S. Levoska, MANUAL PALPATION AND PAIN THRESHOLD IN FEMALE OFFICE EMPLOYEES WITH AND WITHOUT NECK SHOULDER SYMPTOMS, The Clinical journal of pain, 9(4), 1993, pp. 236-241
Objective: The aim of this study was to quantify myofascial tenderness
by using manual palpation and the dolorimeter on female office employ
ees with disturbing neck-shoulder symptoms (DS) and no or occasional n
eck-shoulder symptoms (NOS). The association among neck-shoulder sympt
oms, pain threshold, and age was also analyzed. Design: The cross-sect
ional study of female office employees selected on a voluntary basis f
rom two offices. Setting: The manual palpation of neck-shoulder muscle
s was analyzed at 16 palpation points defined before the examination.
The pain threshold (PT) was measured at four trigger areas of trapeziu
s and levator muscles. Patients: 160 female office employees with mean
age 41 (21-60) years; height was 163 (149-178) cm; and weight was 62
(45-115) kg. Main outcome measures: Manual palpation findings of neck-
shoulder muscles at 16 defined palpation points and PT measurement of
trigger areas in trapezius and levator muscles by a dolorimeter. Resul
ts: The mean number of tender points was 7.25 (SD, 4.5) in subjects wi
th DS and 3.44 (SD, 3.8) in subjects with NOS; the difference was sign
ificant (p < 0.0001). Suboccipital and trapezius muscles were tender i
n most cases in both symptom groups. The PTs of trapezius and levator
muscles were significantly lower in subjects with DS than in subjects
with NOS (p < 0.0001-0.0005). The PT of the trapezius muscles in subje
cts greater-than-or-equal-to 39 years old with DS was significantly lo
wer than in those with NOS (p < 0.0007-0.0402). The PF of subjects wit
h DS was lower in subjects 39 years old and older than in younger subj
ects, while the PT in subjects with NOS was higher in older subjects t
han in younger ones; the differences were statistically nonsignificant
. Conclusions: Suboccipital and trapezius muscles are often tender in
subjects with DS and in those with NOS. The finding that the PT of the
trapezius muscle in older subjects with DS decreases while the PT in
subjects with NOS increases is interesting and needs further investiga
tion.