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Funded by a research grant from the American Fibromyalgia Syndrome Association (AFSA).

Analysis of institutional authors

Alonso-Blanco, CAuthorFernandez-De-Las-Penas, CCorresponding AuthorMorales-Cabezas, MAuthorFlorez-Garcia, MAuthor

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September 27, 2022
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Multiple Active Myofascial Trigger Points Reproduce the Overall Spontaneous Pain Pattern in Women With Fibromyalgia and Are Related to Widespread Mechanical Hypersensitivity

Publicated to:Clinical Journal Of Pain. 27 (5): 405-413 - 2011-06-01 27(5), DOI: 10.1097/AJP.0b013e318210110a

Authors: Alonso-Blanco, Cristina; Fernandez-de-las-Penas, Cesar; Zarco-Moreno, Pedro; Ge, Hong-You; Florez-Garcia, Mariano

Affiliations

Aalborg Univ, Dept Hlth Sci & Technol, Ctr Sensory Motor Interact SMI, Aalborg, Denmark - Author
Fdn Hosp Alcorcon, Dept Rehabil, Madrid, Spain - Author
Fdn Hosp Alcorcon, Dept Rheumatol, Madrid, Spain - Author
Univ Rey Juan Carlos, Dept Hlth Sci 2, Madrid 28922, Spain - Author
Univ Rey Juan Carlos, Esthesiol Lab, Madrid 28922, Spain - Author
Univ Rey Juan Carlos, Fac Ciencias Salud, Dept Phys Therapy Occupat Therapy Rehabil & Phys, Madrid 28922, Spain - Author
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Abstract

Objectives: To determine whether the local and referred pain from active myofascial trigger points (MTrPs) reproduce the overall spontaneous fibromyalgia syndrome (FMS) pain pattern and whether widespread pressure hypersensitivity is related to the presence of widespread active MTrPs in FMS. Methods: Forty-four women with FMS (mean age: 47 + 8 y) and 50 comparable healthy women (age: 48 perpendicular to 7 y) participated in the study. MTrPs in the temporalis, masseter, upper trapezius, splenius capitis, sternocleidomastoid, suboccipital, levator scapulae, scalene, pectoralis major, extensor carpi radialis brevis, extensor digitorum communis, gluteus maximus, piriformis, vastus medialis, and tibialis anterior muscles were explored. Pressure pain thresholds over 18 tender points specified in the 1990 American College of Rheumatology for FMS were also assessed by an assessor blinded to the condition of the participants. Results: The mean +/- SD number of MTrPs for each woman with FMS was 11 +/- 3, of which 10 +/- 2 were active MTrPs and the remaining 1 +/- 1 were latent. Healthy controls only had latent MTrPs (mean +/- SD: 2 +/- 1). The combination of the referred pain patterns from active MTrPs fully reproduced the overall spontaneous clinical pain area in patients with FMS. Patients with FMS had significant lower PPT compared with controls (P < 0.001). Within FMS, a significant positive correlation was found between the number of active MTrPs and spontaneous pain intensity (r(s) = 0.455; P= 0.002). Conclusions: The local and referred pain elicited from widespread active MTrPs fully reproduced the overall spontaneous clinical pain area in patients with FMS. Widespread mechanical pain hypersensitivity was related to a greater number of active MTrPs. This study suggests that nociceptive inputs from active MTrPs may contribute to central sensitization in FMS.

Keywords

Afferent inputArticleClinical articleControlled studyDiagnostic-criteriaDiseaseExtensor carpi muscleExtensor digitorum communis muscleFemaleFibromyalgiaFibromyalgia syndromeGluteus maximus muscleHumanHumansHyperalgesiaInterrater reliabilityLevator scapulae muscleMasseter muscleMiddle agedMigraineMuscleMyofascial painMyofascial pain syndromesMyofascial trigger pointPain parametersPain thresholdPectoralis major musclePhysical stimulationPiriformis musclePressure painPrevalencePriority journalRadialis brevis muscleReferred painScalene muscleSensitizationSkeletal muscleSplenius capitis muscleSternocleidomastoid muscleSuboccipital muscleTemporalis muscleTension-type headacheTibialis anterior muscleTouchTrapezius muscleTreatment outcomeTrigger pointsVastus medialis muscle

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Clinical Journal Of Pain due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2011, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Anesthesiology and Pain Medicine.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 11.17, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Aug 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-08-03, the following number of citations:

  • WoS: 51
  • Scopus: 56
  • Europe PMC: 30

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-03:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 92.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 93 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 0.5.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Denmark.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Alonso Blanco, María Cristina) and Last Author (Flórez García, Mariano Tomás).

the author responsible for correspondence tasks has been Fernández de las Peñas, César.