1
|
Dones VC, Serra MAB, Tangcuangco LPD, Orpilla VB. Superficial fascia displacement in cervical flexion: differentiating myofascial pain syndrome, a cross-sectional study. J Osteopath Med 2024; 124:353-363. [PMID: 38444081 DOI: 10.1515/jom-2023-0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/01/2024] [Indexed: 03/07/2024]
Abstract
CONTEXT Myofascial pain syndrome (MPS) is primarily characterized by myofascial trigger points related to fascial adhesions. MPS hinders fascial flexibility and mobility, leading to myofascial limitations, dysfunctional movement, and limitation of motion (LOM). OBJECTIVES This study determined the association of age, sex, type of work, symptom chronicity, symptom laterality, cervical LOM, altered direction of fascial displacement, and magnitude of superficial fascial displacement during active cervical flexion with the clinical diagnosis of MPS. METHODS A cross-sectional study selectively included MPS and non-MPS participants from different workplaces from January to October 2019. The MPS group exhibited clinical symptoms like tender spots, recognized pain patterns, and local twitch response upon palpation, often accompanied by cervical LOM. The non-MPS group lacked these symptoms, and those with certain pre-existing conditions or recent physiotherapy were not part of the study. Participants performed cervical active range of motion (AROM) while a sonographer recorded superficial fascial displacement utilizing ultrasound, which was later analyzed by three physiotherapists with the Tracker. Aiming for a multiple regression R-squared of 0.2, the target was 384 participants to account for a 20 % dropout, resulting in 307 participants after attrition. To explore the relationships between MPS and various factors, logistic regression models, rigorously tested for reliability and validity, were utilized. RESULTS In the study, there were 192 participants with MPS and 137 without MPS. The median ages were 33 years for the non-MPS group and 38 years for the MPS group. The adjusted model found significant links for sex (odds ratio [OR]=2.63, p<0.01), symptom chronicity (OR=8.28, p<0.01), and cervical LOM (OR=3.77, p=0.01). However, age and the presence of nodules/taut bands were not statistically significant (p>0.05). Also, the type of work, the direction of fascial displacement, and the difference in superficial fascial displacement during cervical flexion did not show a significant association with the clinical diagnosis of MPS (p>0.05). The adjusted model had a sensitivity of 73.80 % and a specificity of 81.34 %, correctly identifying 84.66 % of positive cases and 68.99 % of negative ones, resulting in an overall accuracy of 76.95 % in predicting MPS. CONCLUSIONS We provided an in-depth examination of MPS, identifying sex, duration of symptoms, and cervical LOM as significant predictive factors in its diagnosis. The study emphasizes the critical role of these variables in the accurate diagnosis of MPS, while delineating the comparatively minimal diagnostic value of other factors such as age, type of occupation, presence of nodules or taut bands, and variations in fascial displacement. This study underscores the imperative for further scholarly inquiry into the role of fascial involvement in musculoskeletal disorders, with the objective of enhancing both the theoretical understanding and diagnostic practices in this medical domain.
Collapse
Affiliation(s)
- Valentin C Dones
- Center for Health Research and Movement Science, 37572 University of Santo Tomas , Manila, Philippines
| | - Mark Angel B Serra
- Center for Health Research and Movement Science, 37572 University of Santo Tomas , Manila, Philippines
| | | | - Vergel B Orpilla
- College of Rehabilitation Sciences, 37572 University of Santo Tomas , Manila, Philippines
| |
Collapse
|
2
|
Giorgi V, Sarzi-Puttini P, Pellegrino G, Sirotti S, Atzeni F, Alciati A, Torta R, Varrassi G, Fornasari D, Coaccioli S, Bongiovanni SF. Pharmacological Treatment of Fibromyalgia Syndrome: A Practice-Based Review. Curr Pain Headache Rep 2024:10.1007/s11916-024-01277-9. [PMID: 39042299 DOI: 10.1007/s11916-024-01277-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE OF REVIEW Fibromyalgia Syndrome (FMS) is a complex chronic pain condition characterized by widespread musculoskeletal pain and numerous other debilitating symptoms. The purpose of this review is to provide a comprehensive overview, based on everyday clinical practice, of the drugs presently employed in the treatment of FMS. RECENT FINDINGS The treatment of FMS is based on a multimodal approach, with pharmacologic treatment being an essential pillar. The drugs used include tricyclic antidepressants, serotonin and noradrenaline reuptake inhibitors, other antidepressants, anticonvulsants, myorelaxants, and analgesics. The effectiveness of these medications varies, and the choice of drug often depends on the specific symptoms presented by the patient. Many drugs tend to either address only some domains of the complex FMS symptomatology or have a limited effect on pain. Each treatment option comes with potential side effects and risks that necessitate careful consideration. It may be beneficial to divide patients into clinical subpopulations, such as FMS with comorbid depression, for more effective treatment. Despite the complexities and challenges, the pharmacological treatment remains a crucial part for the management of FMS. This review aims to guide clinicians in prescribing pharmacological treatment to individuals with FMS.
Collapse
Affiliation(s)
- Valeria Giorgi
- Unità di Ricerca Clinica, Gruppo Ospedaliero Moncucco, Via Soldino, 5, 6900, Lugano, CH, Switzerland.
| | - Piercarlo Sarzi-Puttini
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Greta Pellegrino
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Silvia Sirotti
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Fabiola Atzeni
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy
| | - Alessandra Alciati
- Department of Clinical Neurosciences, Villa S. Benedetto Menni, 22032, Albese con Cassano, Como, Italy
- Humanitas Clinical and Research Center, Rozzano, 20089, Milan, Italy
| | - Riccardo Torta
- Clinical Psychology, Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Diego Fornasari
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | | | | |
Collapse
|
3
|
Ustun B, Yorulmaz E, Geler-Kulcu D. Comparison of Dry Needling and Cold-Spray-Stretching Treatments by Ultrasonography and Electrophysiology: Prospective, Randomized Controlled Trial. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1211-1221. [PMID: 38459670 DOI: 10.1002/jum.16445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/01/2024] [Accepted: 02/17/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES To compare the efficacy of dry needling (DN) and cold-spray-stretching treatments using surface electromyography (sEMG) and ultrasound (US) in the treatment of patients with myofascial pain syndrome (MPS) with active trigger point (ATrP) in the upper trapezius muscle. METHODS This prospective randomized single-blind study included 60 MPS patients aged 18-65 years who have ATrP in the upper trapezius muscle. Patients were randomized into two treatment groups as DN and cold spray stretching. Both treatment groups received 1 treatment per week and totally 3 sessions. Evaluation parameters were pain level assessed by Numeric Rating Scale and algometer, neck range of motion angles, neck disability index (NDI). The effects of the treatments on ATrP were evaluated by sEMG and US histogram. All parameters were evaluated at the beginning of the treatment and at the end. Algometer and sEMG were performed also before and after the first and third sessions. RESULTS There was no significant difference between the two groups regarding demographic data. The mean age of the participants was 39.7 ± 11.6 years. Fifty-one patients were female. Significant improvement in terms of pain level, functionality, sEMG, and US histogram were achieved in both groups (P < .05). When comparing the two groups, algometer scores and the NDI score were statistically higher in the cold-spray-stretching group than in the DN group (P < .008 and P < .028, respectively). CONCLUSION Both treatment options should be preferred. The efficacy of both treatments was observed via sEMG and US histograms.
Collapse
Affiliation(s)
- Busra Ustun
- Department of Physical Medicine and Rehabilitation, Van Training and Research Hospital, Van, Turkey
- Department of Physical Medicine and Rehabilitation, Haydarpaşa Training and Research Hospital Faculty of Medicine, Health Sciences University, Istanbul, Turkey
| | - Elem Yorulmaz
- Department of Physical Medicine and Rehabilitation, Haydarpaşa Training and Research Hospital Faculty of Medicine, Health Sciences University, Istanbul, Turkey
| | - Duygu Geler-Kulcu
- Department of Physical Medicine and Rehabilitation, Haydarpaşa Training and Research Hospital Faculty of Medicine, Health Sciences University, Istanbul, Turkey
| |
Collapse
|
4
|
Santos-Vilar LAD, Freitas-Passos IF, Rossi BM, Blauth FG, Pontes VCB, Moriguti JC, Riberto M, Lima NKDC. Lidocaine Needling in Myofascial Pain Syndrome for Palliative Oncologic Care: A Randomized Clinical Study. J Palliat Med 2024; 27:888-894. [PMID: 38484328 DOI: 10.1089/jpm.2023.0641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2024] Open
Abstract
Background: Physical pain is highly prevalent and impacts the well-being of patients with advanced oncologic disease. Although myofascial pain syndrome (MPS) can be one of the components of pain in cancer patients on palliative care (PC), so far there is no evidence about the benefit of treatment with 1% lidocaine needling. Objectives: To evaluate the efficacy of MPS treatment with injection of 1% lidocaine on the reduction of pain in cancer patients on PC. Design: Single-blind randomized clinical trial. Subjects: Patients aged 50 years or older with end-stage cancer, admitted to a cancer ward or monitored during radiotherapy in three Brazilian hospitals, with a diagnosis of MPS with a pain intensity of five or more according to the Visual Analog Scale (VAS). The patients were divided into two groups: trigger point (TP) injection with 1% lidocaine and control. Measurements: Pain intensity was assessed with the VAS, pain threshold with an algometer, and the medications being used were determined before and 72 hours after the intervention. Results: Thirty patients (15 per group) were assessed. After 72 hours, there was a reduction in referred pain intensity (p < 0.001) and an increase in pressure threshold (p = 0.007) in the intervention group (IG), with no difference in the control. The frequency of individuals who reduced the doses and/or classes of pain medications was higher in the IG (p = 0.011). Conclusion: One percent lidocaine needling in TPs was an effective therapy for pain reduction in MPS.
