MANUAL PALPATION AND PAIN THRESHOLD IN FEMALE OFFICE EMPLOYEES WITH AND WITHOUT NECK SHOULDER SYMPTOMS

Objective: The aim of this study was to quantify myofascial tenderness by using manual palpation and the dolorimeter on female office employees with disturbing neck-shoulder symptoms (DS) and no or occasional neck-shoulder symptoms (NOS). The association among neck-shoulder symptoms, pain threshold, and age was also analyzed. Design: The cross-sectional study of female office employees selected on a voluntary basis from two offices. Setting: The manual palpation of neck-shoulder muscles was analyzed at 16 palpation points defined before the examination. The pain threshold (PT) was measured at four trigger areas of trapezius 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. Results: The mean number of tender points was 7.25 (SD, 4.5) in subjects with DS and 3.44 (SD, 3.8) in subjects with NOS; the difference was significant (p < 0.0001). Suboccipital and trapezius muscles were tender in 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 subjects greater-than-or-equal-to 39 years old with DS was significantly lower than in those with NOS (p < 0.0007-0.0402). The PF of subjects with DS was lower in subjects 39 years old and older than in younger subjects, while the PT in subjects with NOS was higher in older subjects than 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 investigation.