{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:30:27Z","timestamp":1760236227977,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Gluteal syndrome (GS) mimicking sciatica is a new disease that has been recently recognized and included in the International Classification of Diseases, 11th Revision. The present study examines nociplastic pain involvement in GS and sciatica patients using a new Skorupska protocol (SP) test that provokes amplified vasodilatation in the area of expected muscle-referred pain. A positive test is confirmed if there is (i) a development of autonomic referred pain (AURP) and (ii) an increase in the delta of average temperature (\u0394\u20b8\u00b0) &gt; 0.3 \u00b0C at the end of the stimulation and during the observation SP phases. Chronic GS (n = 20) and sciatica (n = 30) patients were examined. The SP test confirmed muscle-referred pain for (i) all GS patients with 90.6% positive thermograms (\u0394\u20b8\u00b0 0.6 \u00b1 0.8 \u00b0C; maximum AURP 8.9 \u00b1 13.6% (both p &lt; 0.05)) and (ii) those sciatica (n = 8) patients who reported pain sensation during the test with 20.6% positive thermograms (\u0394\u20b8\u00b0 0.7 \u00b1 0.7 \u00b0C; maximum AURP 15.1 \u00b1 17.8% (both p &lt; 0.05)). The remaining sciatica (n = 22) patients did not report pain during the test and presented a \u0394\u20b8\u00b0 decrease and the AURP size below 1%. Conclusion: Amplified vasodilatation suggesting nociplastic pain involvement was confirmed for all GS and sciatica patients who reported painful sensations in the zone typical for gluteus minimus referred pain during the test.<\/jats:p>","DOI":"10.3390\/jcm10215146","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T12:39:42Z","timestamp":1635856782000},"page":"5146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Amplified Vasodilatation within the Referred Pain Zone of Trigger Points Is Characteristic of Gluteal Syndrome\u2014A Type of Nociplastic Pain Mimicking Sciatica"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9448-6720","authenticated-orcid":false,"given":"Elzbieta","family":"Skorupska","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Poznan University of Medical Sciences, 61-701 Poznan, Poland"},{"name":"Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Dybek","sequence":"additional","affiliation":[{"name":"Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-7378","authenticated-orcid":false,"given":"Micha\u0142","family":"Rychlik","sequence":"additional","affiliation":[{"name":"Department of Virtual Engineering, Poznan University of Technology, 60-965 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Jokiel","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Poznan University of Medical Sciences, 61-701 Poznan, Poland"},{"name":"Department of Traumatology, Orthopedics and Hand Surgery, Poznan University of Medical Sciences, 60-761 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaros\u0142aw","family":"Zawadzi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6436-2487","authenticated-orcid":false,"given":"Pawe\u0142","family":"Dobrakowski","sequence":"additional","affiliation":[{"name":"Psychology Institute, Humanitas University in Sosnowiec, 41-200 Sosnowiec, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S0140-6736(21)00733-9","article-title":"Low back pain","volume":"398","author":"Knezevic","year":"2021","journal-title":"Lancet"},{"key":"ref_2","unstructured":"Stewart, J.D. (2000). Focal Peripheral Neuropathies, Lippincott Williams & Wilkins. [3rd ed.]."},{"key":"ref_3","unstructured":"(2021, May 19). Available online: https:\/\/www.iasp-pain.org\/PublicationsNews\/Content.aspx?ItemNumber=1673&navItemNumber=677."},{"key":"ref_4","unstructured":"Simons, D.G., Travell, J.G., and Simons, L. (2019). Myofascial Pain and Dysfunction: The Trigger Point Manual, Wolters Kluwer. [3rd ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.apmr.2007.10.018","article-title":"Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points","volume":"89","author":"Shah","year":"2008","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1093\/pm\/pnx207","article-title":"International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: A Delphi study","volume":"19","author":"Dommerholt","year":"2018","journal-title":"Pain Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1093\/rheumatology\/keu471","article-title":"A critical evaluation of the trigger point phenomenon","volume":"54","author":"Quintner","year":"2015","journal-title":"Rheumatology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.20883\/medical.e44","article-title":"Sympathetic Nervous System activity\u2014a new concept of the complicated etiology of low back pain radiates distally at the extremities","volume":"1","author":"Skorupska","year":"2014","journal-title":"J. Med. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.pain.2007.05.004","article-title":"Pseudoradicular and radicular low-back pain\u2014A disease continuum rather than different entities? Answers from quantitative sensory testing","volume":"135","author":"Freynhagen","year":"2008","journal-title":"Pain"},{"key":"ref_10","first-page":"45","article-title":"Westeinde Sciatica Trial: Randomized controlled study of bed rest and physiotherapy for acute sciatica","volume":"96","author":"Hofstee","year":"2002","journal-title":"J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.clineuro.2005.10.003","article-title":"Symptomatic and asymptomatic abnormalities in patients with lumbosacral radicular syndrome: Clinical examination compared with MRI","volume":"108","author":"Klemetso","year":"2006","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jmpt.2011.04.010","article-title":"Validity of the straight-leg raise test for patients with sciatic pain with or without lumbar pain using magnetic resonance imaging results as a reference standard","volume":"34","author":"Capra","year":"2011","journal-title":"J. Manip. Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/BRS.0b013e3181cd9adb","article-title":"Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: A systematic review","volume":"36","author":"Endean","year":"2011","journal-title":"Spine"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tawa, N., Rhoda, A., and Diener, I. (2017). Accuracy of clinical neurological examination in diagnosing lumbo-sacral radiculopathy: A systematic literature review. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-016-1383-2"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1300\/J094v15n01_05","article-title":"Physiological reactivity to functional tests in patients with chronic low back pain","volume":"15","author":"Kalezic","year":"2007","journal-title":"J. Musculoskelet. Pain"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.ejpain.2006.11.004","article-title":"Autonomic activation and pain in response to low-grade mental stress in fibromyalgia and shoulder\/neck pain patients","volume":"11","author":"Nilsen","year":"2007","journal-title":"Eur. J. Pain"},{"key":"ref_17","first-page":"91","article-title":"Sympathetic skin response in fifth lumbar and first sacral radiculopathies","volume":"33","author":"Andary","year":"1993","journal-title":"Electromyogr. Clin. Neurophysiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"546497","DOI":"10.1155\/2015\/546497","article-title":"Validation and test-retest reliability of new thermographic technique called thermovision technique of dry needling for gluteus minimus trigger points in sciatica subjects and TrPs-negative healthy volunteers","volume":"2015","author":"Skorupska","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.2147\/JPR.S282233","article-title":"Female Overrepresentation in Low Back-Related Leg Pain: A Retrospective Study of the Autonomic Response to a Minimally Invasive Procedure","volume":"13","author":"Skorupska","year":"2020","journal-title":"J. Pain Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Skorupska, E., Dybek, T., Rychlik, M., Jokiel, M., and Dobrakowski, P. (2021). The Automatization of a New Thermography Method Using Invasive Nociceptive Stimulation to Confirm an Autonomic Phenomenon within a Trigger Point Referred Pain Zone. Brain Sci., 11.","DOI":"10.3390\/brainsci11070893"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"214374","DOI":"10.1155\/2015\/214374","article-title":"Dry Needling Related Short-Term Vasodilation in Chronic Sciatica under Infrared Thermovision","volume":"2015","author":"Skorupska","year":"2015","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Skorupska, E., Rychlik, M., and Samborski, W. (2015). Intensive vasodilatation in the sciatic pain area after dry needling. BMC Complement. Altern. Med., 15.","DOI":"10.1186\/s12906-015-0587-6"},{"key":"ref_23","unstructured":"Travell, J.G., and Simons, D.G. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual, Williams & Wilkins. [2nd ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/00002060-199407000-00006","article-title":"Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response","volume":"73","author":"Hong","year":"1994","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1007\/s11916-001-0054-6","article-title":"The neurophysiology of myofascial pain syndrome","volume":"5","author":"Rivner","year":"2001","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1111\/psyp.12516","article-title":"Sympathetic pain? A role of poor parasympathetic nervous system engagement in vicarious pain states","volume":"52","author":"Nazarewicz","year":"2015","journal-title":"Psychophysiology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0003-9993(97)90057-5","article-title":"Referred pain elicited by palpation and by needling of myofascial trigger points: A comparison","volume":"78","author":"Hong","year":"1997","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s11916-003-0034-0","article-title":"Central sensitization in fibromyalgia and other musculoskeletal disorders","volume":"7","year":"2003","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1002\/ejp.1140","article-title":"Assessment and manifestation of central sensitisation across different chronic pain conditions","volume":"22","author":"Morlion","year":"2018","journal-title":"Eur. J. Pain"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1097\/j.pain.0000000000001010","article-title":"Autonomic responses to tonic pain are more closely related to stimulus intensity than to pain intensity","volume":"158","author":"Nickel","year":"2017","journal-title":"Pain"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1152\/japplphysiol.00298.2010","article-title":"Mechanisms and modifiers of reflex induced cutaneous vasodilation and vasoconstriction in humans","volume":"109","author":"Charkoudian","year":"2010","journal-title":"J. Appl. Physiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3819","DOI":"10.1118\/1.2133720","article-title":"A global bioheat model with self-tuning optimal regulation of body temperature using Hebbian feedback covariance learning","volume":"32","author":"Ong","year":"2005","journal-title":"Med. Phys."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1097\/AJP.0000000000000875","article-title":"Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review","volume":"36","author":"Li","year":"2020","journal-title":"Clin. J. Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.spinee.2013.02.007","article-title":"Neurological examination of the peripheral nervous system to diagnose lumbar spinal disc herniation with suspected radiculopathy: A systematic review and meta-analysis","volume":"13","author":"Hendrick","year":"2013","journal-title":"Spine J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.tics.2016.12.001","article-title":"Brain rhythms of pain","volume":"21","author":"Ploner","year":"2017","journal-title":"Trends Cogn. Sci."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/21\/5146\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:24:47Z","timestamp":1760167487000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/21\/5146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,2]]},"references-count":35,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["jcm10215146"],"URL":"https:\/\/doi.org\/10.3390\/jcm10215146","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2021,11,2]]}}}