Collapse
Affiliation(s)
- Laís Araujo Dos Santos-Vilar
- Department of Internal Medicine, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Isabella Fioravante Freitas-Passos
- Department of Internal Medicine, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Beatriz Menin Rossi
- Department of Internal Medicine, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Gioppo Blauth
- Department of Internal Medicine, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Victor Carvalho Brito Pontes
- Department of Internal Medicine, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Julio César Moriguti
- Department of Internal Medicine, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marcelo Riberto
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Nereida Kilza da Costa Lima
- Department of Internal Medicine, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
5
|
Xiong J, Zhou X, Luo X, Gong X, Jiang L, Luo Q, Zhang S, Jiang C, Pu T, Liu J, Zhang J, Li B, Chi H. Acupuncture therapy on myofascial pain syndrome: a systematic review and meta-analysis. Front Neurol 2024; 15:1374542. [PMID: 38765261 PMCID: PMC11100351 DOI: 10.3389/fneur.2024.1374542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024] Open
Abstract
Purpose Traditional Chinese medicine (TCM) therapies, especially acupuncture, have received increasing attention in the field of pain management. This meta-analysis evaluated the effectiveness of acupuncture in the treatment of myofascial pain syndrome. Methods A comprehensive search was conducted across a number of databases, including PubMed, Cochrane Library, WOS, CNKI, WANFANG, Sinomed, and VIP. Furthermore, articles of studies published from the inception of these databases until November 22, 2023, were examined. This systematic review and meta-analysis encompassed all randomized controlled trials (RCTs) on acupuncture for myofascial pain syndromes, without language or date restrictions. Based on the mean difference (MD) of symptom change, we critically assessed the outcomes reported in these trials. The quality of evidence was assessed using the Cochrane Risk of Bias Tool. The study is registered with PROSPERO under registration number CRD42023484933. Results Our analysis included 10 RCTs in which 852 patients were divided into two groups: an acupuncture group (427) and a control group (425). The results of the study showed that acupuncture was significantly more effective than the control group in treating myofascial pain syndromes, which was reflected in a greater decrease in VAS scores (MD = -1.29, 95% [-1.65, -0.94], p < 0.00001). In addition, the improvement in PRI and PPI was more pronounced in the acupuncture group (PRI: MD = -2.04, 95% [-3.76, -0.32], p = 0.02) (PPI: MD = -1.03, 95% [-1.26, -0.79], p < 0.00001) compared to the control group. These results suggest that acupuncture is effective in reducing myofascial pain. It is necessary to further study the optimal acupoints and treatment time to achieve the best therapeutic effect. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023484933.
Collapse
Affiliation(s)
- Jingwen Xiong
- Department of Sports Rehabilitation, Southwest Medical University, Luzhou, China
| | - Xuancheng Zhou
- Department of Psychiatry, Southwest Medical University, Luzhou, China
| | - Xiufang Luo
- Department of Geriatric, Dazhou Central Hospital, Dazhou, China
| | - Xiangjin Gong
- Department of Sports Rehabilitation, Southwest Medical University, Luzhou, China
| | - Lai Jiang
- School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - Qiang Luo
- Department of Sports Rehabilitation, Southwest Medical University, Luzhou, China
| | - Shengke Zhang
- School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - Chenglu Jiang
- School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - Tong Pu
- College of Acupuncture and Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Jie Liu
- Department of General Surgery, Dazhou Central Hospital, Dazhou, China
| | - Jun Zhang
- Department of General Surgery, Dazhou Central Hospital, Dazhou, China
| | - Bo Li
- Department of General Surgery (Hepatopancreatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Academician (Expert) Workstation of Sichuan Province, Metabolic Hepatobiliary and Pancreatic Diseases Key Laboratory of Luzhou City, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hao Chi
- School of Clinical Medicine, Southwest Medical University, Luzhou, China
| |
Collapse
|
6
|
Lam C, Francio VT, Gustafson K, Carroll M, York A, Chadwick AL. Myofascial pain - A major player in musculoskeletal pain. Best Pract Res Clin Rheumatol 2024:101944. [PMID: 38644073 DOI: 10.1016/j.berh.2024.101944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/23/2024]
Abstract
Myofascial pain is a soft tissue pain syndrome with local and referred musculoskeletal pain arising from trigger points. Myofascial pain and myofascial pain syndromes are among some of the most common acute and chronic pain conditions. Myofascial pain can exist independently of other pain generators or can coexist with or is secondary to other acute and chronic painful musculoskeletal conditions. Myofascial pain is most effectively treated with a multimodal treatment plan including injection therapy (known as trigger point injections, physical therapy, postural or ergonomic correction, and treatment of underlying musculoskeletal pain generators. The objectives of this review are to outline the prevalence of myofascial pain, describe the known pathophysiology of myofascial pain and trigger points, discuss the clinical presentation of myofascial pain, and present evidence-based best practices for pharmacologic, non-pharmacologic, and interventional treatments for myofascial pain.
Collapse
Affiliation(s)
- Christopher Lam
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
| | - Vinicius Tieppo Francio
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
| | - Kelsey Gustafson
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
| | - Michael Carroll
- Department of Physical Medicine and Rehabilitation, University of Kansas School of Medicine, Kansas City, KS, USA.
| | - Abigail York
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
| | - Andrea L Chadwick
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
| |
Collapse
|
7
|
KARDES K, VAN DER VEER P, TUTUNEKEN YE, AYKAC HN, ARSLAN E, AKSOY A, BURAN CIRAK Y. Effects of Different Taping Techniques in Individuals with Myofascial Pain Syndrome with a Trigger Point in the Trapezius Muscle: A Sham-controlled Randomized Study. Medeni Med J 2024; 39:39-48. [PMID: 38511849 PMCID: PMC10961666 DOI: 10.4274/mmj.galenos.2024.59207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/25/2024] [Indexed: 03/22/2024] Open
Abstract
Objective This study aimed to compare the effects of three different kinesio taping (KT) techniques in individuals with myofascial pain syndrome (MPS) who have a trigger point in the trapezius muscle. Methods The individuals included in our study were randomly divided into four groups: Group 1: Functional correlation technique, group 2: Fascia correlation technique, group 3: Star taping technique (STT), and group 4: Sham group. The visual analog scale was used to assess pain, cervical joint range of motion (ROM) with a universal goniometer, grip strength with a hand dynamometer, number of active trigger points by palpation, pressure-pain threshold with an algometer, quality of life with the Nottingham Health Profile and functional level with the Neck Disability index were evaluated before and after treatment. Results There was no difference between the groups in terms of demographic data and pre-treatment outcome measures (p>0.05). There was a significant difference in the pain score between the groups after treatment (p<0.05). A statistically significant difference was found in the cervical flexion ROM of all groups after treatment (p<0.05). In pairwise comparisons, these differences were found due to group 3 (p<0.05). Conclusions The three KT techniques are effective in reducing pain, increasing ROM, reducing the number of active trigger points, and increasing grip strength. Among these techniques, STT was found to be more effective in reducing pain and increasing cervical flexion ROM. KT is a method that can be used in the clinic for patients with MPS.
Collapse
Affiliation(s)
- Kubra KARDES
- Istinye University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
- Istanbul University-Cerrahpasa Institute of Graduate Studies, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Pinar VAN DER VEER
- Istinye University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
- Istanbul University-Cerrahpasa Institute of Graduate Studies, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Yunus Emre TUTUNEKEN
- Istinye University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
- Istanbul University-Cerrahpasa Institute of Graduate Studies, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Hale Nur AYKAC
- Kocaeli Metropolitan Municipality Belde Inc, Kocaeli, Turkey
| | | | - Aysenur AKSOY
- Istinye University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Yasemin BURAN CIRAK
- Istinye University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| |
Collapse
|
8
|
Bingölbali Ö, Taşkaya C, Alkan H, Altındağ Ö. The effectiveness of deep tissue massage on pain, trigger point, disability, range of motion and quality of life in individuals with myofascial pain syndrome. Somatosens Mot Res 2024; 41:11-17. [PMID: 36645811 DOI: 10.1080/08990220.2023.2165054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 01/02/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE This study aims to examine the effect of deep tissue massage (DTM) on the myofascial trigger point (MTrP) number, neck range of motion (ROM), pain, disability and quality of life in patients with Myofacial pain syndrome (MPS). METHODS The study involved patients with MPS between the ages of 20-57. The patients were randomly divided into two groups: the control group (n = 40) and the study group (n = 40). Transcutaneous Electrical Neuromuscular Stimulation (TENS), hotpack and ultrasound were applied to 40 patients in the control group. The study group was also administered DTM for 12 sessions in addition to TENS, hotpack and ultrasound applications. Neck pain and disability scale (NPDS) for a neck disability, universal goniometer for neck ROM, MTrP count using manual palpation, Short Form 36 (SF-36) for quality of life and severity of neck pain were evaluated using a visual analog scale (VAS). All patients were evaluated before and after treatment. RESULTS It was found that the DTM group has statistically more improvement than the control group for VAS, NPDS and SF-36. Moreover, although there was a significant improvement in favour of the study group for extension, lateral flexion, right rotation and left rotation in the neck ROM, there was no significant difference in flexion measurements between the study and control group. CONCLUSION In addition to the traditional rehabilitation program, DTM is effective on neck ROM, pain, disability and quality of life. Therefore, DTM treatment is a safe and inexpensive treatment method that can be applied in patients with MPS.
