Central Sensitization and Catastrophism Symptoms Are Associated with Chronic Myofascial Pain in the Gastrocnemius of Athletes

• Published in: Pain medicine (Malden, Mass.) Vol. 21; no. 8; pp. 1616 - 1625
• Main Authors: San-Antolín, Marta, Rodríguez-Sanz, David, Becerro-de-Bengoa-Vallejo, Ricardo, Losa-Iglesias, Marta Elena, Casado-Hernández, Israel, López-López, Daniel, Calvo-Lobo, César
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.08.2020
• Subjects: Athletes; Case-Control Studies; Central Nervous System Sensitization; Chronic Pain; Female; Health aspects; Health psychology; Humans; Myofascial pain syndrome; Myofascial Pain Syndromes - diagnosis; Myofascial Pain Syndromes - epidemiology; Neurological disorders; Pain; Psychological aspects; Psychological manifestations of general diseases; Risk factors; Statistical analysis; Spain; Myofascial Pain Syndromes; Trigger Points; Central Nervous System Sensitization; Musculoskeletal Pain; Athletes; Chronic Pain; Sports
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1093/pm/pnz296

Abstract Objective To compare central sensitization symptoms, presence of central sensitivity syndrome (CSS), catastrophism, rumination, magnification, and helplessness symptoms between athletes with gastrocnemius myofascial pain and healthy athletes. Furthermore, to predict central sensitization symptoms based on sociodemographic and descriptive data, catastrophism features, and presence of gastrocnemius myofascial pain in athletes. Design Case–control study. Setting Outpatient clinic. Subjects Fifty matched paired athletes were recruited and divided into patients with chronic (more than three months) gastrocnemius myofascial pain (N = 25) and healthy subjects (N = 25). Methods Central sensitization symptoms and CSS presence (≥40 points) were determined by the Central Sensitization Questionnaire (CSQ). Catastrophism symptoms and rumination, magnification, and helplessness domains were measured by the Pain Catastrophizing Scale (PCS). Statistical significance was set at P < 0.01 for a 99% confidence interval. Results Statistically significant differences (P ≤ 0.001) with a large effect size (d = 1.05–1.19) were shown for higher CSQ scores and PCS total and domain scores in athletes with gastrocnemius myofascial pain vs healthy athletes. Nevertheless, CSS presence (CSQ ≥ 40 points) did not show statistically significant differences (P = 0.050) between groups. A linear regression model (R2 = 0.560, P < 0.01) predicted higher CSQ scores based on PCS total score (R2 = 0.390), female sex (R2 = 0.095), and myofascial pain presence (R2 = 0.075). Conclusions Greater symptoms of central sensitization, catastrophism, rumination, magnification, and helplessness were shown in athletes with gastrocnemius myofascial pain compared with healthy athletes. Nevertheless, there was not a statistically significant presence of CSS comparing both groups. Greater central sensitization symptoms were predicted by catastrophism symptoms, female sex, and presence of gastrocnemius myofascial pain in athletes.