the SF-36. Morever vitality, social function, mental health, and emotional role dimensions scores were significantly lower in MPS patients with neuropathic pain than MPS patients without neuropathic pain (p<0.01).

Conclusion: An appropriate diagnosis and treatment of the neuropathic pain plays an important role and can reduce the pain, improve the quality of life and sleep qulity, and decrease the level of depression in treatment of MPS.


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Erdem Sultanoğlu, T., Ataoğlu, S., Demir, K., & Samanci, R. (2022). Evaluation of Neuropathic Pain Component in Myofascial Pain Syndrome; Its Effect on Emosyonel Status, Sleep and Quality of Life. Medical Science and Discovery, 9(1), 1–6. https://doi.org/10.36472/msd.v9i1.668
Research Article
Received 2022-01-10
Accepted 2022-01-20
Published 2022-01-24


Fleckenstein J, Zaps D, Rüger LJ, Lehmeyer L, Freiberg F, Lang PM, Irnich D. (2010). Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey. BMC musculoskeletal disorders. 2010;11(1):32. https://doi.org/10.1186/1471-2474-11-32

Spicher JS, Sharan CJ, Sharan D. Co-existence of Neuropathic Pain and Myofascial Pain: a Key Point to Consider. Neuro Pain Rehab. 2019;16(2):52-55.

Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol. 2011;25(2):185-98.

Sanchez-Romero EA, Pecos-Martín D, Calvo-Lobo C, et al. Clinical features and myofascial pain syndrome in older adults with knee osteoarthritis by sex and age distribution: a cross-sectional study. Knee. 2019;26(1):165-73. https://doi.org/10.1016/j.knee.2018.09.011

Huguenin LK. Myofascial trigger points: the current evidence. Physical therapy in sport. 2004;5(1): 2-12. https://doi.org/10.1016/j.ptsp.2003.11.002

Spicher C, Quintal I, Vittaz M. (2015). Rééducation sensitive des douleurs neuropathiques (3e édition) - Préface: S. Marchand. Montpellier, Paris: Sauramps Médical, 369 pages.

Simons DG, Travell JG, Simons LS: Myofascial pain and Dysfunction: The Trigger Point Manual, Vol. 1, Upper Half of the Body. Baltimore, 1999, Williams and Wilkins.

Simons DG. Clinical and etiological update of myofascial pain from trigger points. Journal of musculoskeletal pain. 1996;4(1-2):93-122. https://doi.org/10.1300/J094v04n01_07

Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16(1):87-101. https://doi.org/10.1016/0304-3959(83)90088-X

Bouhassira D, Attal N. Diagnosis and assessment of neuropathic pain: the saga of clinical tools. Pain 2011; 152(3 Suppl): 74-83. doi: 10.1016/j.pain.2010.11.027

Haanpää M, Attal N, Backonja M, Baron R, Bennett M, Bouhassira D, et al. NeuPSIG guidelines on neuropathic pain assessment. Pain. 2011;152(1):14-27. https://doi.org/10.1016/j.pain.2010.07.031

Attal N, Bouhassira D, Baron R. Diagnosis and assessment of neuropathic pain through questionnaires. The Lancet Neurology. 2018;17(5):456-466. https://doi.org/10.1016/S1474-4422(18)30071-1

Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114(1-2):29-36. https://doi.org/10.1016/j.pain.2004.12.010

Unal Cevik I, Sarioglu-Ay S, Evcik DA. A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. The Journal of Pain. 2010;11(11):1129-1135. https://doi.org/10.1016/j.jpain.2010.02.003

Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research 1989;28(2):193-213. https://doi.org/10.1016/0165-1781(89)90047-4

Agargun MY. Pittsburgh uyku kalitesi indeksinin gecerligi ve guvenirligi. Turk Psikiyatri Dergisi 1996;7:107-115.