Collapse
Affiliation(s)
- Ömer Bingölbali
- Department of Health Care Services, Health Services Vocational School, Muş Alparslan University, Muş, Turkey
| | - Cengiz Taşkaya
- Department of Health Care Services, Health Services Vocational School, Muş Alparslan University, Muş, Turkey
| | - Halil Alkan
- Department of Physiotherapy and Rehabilitation, Muş Alparslan University, Muş, Turkey
| | - Özlem Altındağ
- Department of Physical Medicine and Rehabilitation Gaziantep, Gaziantep University, Gaziantep, Turkey
| |
Collapse
|
9
|
Adams W, Idnani S, Kim J. Transcranial Direct Current Stimulation for Orthopedic Pain: A Systematic Review with Meta-Analysis. Brain Sci 2024; 14:66. [PMID: 38248281 PMCID: PMC10813248 DOI: 10.3390/brainsci14010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/16/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
(1) Background: Transcranial direct current stimulation (tDCS) appears to alleviate chronic pain via a brain-down mechanism. Although several review studies have examined the effects of tDCS on patients with chronic pain, no systematic review or meta-analysis has comprehensively analyzed the effects of tDCS on chronic orthopedic joint pain in one study. We aim to evaluate the effectiveness of tDCS for pain reduction in chronic orthopedic patients; (2) Methods: A comprehensive search of five electronic databases (Medline, Embase, Web of Science, CINAHL, and Cochrane) was performed. Only randomized controlled trials that compared tDCS with a control intervention were included. Eighteen studies met our inclusion criteria. We identified four categories of chronic orthopedic pain: knee (k = 8), lower back (k = 7), shoulder (k = 2), and orofacial pain (k = 1). Random effect models were utilized, and a sensitivity analysis was conducted in the presence of significant heterogeneity. Studies within each pain condition were further classified according to the number of treatment sessions: 1-5 sessions, 6-10 sessions, and >10 sessions.; (3) Results: Significant reductions in chronic orthopedic joint pain were observed following tDCS compared to controls for knee (g = 0.59, p = 0.005), lower back (g = 1.14, p = 0.005), and shoulder (g = 1.17, p = 0.020). Subgroup analyses showed pain reductions after 6-10 tDCS sessions for knee pain and after 1-5 and >10 sessions for lower back pain; (4) Conclusions: tDCS could be considered a potential stand-alone or supplemental therapy for chronic knee and lower back pain. The effectiveness of tDCS treatment varies depending on the number of treatment sessions. Our findings suggest the importance of implementing individualized treatment plans when considering tDCS for chronic pain conditions.
Collapse
Affiliation(s)
- William Adams
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA; (W.A.); (S.I.)
| | - Sherina Idnani
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA; (W.A.); (S.I.)
| | - Joosung Kim
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA; (W.A.); (S.I.)
- Department of Health and Human Performance, Texas State University, San Marcos, TX 78666, USA
| |
Collapse
|
10
|
Suarez-Ramos C, Gonzalez-Suarez C, Gomez IN, Gonzalez MK, Co PH, Llamas JA. Effectiveness of ultrasound guided interfascial hydrodissection with the use of saline anesthetic solution for myofascial pain syndrome of the upper trapezius: a single blind randomized controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1281813. [PMID: 38149112 PMCID: PMC10750391 DOI: 10.3389/fresc.2023.1281813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/31/2023] [Indexed: 12/28/2023]
Abstract
Background Myofascial pain syndrome (MPS) is described as pain that arise from myofascial trigger points (MTrPs) which is a hyperirritable spot within a taut band of skeletal muscle. A newer needling technique called the interfascial hydrodissection (IH), wherein anesthetic saline solution (ASS) is injected between the fascia of the muscles using ultrasound as guide. It is theorized that this technique blocks the nerve branches and improve gliding in between the muscle and fascia. Objective To determine the short and long-term effects of interfascial hydrodissection using 2% Lidocaine and saline solution compared to dry needling with MPS of the upper trapezius on pain and quality of life using. Methods This study is a single-blind randomized controlled trial where ultrasound guided IH with ASS was compared to dry needling (DN) of the MTrPs. Both groups were taught self-stretch exercises (SSE) to be done everyday after the procedure. Outcome measures were pain using the visual analogue scale (VAS) and quality of life assessment with EQ-5D-5l questionnaire. All participants were assessed by a blinded assessor before the intervention, immediately after, 10 and 30 min, one week, two weeks, four weeks, three months, and six months after the procedure. Data Analysis: Two-way mixed ANOVA and follow-up independent T-test were conducted for the outcome measures across several time points between the 2 groups. Results A total of 46 participants with two dropouts were all included during the final analysis. Both groups demonstrated significant differences in VAS scores between baseline and the different time points, the IH + SSE group demonstrated the more significant effect size at as compared to the DN + SSE group. For EQ-5D-5l, no statistical differences were seen in all dimensions but there was a larger effect size for usual activities, pain/discomfort and anxiety/depression. Conclusion Interfascial hydrodissection is a technique that can manage both short and long term symptoms of MPS. This could be utilized as an alternative management for those with chronic MPS of the upper trapezius. Philippine Health Research Registry ID PHRR221003-005034.
Collapse
Affiliation(s)
- Charidy Suarez-Ramos
- Physical Medicine and Rehabilitation, Our Lady of Lourdes Hospital, Manila, Philippines
| | - Consuelo Gonzalez-Suarez
- Physical Medicine and Rehabilitation, Our Lady of Lourdes Hospital, Manila, Philippines
- Research Center for Health Science, University of Santo Tomas, Manila, Philippines
| | - Ivan Neil Gomez
- Department of Occupational Therapy, College of Rehabilitation Science, University of Santo Tomas, Manila, Philippines
- Center of Health Research and Movement Sciences, University of Santo Tomas, Manila, Philippines
| | - Maria Katherine Gonzalez
- Physical Therapy and Rehabilitation Medicine Department, Gat Andres Bonifacio Medical Center, Manila, Philippines
| | - Philippe Hubert Co
- Health Hub Physical Therapy, Rehabilitation Medicine and Orthopedics Clinic Inc., Manila, Philippines
| | - Jose Alfonso Llamas
- Physical Therapy and Rehabilitation Medicine Department, Region I Medical Center, Dagupan City, Pangasinan, Philippines
| |
Collapse
|
11
|
Taheri P, Sadri S, Maghroori R. Effect of Adding Transfer Energy Capacitive and Resistive Therapy to Conventional Therapy for Patients With Myofascial Pain Syndrome in Upper Trapezius: A Randomized Clinical Trial. J Chiropr Med 2023; 22:257-264. [PMID: 38205230 PMCID: PMC10774611 DOI: 10.1016/j.jcm.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 01/12/2024] Open
Abstract
Objective The purpose of this study was to compare the effect of adding transfer energy capacitive and resistive (TECAR) therapy to conventional therapy on patients' symptoms of myofascial pain syndrome (MPS) in the upper trapezius. Methods Fifty patients with MPS in the upper trapezius were randomized into 2 groups. The intervention group received TECAR therapy (capacitive mode, 2 sessions weekly), and conventional treatment comprised of stretching exercise (9 times a day) and medication (acetaminophen and tizanidine) for 3 weeks, and the comparison group received conventional treatment (same as the intervention group) alone. The patients completed the Numeric Pain Scale, Neck Disability Index, and Shoulder Pain and Disability Index before, after, and 1 month after the treatment. Results All variables were significantly reduced within both groups by time and treatment separately (P < .001), while a general comparison among the groups showed a significant reduction for all variables in the intervention group compared with the comparison group (P < .05) except for shoulder disability (P = .114). Moreover, the intervention group had better results compared with the comparison group based on the minimal clinically important difference. Conclusion A combination of TECAR therapy, exercise, and medication substantially reduced symptom severity for patients with MPS in the upper trapezius when compared to only exercise and medication.
Collapse
Affiliation(s)
- Parisa Taheri
- Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soroush Sadri
- Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Maghroori
- Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
12
|
Muallem J, Velho RV, Netzl J, Sehouli J, Mechsner S. Pelvic floor hypertension: possible factors for pelvic floor tenderness in endometriosis patients-a pilot study. Arch Gynecol Obstet 2023; 308:1803-1809. [PMID: 37672087 PMCID: PMC10579168 DOI: 10.1007/s00404-023-07192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/13/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE Chronic pelvic pain (CPP) is one of the main problems of endometriosis, leading to a significant impairment of quality of life. Understanding the pain mechanisms and the pelvic floor muscles (PFM) changes in these patients is essential to integrate additional therapeutic strategies. We hypothesize that endometriosis patients have changes in PFM and that targeted vaginal electrostimulation can be a treatment option for CPP in this disease. METHODS Fifteen patients with endometriosis and chronic acyclical pelvic pain were included. PFM electromyography with the Multiple Array Probe Leiden (MAPLe) was performed. Mapping of PFM was utilized and targeted electrostimulation of the hypertensive muscles was conducted. Control electromyography was performed afterward to evaluate the electrostimulation therapeutic effect. RESULTS In 12/15 (80%) patients, the myofascial trigger point could be localized by digital examination. The most frequently affected muscle was the puborectalis (10/15-66.7%). Most of the patients showed serious changes in the average resting tone (aRT) of PFM. aRT was significantly increased in all patients and decreased after stimulation, whereby the difference prior to and after stimulation was not significant (p = 0.064). The detailed separated analysis of the hypertensive muscles showed a significant (p = 0.026) reduction in their resting tone (hRT), after targeted stimulation. CONCLUSION Vaginal electrostimulation is a promising and feasible complementary treatment option for CPP in endometriosis patients. Targeted treatment of pelvic floor dysfunction should be included in clinical trials.
Collapse
Affiliation(s)
- Jumana Muallem
- Department of Gynecology Charité with Center of Oncological Surgery, Endometriosis Research Center Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Renata Voltolini Velho
- Department of Gynecology Charité with Center of Oncological Surgery, Endometriosis Research Center Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Johanna Netzl
- Department of Gynecology Charité with Center of Oncological Surgery, Endometriosis Research Center Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology Charité with Center of Oncological Surgery, Endometriosis Research Center Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Sylvia Mechsner
- Department of Gynecology Charité with Center of Oncological Surgery, Endometriosis Research Center Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| |
Collapse
|
13
|
Alshammari SS, Amin S, Siddiqui AA, Malik YR, Alshammari AF, Amin J. An Evidence-Based Treatment of Myofascial Pain and Myofascial Trigger Points in the Maxillofacial Area: A Narrative Review. Cureus 2023; 15:e49987. [PMID: 38179392 PMCID: PMC10766389 DOI: 10.7759/cureus.49987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
Myofascial pain (MFP) is characterized by localized pain in the maxillofacial region attributed to the presence of hypersensitive spots known as trigger points (TrPs). This condition is particularly prevalent in the maxillofacial area, warranting a comprehensive examination of evidence-based management techniques. This review aims to equip healthcare professionals with a more profound insight into evidence-based MFP management techniques, facilitating improved patient care and treatment outcomes. In this review, we conducted a thorough literature search using Google Scholar, Scopus, Web of Science (WOS), and MEDLINE, with the keywords "Myofascial pain syndrome," "Pain," and "Orofacial pain." Articles were selected based on their relevance to the study's objective. Pharmacological interventions, such as analgesics and muscle relaxants, are frequently prescribed. Additionally, a range of non-pharmacological modalities, including transcutaneous electrical nerve stimulation (TENS), ultrasound therapy, topical applications, dry needling, TrP injections, oral myofunctional therapy, and stretching exercises, have demonstrated efficacy in MFP management. The authors hope to give clinicians a more thorough understanding of the therapies for MFP by conducting a rigorous evidence-based evaluation of pharmacologic and non-pharmacological treatments. Our findings support the use of a combined approach that integrates both pharmacological and non-pharmacological strategies for the holistic management of TrPs.
Collapse
Affiliation(s)
- Sattam S Alshammari
- Department of Preventive Dental Sciences, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Salman Amin
- Department of Oral and Maxillofacial Surgery, College of Medicine and Dentistry, The University of Lahore, Lahore, PAK
| | - Ammar Ahmed Siddiqui
- Department of Preventive Dental Sciences, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Yasser Riaz Malik
- Department of Preventive Dental Sciences, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Abdullah Faraj Alshammari
- Department of Basic Dental and Medical Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Junaid Amin
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha'il, Ha'il, SAU
| |
Collapse
|
14
|
Marques Azzini GO, Marques Azzini VO, Santos GS, Visoni S, Fusco MA, Beker NS, Mahmood A, Bizinotto Lana JV, Jeyaraman M, Nallakumarasamy A, Jeyaraman N, da Fonseca LF, Luz Arab MG, Vicente R, Rajendran RL, Gangadaran P, Ahn BC, Duarte Lana JFS. Cannabidiol for musculoskeletal regenerative medicine. Exp Biol Med (Maywood) 2023; 248:445-455. [PMID: 37158062 PMCID: PMC10281618 DOI: 10.1177/15353702231162086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Chronic musculoskeletal (MSK) pain is one of the most prevalent causes, which lead patients to a physician's office. The most common disorders affecting MSK structures are osteoarthritis, rheumatoid arthritis, back pain, and myofascial pain syndrome, which are all responsible for major pain and physical disability. Although there are many known management strategies currently in practice, phytotherapeutic compounds have recently begun to rise in the medical community, especially cannabidiol (CBD). This natural, non-intoxicating molecule derived from the cannabis plant has shown interesting results in many preclinical studies and some clinical settings. CBD plays vital roles in human health that go well beyond the classic immunomodulatory, anti-inflammatory, and antinociceptive properties. Recent studies demonstrated that CBD also improves cell proliferation and migration, especially in mesenchymal stem cells (MSCs). The foremost objective of this review article is to discuss the therapeutic potential of CBD in the context of MSK regenerative medicine. Numerous studies listed in the literature indicate that CBD possesses a significant capacity to modulate mammalian tissue to attenuate and reverse the notorious hallmarks of chronic musculoskeletal disorders (MSDs). The most of the research included in this review report common findings like immunomodulation and stimulation of cell activity associated with tissue regeneration, especially in human MSCs. CBD is considered safe and well tolerated as no serious adverse effects were reported. CBD promotes many positive effects which can manage detrimental alterations brought on by chronic MSDs. Since the application of CBD for MSK health is still undergoing expansion, additional randomized clinical trials are warranted to further clarify its efficacy and to understand its cellular mechanisms.
Collapse
Affiliation(s)
| | | | - Gabriel Silva Santos
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
| | - Silvia Visoni
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
| | | | | | - Ansar Mahmood
- University Hospitals Birmingham,
Birmingham B15 2PR, UK
| | - João Vitor Bizinotto Lana
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Medical Specialties School Centre,
Centro Universitário Max Planck, Indaiatuba, 13343-060, Brazil
| | - Madhan Jeyaraman
- Department of Orthopaedics, A.C.S.
Medical College and Hospital, Dr.M.G.R. Educational and Research Institute, Chennai
600056, India
- Department of Biotechnology, School of
Engineering and Technology, Sharda University, Greater Noida 201310, India
- South Texas Orthopaedic Research
Institute (STORI Inc.), Laredo, TX 78045, USA
- Indian Stem Cell Study Group (ISCSG)
Association, Lucknow 226010, India
| | - Arulkumar Nallakumarasamy
- Indian Stem Cell Study Group (ISCSG)
Association, Lucknow 226010, India
- Department of Orthopaedics, All India
Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Naveen Jeyaraman
- Indian Stem Cell Study Group (ISCSG)
Association, Lucknow 226010, India
- Department of Orthopaedics, Atlas
Hospitals, Tiruchirappalli 620002, India
| | - Lucas Furtado da Fonseca
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Universidade Federal de São Paulo
(UNIFESP), São Paulo, 04021-001, Brazil
| | - Miguel Gustavo Luz Arab
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Saúde Máxima (SAMAX), São Paulo,
01239-040, Brazil
| | - Rodrigo Vicente
- Brazilian Institute of Regenerative
Medicine (BIRM), Indaiatuba 13334-170, Brazil
- Ultra Sports Science, São Paulo,
Brazil
| | - Ramya Lakshmi Rajendran
- Department of Nuclear Medicine,
School of Medicine, Kyungpook National University Hospital, Kyungpook National
University, Daegu 41944, Republic of Korea
| | - Prakash Gangadaran
- Department of Nuclear Medicine,
School of Medicine, Kyungpook National University Hospital, Kyungpook National
University, Daegu 41944, Republic of Korea
- BK21 FOUR KNU Convergence Educational
Program of Biomedical Sciences for Creative Future Talents, Department of Biomedical
Science, School of Medicine, Kyungpook National University, Daegu 41944, Republic of
Korea
| | - Byeong-Cheol Ahn
- Department of Nuclear Medicine,
School of Medicine, Kyungpook National University Hospital, Kyungpook National
University, Daegu 41944, Republic of Korea
- BK21 FOUR KNU Convergence Educational
Program of Biomedical Sciences for Creative Future Talents, Department of Biomedical
Science, School of Medicine, Kyungpook National University, Daegu 41944, Republic of
Korea
| | | |
Collapse
|
15
|
Majidi L, Kargar Z, Alaei B, Nikoo MR. Comparison of The Effectiveness of Exercise Therapy and Electroacupuncture in Patients with Forward Head Abnormalities and Myofascial Pain Syndrome: A Randomized Clinical Trial. Med J Islam Repub Iran 2023; 37:34. [PMID: 37521125 PMCID: PMC10382183 DOI: 10.47176/mjiri.37.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Indexed: 08/01/2023] Open
Abstract
Background Forward Head Posture (FHP), which refers to the head being more forward than the shoulder, is one of the most common postural defects of all ages. Therefore, in this study, we aimed to compare the effectiveness of exercise therapy and electroacupuncture in patients with FHP and myofascial pain syndrome (MPS). Methods The present study was an open-label randomized clinical trial. A total of 61 patients with FHP and MPS who were referred to the physical medicine clinic of Besat Hospital between 2020 and 2021 were analyzed. Patients in one group were treated with electroacupuncture, and another one was treated with exercise therapy. The primary outcomes were FHP angles (CVA, CA, and shoulder angle), pain intensity (VAS), and quality of life (SF-12). Paired t-test was used to compare the results obtained in the pre-test and post-test. To detect differences over time, the analysis of variance models was used to repeat the observations. If the p-test result is less than the test significance level of 0.05, the null hypothesis is not confirmed. Results The rate of final CVA and increase in CVA in the exercise therapy group were significantly higher than in the electroacupuncture group (P < 0.001). The average shoulder angle in the exercise therapy group increased from 47.1° ± 3.0° to 51.9° ± 3.3° (P < 0.001) and in the electroacupuncture group from 47.9° ± 3.1° to 51.0° ± 2.8° (P < 0.001). A significant difference was observed between the two groups in terms of pain intensity changes during the study. Conclusion Overall, the results of this study showed that both exercise therapy and electroacupuncture significantly improved patients' posture, reduced pain intensity, and increased quality of life in FHP patients with MPS; But exercise therapy was more effective in improving FHP angles and electroacupuncture was more successful in reducing patients' pain intensity.