Ware JE, Sherbourne CD. The Medical Outcomes Study (MOS) 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30(6):473-483. https://www.jstor.org/stable/3765916

Pinar R. Reliability and construct validity of the SF-36 in Turkish cancer patients. Quality of Life Research. 2005;14(1):259-264. https://doi.org/10.1007/s11136-004-2393-3

Beck AT, Epstein N, Brown G, Steer RA. An Inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychology 1988;56(6):893-897. DOI: 10.1037//0022-006x.56.6.893

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39(2):175-191. doi.org/10.3758/BF03193146

Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160. doi.org/10.3758/BRM.41.4.1149

Weller JL, Comeau D, Otis JAD. Myofascial Pain. Semin Neurol. 2018;38(6):640-643. doi: 10.1055/s-0038-1673674. Epub 2018 Dec 6. PMID: 30522139.

Cao QW, Peng BG, Wang L, Huang YQ, Jia DL, Jiang H, Huang D. Expert consensus on the diagnosis and treatment of myofascial pain syndrome. World journal of clinical cases. 2021;9(9):2077-2089. doi: 10.12998/wjcc.v9.i9.2077

Vulfsons S, Minerbi A. The Case for Comorbid Myofascial Pain-A Qualitative Review. International Journal of Environmental Research and Public Health. 2020;17(14):5188. https://doi.org/10.3390/ijerph17145188

Yunus MB. "Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness." Seminars in arthritis and rheumatism. Vol. 37. No. 6. WB Saunders, 2008.

Attal N, Bouhassira D, Baron R. Diagnosis and assessment of neuropathic pain through questionnaires. The Lancet Neurology. 2018;17(5):456-466. https://doi.org/10.1016/S1474-4422(18)30071-1

Ko EJ, Jeon JY, Kim W, Hong JY, Yi YG. Referred symptom from myofascial pain syndrome: One of the most important causes of sensory disturbance in breast cancer patients using taxanes. European journal of cancer care. 2017;26(6):e12615. https://doi.org/10.1111/ecc.12615

Isaac Z, Katz JN, Borenstein DG. Lumbar spine disorders. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt M, Weisman MH. Rheumatology. Philadelphia: Mosby Elsevier, 2008:593-618.

Hassan AE, Saleh HA, Baroudy YM, Khalid AR, Najjar MW, Kazi MS, et al. Prevelance of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia. Saudi Med J. 2004;25(12):1986-90. PMID: 15711681

Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber LH. Myofascial trigger points then and now: A historical and scientific perspective: The Journal of Injury, Function, and Rehabilitation. 2015;7(7):746-761 https://doi.org/10.1016/j.pmrj.2015.01.024.

Bonakdar RA. Myofascial Pain Syndrome In: Rakel D, eds. Integrative Medicine. 3rd ed. Philadelphia. Elsevier Saunders; 2012; 579-587.

Kohrt BA, Grith JL, Patel V. Chronic pain and mental health: Integrated solutions for global problems. Pain. 2018;159(1):85-90. doi: 10.1097/j.pain.0000000000001296

Castro M, Daltro C. Sleep patterns and symptoms of anxiety and depression in patients with chronic pain. Arquivos de neuro-psiquiatria. 2009;67(1):25-28. https://doi.org/10.1590/S0004-282X2009000100007

Smith BH, Torrance N, Bennett MI, Lee AJ. Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain. 2007; 23(2):143-149. doi: 10.1097/01.ajp.0000210956.31997.89

Martínez-Lavin M, López S, Medina M, Nava A. Use of the leeds assessment of neuropathic symptoms and signs questionnaire in patients with fibromyalgia. Semin Arthritis Rheum. 2003;32(6):407-11. https://doi.org/10.1053/sarh.2003.50017

Gauffin J, Hankama T, Kautiainen H, Hannonen P, Haanpää M. Neuropathic pain and use of PainDETECT in patients with fibromyalgia: a cohort study. BMC Neurol. 2013;13:21 https://doi.org/10.1186/1471-2377-13-21

Koroschetz J, Rehm SE, Gockel U, Brosz M, Freynhagen R, Tölle TR, et al. Fibromyalgia and neuropathic pain--differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia. BMC Neurol. 2011;11:55. https://doi.org/10.1186/1471-2377-11-55