Collapse
Affiliation(s)
- Lobat Majidi
- Department of Physical Medicine and Rehabilitation, School of Medicine Sina (Farshchian) Educational and Medical Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Zohdieh Kargar
- Department of Physical Medicine and Rehabilitation, School of Medicine Sina (Farshchian) Educational and Medical Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Behnaz Alaei
- Department of Physical Medicine and Rehabilitation, School of Medicine Sina (Farshchian) Educational and Medical Center, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Mohammad Reza Nikoo
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Sung YH. Classification of cervicogenic dizziness. HEARING, BALANCE AND COMMUNICATION 2023. [DOI: 10.1080/21695717.2023.2168415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Yun-Hee Sung
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Republic of Korea
| |
Collapse
|
17
|
Li J, Xie P, Liu X, Li D, Tang J. Case report: Paralysis after epidural analgesia due to a hemorrhage of pure epidural venous hemangioma. Front Neurol 2023; 13:1077272. [PMID: 36703633 PMCID: PMC9871885 DOI: 10.3389/fneur.2022.1077272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/05/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose To report a case of sudden paralysis after epidural analgesia to raise awareness of the condition and the importance of early identification and appropriate treatment of extradural venous angiomas. Clinical features A 28-year-old man with myofascial pain syndrome experienced paraplegia after receiving an epidural block for pain relief, which was later discovered to be caused by hemorrhage from extradural venous angiomas. Decompression surgery was performed immediately and successfully. A follow-up examination was performed 5 months after surgery. The patient reported improvement in urinary retention. The muscle strength in both his lower extremities had recovered to 4 out of 5 but still exhibited considerable residual spasticity. Conclusions Before administering epidural analgesia to relieve undetermined pain, it is prudent to carefully weigh potential benefits against potential risks to patient health to minimize the likelihood of complications.
Collapse
|
18
|
Alayat MSM, Battecha KH, Elsodany AM, Alzahrani OA, Alqurashi AKA, Jawa AT, Alharthi YS. Effectiveness of Photobiomodulation Therapy in the Treatment of Myofascial Pain Syndrome of the Upper Trapezius Muscle: A Systematic Review and Meta-Analysis. Photobiomodul Photomed Laser Surg 2022; 40:661-674. [DOI: 10.1089/photob.2022.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Mohamed Salaheldien Mohmed Alayat
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Egypt
| | - Kadrya Hosney Battecha
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Egypt
| | | | - Omer Abdulaziz Alzahrani
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
| | | | - AbdulAziz Talal Jawa
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Yazan Saleh Alharthi
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
| |
Collapse
|
19
|
Kohns DJ, Scott R, Castellanos J, Scribner D, Hodges R, Clauw DJ. The impact of nociplastic pain features on the response to physical therapy in patients with primary myofascial pain. J Back Musculoskelet Rehabil 2022; 35:1143-1151. [PMID: 35213348 DOI: 10.3233/bmr-210244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Myofascial pain is a common, but poorly understood multifactorial condition. OBJECTIVE This study analyzed how the degree of central sensitization (nociplastic pain) can impact the response to physical therapy for patients with myofascial pain. METHODS This prospective, observational cohort study compared pain phenotyping and functional measures in 30 participants with non-acute neck/shoulder girdle primary myofascial pain following 3-months of physical therapy. The Fibromyalgia Survey Questionnaire Score served as a surrogate of central sensitization. RESULTS All participants demonstrated some benefit from physical therapy; however, those with moderate levels of nociplastic pain features were less likely to have clinically significant improvements on the Neck Disability Index, PEG score, or pain catastrophizing measures. Those with higher levels of nociplastic pain had a similar chance of showing improvement as those with lower levels, except regarding catastrophizing. Significant improvements were independent of the type or amount of therapy received. CONCLUSION The degree of nociplastic pain in patients with myofascial pain appears to be inversely related to improvements from a peripherally based treatment. This is not to say that individuals with moderate to higher levels of nociplastic pain do not benefit from physical therapy, but they proportionally benefit less.
Collapse
Affiliation(s)
- David J Kohns
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI, USA
| | - Ryan Scott
- Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA
| | - Joel Castellanos
- Center of Pain Medicine, Department of Anesthesia, University of California San Diego, La Jolla, CA, USA
| | - Darin Scribner
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI, USA
| | - Ryan Hodges
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI, USA
| | - Daniel J Clauw
- Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
20
|
Ryskalin L, Morucci G, Natale G, Soldani P, Gesi M. Molecular Mechanisms Underlying the Pain-Relieving Effects of Extracorporeal Shock Wave Therapy: A Focus on Fascia Nociceptors. Life (Basel) 2022; 12:life12050743. [PMID: 35629410 PMCID: PMC9146519 DOI: 10.3390/life12050743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 12/11/2022] Open
Abstract
In recent years, extracorporeal shock wave therapy (ESWT) has received increasing attention for its potential beneficial effects on various bone and soft-tissue pathologies, yielding promising outcomes for pain relief and functional recovery. In fact, ESWT has emerged as an alternative, non-invasive, and safe treatment for the management of numerous musculoskeletal disorders, including myofascial pain syndrome (MPS). In particular, MPS is a common chronic painful condition, accounting for the largest proportion of patients affected by musculoskeletal problems. Remarkably, sensory innervation and nociceptors of the fascial system are emerging to play a pivotal role as pain generators in MPS. At the same time, increasing evidence demonstrates that application of ESWT results in selective loss of sensory unmyelinated nerve fibers, thereby inducing long-lasting analgesia. The findings discussed in the present review are supposed to add novel viewpoints that may further enrich our knowledge on the complex interactions occurring between disorders of the deep fascia including changes in innervation, sensitization of fascial nociceptors, the pathophysiology of chronic musculoskeletal pain of MPS, and EWST-induced analgesia. Moreover, gaining mechanistic insights into the molecular mechanisms of pain-alleviating effects of ESWT may broaden the fields of shock waves clinical practice far beyond the musculoskeletal system or its original application for lithotripsy.
Collapse
Affiliation(s)
- Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, 56121 Pisa, Italy
| | - Gabriele Morucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, 56121 Pisa, Italy
| | - Gianfranco Natale
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, 56121 Pisa, Italy
- Museum of Human Anatomy "Filippo Civinini", University of Pisa, 56126 Pisa, Italy
| | - Paola Soldani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, 56121 Pisa, Italy
| | - Marco Gesi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, 56121 Pisa, Italy
| |
Collapse
|
21
|
Karamiani F, Mostamand J, Rahimi A, Nasirian M. The Effect of Gluteus Medius Dry Needling on Pain and Physical Function of Non-athlete women with Unilateral Patellofemoral Pain Syndrome: A Double-Blind Randomized Clinical Trial. J Bodyw Mov Ther 2022; 30:23-29. [DOI: 10.1016/j.jbmt.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/07/2021] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
|
22
|
Ginszt M, Szkutnik J, Zieliński G, Bakalczuk M, Stodółkiewicz M, Litko-Rola M, Ginszt A, Rahnama M, Majcher P. Cervical Myofascial Pain Is Associated with an Imbalance of Masticatory Muscle Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031577. [PMID: 35162600 PMCID: PMC8834744 DOI: 10.3390/ijerph19031577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to assess the relationship between the occurrence of cervical myofascial pain with active myofascial trigger points (MTrPs) within the upper trapezius muscle and the electromyographic asymmetry index (AsI) of masticatory muscles: temporalis anterior (TA), superficial part of the masseter muscle (MM), and anterior belly of the digastric muscle (DA). The study group comprised 100 subjects (80 women and 20 men) aged 18 to 30 years (mean 23 ± 2.6 years) reporting pain in the neck muscles, diagnosed with myofascial pain with active MTrPs only within the upper trapezius muscle. The control group comprised 60 healthy, pain-free subjects (42 women and 18 men) aged 20 to 30 years (mean 22.8 ± 2.6 years) without MTrPs in the upper trapezius muscle. The palpation measurement, based on the diagnostic criteria of Travell and Simons, was used to diagnose active MTrPs. The masticatory muscle activity was recorded using an 8-channel device for surface electromyography—BioEMG IIITM. Significant differences in electromyographic patterns between the group with MTrPs in the right side of upper trapezius muscle and the control group were observed within resting activity for the AsI TA (MTrPs: 8.64 vs. controls: −3.22; p = 0.001) and AsI MM (MTrPs: 7.05 vs. controls: −2.09; p = 0.018). Controls presented different electromyographic patterns during maximum voluntary clenching with cotton rolls between teeth within masseter muscle compared to the MTrPs group (MTrPs: 9.27 vs. controls: −0.43 vs. p = 0.041). Participants with MTrPs in the left side of upper trapezius muscle presented predomination of left-sided electromyographic patterns at rest within temporalis anterior in comparison to controls (MTrPs: −19.22 vs. controls: −3.22; p = 0.001). MTrPs within the trapezius muscle may be related to asymmetry within the masticatory muscle activity, suggesting that the presence of myofascial pain within the cervical muscles plays a role in the imbalance of the stomatognathic system. A unilateral active MTrPs within the trapezius muscle may increase the sEMG activity on the same side of the temporalis anterior and masseter muscles.
Collapse
Affiliation(s)
- Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (A.G.); (P.M.)
- Correspondence:
| | - Jacek Szkutnik
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Magdalena Bakalczuk
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Małgorzata Stodółkiewicz
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Monika Litko-Rola
- Independent Unit of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland; (J.S.); (M.B.); (M.S.); (M.L.-R.)
| | - Apolinary Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (A.G.); (P.M.)
| | - Mansur Rahnama
- Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Piotr Majcher
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (A.G.); (P.M.)
| |
Collapse
|
23
|
Bansal N, Angara P, Blondell R, Gulati A, Mehta N, Chen GH, Bansal P. Effect of a Structured Stretching Exercise Program on Resolution of Myofascial Pain and Opioid Usage in "Legacy Pain" Patients: A Retrospective Cohort Study. Pain Pract 2022; 22:447-452. [PMID: 35066974 DOI: 10.1111/papr.13100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/17/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine if the implementation of a structured exercise stretching routine targeted at resolving myofascial pain is effective in improving outcomes of "legacy pain" patients. DESIGN Retrospective cohort study. SETTING Private community based interventional pain management practice. SUBJECTS "Legacy pain" patients, defined as patients on opioid therapy for greater than one year. METHODS Subjects were initiated on a structured home exercise stretching routine targeted at resolving myofascial pain consisting of 14 lumbar, 4 thoracic and 7 cervical stretches as appropriate. Daily morphine milligram equivalent, functional status (Oswestry Disability Index) and pain level (Numeric Rating Scale) were compared pre and post treatment at one year. RESULTS After one year, exercise techniques reduced daily morphine milligram equivalent intake on average from 76.3 mg to 21.0 mg (p < 0.001) with 84.4% of patients decreasing their total opioid dose (p < 0.001) and 34.4% of patients being completely weaned off of opioids (p < 0.001). Numeric Rating Scale of pain and Oswestry Disability Indices were unchanged with treatment, 7.0 to 6.7 (p = 0.122) and 30.4 to 29.3 (p = 0.181), respectively. CONCLUSIONS The addition of a structured stretching exercise program focusing on the resolution of the myofascial pain in the treatment of "legacy pain" patients was shown to significantly reduce and often discontinue opioid use without adversely affecting pain score or functionality.
Collapse
Affiliation(s)
- Nitin Bansal
- New York Presbyterian - Weill Cornell Medicine, Anesthesiology, New York, NY, USA
| | - Prashant Angara
- New York Presbyterian - Weill Cornell Medicine, Anesthesiology, New York, NY, USA
| | - Richard Blondell
- Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, Family Medicine, Buffalo, NY, USA
| | - Amitabh Gulati
- Memorial Sloan Kettering, Anesthesiology, New York, NY, USA
| | - Neel Mehta
- New York Presbyterian - Weill Cornell Medicine, Anesthesiology, New York, NY, USA
| | - Grant H Chen
- Memorial Sloan Kettering, Anesthesiology, New York, NY, USA
| | - Pratibha Bansal
- Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, Family Medicine, Buffalo, NY, USA
| |
Collapse
|
24
|
Winkler SL, Urbisci AE, Best TM. Sustained acoustic medicine for the treatment of musculoskeletal injuries: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2021; 13:159. [PMID: 34922606 PMCID: PMC8684070 DOI: 10.1186/s13102-021-00383-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Musculoskeletal injuries account for 10 million work-limited days per year and often lead to both acute and/or chronic pain, and increased chances of re-injury or permanent disability. Conservative treatment options include various modalities, nonsteroidal anti-inflammatory drugs, and physical rehabilitation programs. Sustained Acoustic Medicine is an emerging prescription home-use mechanotransductive device to stimulate cellular proliferation, increase microstreaming and cavitation in situ, and to increase tissue profusion and permeability. This research aims to summarize the clinical evidence on Sustained Acoustic Medicine and measurable outcomes in the literature. METHODS A systematic literature review was conducted using PubMed, EBSCOhost, Academic Search Complete, Google Scholar and ClinicalTrials.gov to identify studies evaluating the effects of Sustained Acoustic Medicine on the musculoskeletal system of humans. Articles identified were selected based on inclusion criteria and scored on the Downs and Black checklist. Study design, clinical outcomes and primary findings were extracted from included studies for synthesis and meta-analysis statistics. RESULTS A total of three hundred and seventy-two participants (372) were included in the thirteen clinical research studies reviewed including five (5) level I, four (4) level II and four (4) level IV studies. Sixty-seven (67) participants with neck and back myofascial pain and injury, one hundred and fifty-six (156) participants with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade II/III), and one hundred forty-nine (149) participants with generalized soft-tissue injury of the elbow, shoulder, back and ankle with limited function. Primary outcomes included daily change in pain intensity, change in Western Ontario McMaster Osteoarthritis Questionnaire, change in Global Rate of Change, and functional outcome measures including dynamometry, grip strength, range-of-motion, and diathermic heating (temperature measurement). CONCLUSION Sustained Acoustic Medicine treatment provides tissue heating and tissue recovery, improved patient function and reduction of pain. When patients failed to respond to physical therapy, Sustained Acoustic Medicine proved to be a useful adjunct to facilitate healing and return to work. As a non-invasive and non-narcotic treatment option with an excellent safety profile, Sustained Acoustic Medicine may be considered a good therapeutic option for practitioners.
Collapse
Affiliation(s)
| | | | - Thomas M Best
- UHealth Sports Medicine Institute, University of Miami, Coral Gables, FL, USA.
| |
Collapse
|
25
|
Şan AU. YouTube as a Source of Patient Information on Myofascial Pain
Syndrome. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1652-1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Introduction Myofascial pain syndrome is a local disorder characterised by
pathological myofascial constrictions and trigger points. One of the most
popular sources of internet-based information for patients is YouTube, which
provides a lot of videos related to myofascial pain syndrome, making it one of
the top clinical conditions searched for on the site. This study aimed to
examine the quality of the YouTube video content on myofascial pain
syndrome.
Method This study was designed as a cross-sectional study and used the
YouTube video sharing website as the main source of data. A search of the
relevant videos was performed by entering the words “myofascial pain
syndrome” in June 2021. Video characteristics were recorded, and the
quality of the videos was assessed according to the Journal of the American
Medical Association (JAMA) benchmark criteria, the DISCERN Scale and the Global
Quality Scale.
Results A total of 322 videos were evaluated, 186 of which were subjected
to analysis after applying the inclusion/exclusion criteria. The videos
were categorised into groups, with 10 (5.4%) falling into the
high-quality group, 16 (8.6%) into the intermediate quality group, and
160 (86%) into the low-quality group. The findings from the study showed
that the most popular videos, the highest number of video likes and the highest
number of video views were in the intermediate group, while the high-quality
group had the lowest popularity level, number of video likes and number of video
views (p ˂ 0.05).
Conclusions Although there are videos with high-quality content on YouTube
offering guidance to patients about the disease, it is important to keep in mind
that inaccurate and deficient information about the disease may also be present
on this platform.
Collapse
Affiliation(s)
- Ayça Uran Şan
- Gaziler Physical Therapy and Rehabilitation Training and Research
Hospital, Department of Physical Medicine and Rehabilitation, Ankara,
Turkey
| |
Collapse
|
26
|
Masticatory Myofascial Pain Syndrome: Implications for Endodontists. J Endod 2021; 48:55-69. [PMID: 34710470 DOI: 10.1016/j.joen.2021.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Masticatory myofascial pain syndrome can present similarly to other dental conditions in odontogenetic structures. Endodontists should be familiar with the symptomology and pathophysiology of masticatory myofascial pain syndrome to avoid misdiagnosis, incorrect treatment, and medicolegal repercussions. The aim of this review was to provide a foundational summary for endodontists to identify and correctly manage masticatory myofascial pain syndrome. METHODS A narrative review of the literature was performed through a MEDLINE search and a hand search of the major myofascial pain textbooks. RESULTS Masticatory myofascial pain syndrome is a musculoligamentous syndrome that can present similarly to odontogenic pain or refer pain to the eyebrows, ears, temporomandibular joints, maxillary sinus, tongue, and hard palate. Currently, the most comprehensive pathophysiology theory describing masticatory myofascial pain syndrome is the expanded integrated hypothesis. The most widely accepted diagnostic guidelines for masticatory myofascial pain syndrome are the Diagnostic Criteria for Temporomandibular Disorders; however, their diagnostic capability is limited. There is no hierarchy of treatment methods because each patient requires a tailored and multidisciplinary management aimed at regaining the muscle's range of motion, deactivating the myofascial trigger points, and maintaining pain relief. CONCLUSIONS The pain patterns for masticatory myofascial pain syndrome are well-known; however, there is a lack of consensus on the most proper method of trigger point diagnosis or pain quantification. The diagnostic strategies for masticatory myofascial pain syndrome vary, and the diagnostic aids are not well developed.
Collapse
|
27
|
Patel J, Javed S. Myofascial pain syndrome and SARS-CoV-2: a case series. Pain Manag 2021; 12:255-260. [PMID: 34601951 PMCID: PMC8491650 DOI: 10.2217/pmt-2021-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SARS-CoV-2 is a novel virus that has caused a plethora of dysfunctions and changes in the human body. Our goal in this case study series was to demonstrate the relationship that coronavirus has had in newly diagnosing patients with myofascial pain syndrome (MFPS). Medical records were obtained from a pain clinic that demonstrated the effects of this virus on patients who developed MFPS between March 2020 and December 2020. Chart reviews were performed and demonstrated patients who had a history of chronic pain had subsequent episodes of worsening exacerbations of pain, more specifically trigger points, after being diagnosed with coronavirus. MFPS and SARS-CoV-2 are proposed to be correlated amongst chronic pain patients. Potential pathological mechanisms include coronavirus-induced hypoxic muscle dysfunctions as well as psychological stress triggering pain receptors, leading to myofascial pain syndrome. COVID-19, the disease caused by the SARS-CoV-2 virus, may cause many problems and changes in the human body. In this case series, we propose a relationship between COVID-19 and myofascial pain syndrome (MFPS), a kind of chronic muscle pain affecting connective tissue in the muscles. Medical records of people who developed MFPS after a diagnosis of COVID-19 between March 2020 and December 2020 were obtained from a pain clinic. Chart reviews demonstrated that the three people with chronic pain included in this case series had episodes of worsening pain, more specifically in focal points, after being diagnosed with COVID-19. COVID-19 is suggested to have affected the development of MFPS in these chronic pain patients. Potential mechanisms of this relationship include different types of stress leading to MFPS.
Collapse
Affiliation(s)
- Jaldhi Patel
- Department of Anesthesiology, University of Texas Health & Sciences Center, Houston, TX, USA
| | - Saba Javed
- Department of Pain Management, University of Texas Health & Sciences Center, Houston, TX, USA
| |
Collapse
|
28
|
Karamanlioglu DS, Geler Kulcu D, Ozturk G, Akpinar P, Unlu Ozkan F, Aktas I. Effectiveness of pregabalin treatment for trigger points in patients with comorbid myofascial pain syndrome and fibromyalgia syndrome: a randomized controlled trial. Somatosens Mot Res 2021; 38:327-332. [PMID: 34544324 DOI: 10.1080/08990220.2021.1977265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM OF THE STUDY Myofascial pain syndrome (MPS) is a common problem in the general population. MPS should not be a local/peripheral painful syndrome and considered to be a syndrome of central sensitivity. We aimed to investigate the effect of pregabalin in patients with MPS in this study. MATERIALS AND METHODS We randomized 40 patients into two groups, and 17 patients per group completed the study. Female patients in group I received pregabalin and exercise therapy, whereas those in group II received exercise therapy alone. All patients were evaluated as follows: for pain by visual analog scale (VAS); trigger-point pressure pain threshold-(PPT) by algometry; neuropathic pain using the Douleur Neuropathique en 4 Questions (DN4) and quality of life with the Short Form-36 (SF36). Evaluations were performed pre-treatment and at the end of the first and third months of treatment. Clinical trial ID: NCT04600037, retrospectively registered 20/10/2020. RESULTS In group I, significant improvements were observed in VAS, trigger-point-PPT, physical component summary-SF-36, at the first and third months. In group II, statistically significant improvements were observed in VAS, trigger-point-PPT after the first and third months. Group I showed statistically better improvements in VAS, trigger points-PPT, physical component summary-SF36 compared with group II by the third month. CONCLUSION Pregabalin treatment is effective for controlling trigger points. Pregabalin treatment is also more effective than exercise treatment at improving quality of life in patients with MPS.
Collapse
Affiliation(s)
- Duygu Silte Karamanlioglu
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Duygu Geler Kulcu
- Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Gulcan Ozturk
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Pinar Akpinar
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Feyza Unlu Ozkan
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Aktas
- Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
29
|
Lindquist KA, Belugin S, Hovhannisyan AH, Corey TM, Salmon A, Akopian AN. Identification of Trigeminal Sensory Neuronal Types Innervating Masseter Muscle. eNeuro 2021; 8:ENEURO.0176-21.2021. [PMID: 34580157 PMCID: PMC8513531 DOI: 10.1523/eneuro.0176-21.2021] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/18/2021] [Accepted: 09/01/2021] [Indexed: 11/21/2022] Open
Abstract
Understanding masseter muscle (MM) innervation is critical for the study of cell-specific mechanisms of pain induced by temporomandibular disorder (TMDs) or after facial surgery. Here, we identified trigeminal (TG) sensory neuronal subtypes (MM TG neurons) innervating MM fibers, masseteric fascia, tendons, and adjusted tissues. A combination of patch clamp electrophysiology and immunohistochemistry (IHC) on TG neurons back-traced from reporter mouse MM found nine distinct subtypes of MM TG neurons. Of these neurons, 24% belonged to non-peptidergic IB-4+/TRPA1- or IB-4+/TRPA1+ groups, while two TRPV1+ small-sized neuronal groups were classified as peptidergic/CGRP+ One small-sized CGRP+ neuronal group had a unique electrophysiological profile and were recorded from Nav1.8- or trkC+ neurons. The remaining CGRP+ neurons were medium-sized, could be divided into Nav1.8-/trkC- and Nav1.8low/trkC+ clusters, and showed large 5HT-induced current. The final two MM TG neuronal groups were trkC+ and had no Nav1.8 and CGRP. Among MM TG neurons, TRPV1+/CGRP- (somatostatin+), tyrosine hydroxylase (TH)+ (C-LTMR), TRPM8+, MrgprA3+, or trkB+ (Aδ-LTMR) subtypes have not been detected. Masseteric muscle fibers, tendons and masseteric fascia in mice and the common marmoset, a new world monkey, were exclusively innervated by either CGRP+/NFH+ or CGRP-/NFH+ medium-to-large neurons, which we found using a Nav1.8-YFP reporter, and labeling with CGRP, TRPV1, neurofilament heavy chain (NFH) and pgp9.5 antibodies. These nerves were mainly distributed in tendon and at junctions of deep-middle-superficial parts of MM. Overall, the data presented here demonstrates that MM is innervated by a distinct subset of TG neurons, which have unique characteristics and innervation patterns.
Collapse
Affiliation(s)
- Karen A Lindquist
- Integrated Biomedical Sciences (IBMS) Program, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
| | - Sergei Belugin
- Endodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
| | - Anahit H Hovhannisyan
- Endodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
| | - Tatiana M Corey
- Laboratory Animal Resources Departments, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
| | - Adam Salmon
- Molecular Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
- Sam and Ann Barshop Institute for Longevity and Aging Studies, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
- South Texas Veterans Health Care System, Geriatric Research Education and Clinical Center San Antonio, TX 78229
| | - Armen N Akopian
- Integrated Biomedical Sciences (IBMS) Program, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
- Endodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
- Pharmacology, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229
| |
Collapse
|
30
|
Srikaew N, Kietinun S, Sriyakul K, Tungsukruthai P, Pawa KK. Effectiveness of court-type traditional Thai massage plus meditation in patients with myofascial pain syndrome on upper trapezius. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
31
|
Dry needling has lasting analgesic effect in shoulder pain: a double-blind, sham-controlled trial. Pain Rep 2021; 6:e939. [PMID: 34235343 PMCID: PMC8240781 DOI: 10.1097/pr9.0000000000000939] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/16/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Dry needling has analgesic effects in shoulder pain associated with myofascial pain syndrome. The analgesic effects last for up to 1 week. Introduction: Myofascial pain syndrome (MPS) affects most patients with chronic shoulder pain. Dry needling (DN) is a common treatment for MPS, but its temporal pattern and sensory effects remain unknown. Objectives: We evaluated in a randomized, sham-controlled study the pattern of analgesic efficacy and local sensory changes of a single session of DN for MPS in patients with chronic shoulder pain. Methods: Patients with chronic shoulder pain were randomized into active (n = 20) or sham (n = 21) groups. A single DN was performed by a researcher blinded to group assignment and pain outcomes. Pain intensity was assessed by the numeric rating score, and sensory thresholds were evaluated with a quantitative sensory testing protocol, including the area of tactile sensory abnormalities 7 days before needling, right before, and 7 days after the intervention. Results: Dry needling led to significant larger pain intensity reduction (from 6.30 ± 2.05 to 2.40 ± 2.45 in the active group; P = 0.02, effect size = −1.3 (95% CI [−2.0 to −0.68]); (number necessary to treat = 2.1). Pain reduction scores were significantly different on the second day after needling and persisted so until the seventh day and were accompanied by improvement in other dimensions of pain and a decrease in the area of mechanical hyperalgesia in the active DN group alone (P < 0.05). Conclusion: Active trigger points DN provided analgesic effects compared with sham and decreased the area of local mechanical hyperalgesia. These findings have practical clinical implications and may provide mechanistic insights behind MPS.
Collapse
|
32
|
Fahmy EM, Ibrahim AR, Elabd AM. Ischemic Pressure vs Postisometric Relaxation for Treatment of Rhomboid Latent Myofascial Trigger Points: A Randomized, Blinded Clinical Trial. J Manipulative Physiol Ther 2021; 44:103-112. [PMID: 33715788 DOI: 10.1016/j.jmpt.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 05/21/2020] [Accepted: 07/19/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of ischemic pressure (IP) vs postisometric relaxation (PIR) on rhomboid-muscle latent trigger points (LTrPs). METHODS Forty-five participants with rhomboid-muscle LTrPs were randomly assigned into 3 groups and received 3 weeks of treatment-group A: IP and traditional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR and traditional treatment; and group C: traditional treatment. Shoulder pain and disability, neck pain and disability, and pressure pain threshold (PPT) of 3 points on each side were measured before and after treatment. RESULTS Multivariate analysis of variance indicated a statistically significant Group × Time interaction (P = .005). The PPT for the right lower point was increased in group A more than in groups B or C. Neck pain was reduced in group B more than in group C. Moreover, shoulder and neck disability were reduced in both groups A and B more than in group C. The PPTs of the left lower and middle points were increased in group B compared with groups A and C. The PPT of the left upper point was increased in group A more than in group C. There were significant changes in all outcomes in the 2 experimental groups (P < .05). No changes were found in the control group except in pain intensity, shoulder disability, and PPT of the left lower point. CONCLUSION This study found that IP may be more effective than PIR regarding PPT, but both techniques showed changes in the treatment of rhomboid-muscle LTrPs.
Collapse
Affiliation(s)
- Eman M Fahmy
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Abeer R Ibrahim
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt; Physiotherapy Department, College of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Aliaa M Elabd
- Basic Science Department, Faculty of Physical Therapy, Pharos University in Alexandria, Alexandria, Egypt.
| |
Collapse
|
33
|
Xiong W, Cheng L, Zhong Z, Hou X, Zhu M, Zhou X, Zhu S, Chen J. A comparison of the effects of fire needle and routine acupuncture for myofascitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25473. [PMID: 34114979 PMCID: PMC8202649 DOI: 10.1097/md.0000000000025473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Myofascitis is a common disease in clinic. The main cause of the disease is aseptic inflammation of local muscles and connective tissues such as myofascial, which can be manifested as paralysis, distension, and other discomfort, local muscle stiffness, spasm or palpable strain-like nodules. Chinese medicine ascribes it to "bi disease" and "Arthralgia disease," while Western medicine believes that the disease is mainly due to local muscle and fascia edema and exudation caused by trauma or long-term strain, forcing nerves to jam and producing pain and other abnormal feelings. Although the disease is not life-threatening, the pain and distension caused by local inflammatory stimuli can affect the patient's daily life and sleep quality. The purpose of this systematic review is to evaluate the efficacy of fire needle vs routine acupuncture in the treatment of myofascitis. METHODS Randomized controlled trials (RCTS) of fire needle vs routine acupuncture for myofascial inflammation will be comprehensively searched from inception to September 2020 on PubMed, Embase, Cochrane Library, China Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), and Wanfang. Additionally, RCT registered sites, including http://www.ClinicalTrials.gov and http://www.chictr.org.cn, also will be the search. Visual analogue scale (VAS) was used to score the pain before and after treatment. The primary outcome will be to compare the difference in pain scores between the 2 interventions. Two independent authors filtered the literature in the above database, extracted the data, and cross-checked it. RESULTS This study will offer a reasonable comprehensive evidence for the treatment of myofascitis with fire needle. CONCLUSION The conclusion of this study will provide evidence to judge the effectiveness of fire needle on myofascitis. REGISTRATION NUMBER INPLASY202080034.
Collapse
Affiliation(s)
- Wei Xiong
- Nanchang Hongdu Hospital of Traditional Chinese Medicine
| | - Ling Cheng
- Nanchang Hongdu Hospital of Traditional Chinese Medicine
| | - Zhiying Zhong
- Jiangxi University of Traditional Chinese Medicine, Nanchang, PR China
| | - Xinju Hou
- Nanchang Hongdu Hospital of Traditional Chinese Medicine
| | - Manhua Zhu
- Nanchang Hongdu Hospital of Traditional Chinese Medicine
| | - Xingchen Zhou
- Jiangxi University of Traditional Chinese Medicine, Nanchang, PR China
| | - Siyuan Zhu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, PR China
| | - Jun Chen
- Jiangxi University of Traditional Chinese Medicine, Nanchang, PR China
| |
Collapse
|
34
|
Shanmugam S, Mathias L, Manickaraj N, Kumar KUD, Kandakurti PK, Dorairaj SK, Muthukrishnan R. Intramuscular Electrical Stimulation Combined with Therapeutic Exercises in Patients with Shoulder Adhesive Capsulitis: A Randomised Controlled Trial. Int J Surg Protoc 2021; 25:71-83. [PMID: 34056148 PMCID: PMC8139297 DOI: 10.29337/ijsp.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Myofascial trigger points (MTrPs) precipitate the shoulder pain severity and disability in patients with shoulder adhesive capsulitis (SAC). This study aims to compare the effectiveness of intramuscular electrical stimulation (IMES) combined with therapeutic exercises versus dry needling (DN) combined with therapeutic exercises in improving the clinical outcomes in patients with SAC. Methods and Materials: In this randomized controlled trial, IMES (n = 45) and DN (43) groups had received respectively IMES, and DN twice weekly for three consecutive weeks. Both groups received therapeutic exercises 1520 minutes, five days in a week during the second and third week. Pain, disability, kinesiophobia, number of active and latent MTrPs, shoulder abduction and external rotation range of motion were assessed at baseline, week-1, week-2, week-3 and follow-up at 3 months. A repeated measures ANOVA performed to find out the significant differences in the clinical outcomes between the groups. Results: The results of repeated measures of ANOVA shows that the post intervention timelines assessment scores of VAS, DASH, shoulder abduction and external rotation ROM, number of active and latent MTrPs and kinesiophobia were significantly (p. < 0.05) improved in both groups. However, IMES group had achieved a greater improvement over DN group (p. < 0.05) on the shoulder pain severity and disability, shoulder range of motion, number of active and latent MTrPs and kinesiophobia. Despite the significant statistical differences between the groups, IMES group did not achieve the minimal clinically important differences of 1.5cm and 11-points respectively for the VAS and DASH scores. No serious adverse effects occurred during the three weeks of treatment. Conclusion: IMES combined with therapeutic exercises is an effective treatment to reduce the shoulder pain severity and upper limb disability by deactivating the active and latent MTrPs and improving the shoulder abduction and external rotation range of motion in patients with SAC.
Collapse
Affiliation(s)
- Sukumar Shanmugam
- College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates.,Nitte Institute of Physiotherapy, Nitte Deemed to be University, Mangaluru, India
| | - Lawrence Mathias
- K S Hegde Medical Academy, Nitte Deemed to be University, Mangaluru, India
| | | | - K U Dhanesh Kumar
- Nitte Institute of Physiotherapy, Nitte Deemed to be University, Mangaluru, India
| | | | | | | |
Collapse
|
35
|
Koukoulithras I, Plexousakis M, Kolokotsios S, Stamouli A, Mavrogiannopoulou C. A Biopsychosocial Model-Based Clinical Approach in Myofascial Pain Syndrome: A Narrative Review. Cureus 2021; 13:e14737. [PMID: 33936911 PMCID: PMC8081263 DOI: 10.7759/cureus.14737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
One of the most common chronic musculoskeletal pain syndromes is myofascial pain syndrome (MPS). Trigger points (TrPs) are hypersensitive taut bands that appear in two genres, each with a different ratio in specific areas of the muscles, and when triggered, they can produce pain, numbness, and tingling. Various underlying causes (mechanical, nutritional, and psychological) have been discovered to participate in the pathogenesis of MPS, activating trigger points and intensifying the pain. Furthermore, genetic, social, and psychological factors seem to exacerbate these patients' clinical appearance, according to the biopsychosocial model, which seems to be closely linked to the formation of trigger points. Chronic pain and psychological distress frequently coexist, and psychological and social factors have been found to worsen the patient's quality of life and perpetuate the existing pain. The diagnosis is formed following a comprehensive physical and clinical examination, and the appropriate management technique is selected. For MPS treatment, management techniques based on the biopsychosocial model are used in conjunction with various myofascial release strategies and pharmacologic care. Exercise, posture correction, and a vitamin balance in the diet, especially in the Vitamin B complex, appear to prevent trigger point (TrP) activation. The precise etiology of MPS is not clear yet, and further research is needed to determine the root cause. A holistic approach, which blends the basic clinical care with the management of the biopsychosocial model, is essential to patients with MPS to regain their function and improve their quality of life and wellbeing.
Collapse
Affiliation(s)
- Ioannis Koukoulithras
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Ioannina, Greece, Athens, GRC
| | - Minas Plexousakis
- Department of Physical Therapy, University Hospital, University of West Attica, Greece, Athens, GRC
| | - Spyridon Kolokotsios
- Department of Physical Therapy, University Hospital, University of West Attica, Greece, Athens, GRC
| | - Alexandra Stamouli
- Department of Physical Therapy, University Hospital, University of West Attica, Greece, Athens, GRC
| | | |
Collapse
|
36
|
Effectiveness of training about kinesiotaping in myofascial pain syndrome: A prospective, single-blind, randomized-controlled study. Turk J Phys Med Rehabil 2021; 67:17-24. [PMID: 33948539 PMCID: PMC8088793 DOI: 10.5606/tftrd.2021.4258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 10/15/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives
In this study, we aimed to investigate whether there was any difference in kinesiotaping (KT) application on the upper trapezius muscle between a trained and untrained physiatrist in the management of patients with myofascial pain syndrome (MPS).
Patients and methods
Between April 2013 and July 2015, a total of 45 patients (44 females, 1 males; mean age 31.9±8.0 years; range, 18 to 55 years) with MPS were included in this prospective, single-blind, randomized-controlled study. The patients were randomly divided into two groups. The first group (intervention group, n=24) was administered KT band with the muscle in a tense condition according to the muscle technique performed by a trained physiatrist, from the muscle origo toward its insertion point. The second group (control group, n=21) received no technique and KT was applied to the painful area by an untrained physiatrist using a randomly selected method. Primary outcome measures were pain at rest, during activity (0-10 cm visual analog scale), and threshold measurement with algometry (kg/cm2). Secondary outcome measures were function (Neck Pain and Disability Scale), degree of palpable muscle spasm, and quality of life (Nottingham Health Profile). All evaluations were performed at baseline, at three and six weeks after the treatment.
Results
There were significant improvements in all parameters in both groups. There were no significant differences in any parameters at six weeks. We demonstrated that KT, which was applied on active trigger points on the upper trapezius muscle by trained and untrained physiatrists, improved pain, palpable muscle spasm, neck function, quality of life, and patient satisfaction degree in patients with MPS.
Conclusion
Our study results show that KT, which is applied by trained and untrained physiatrists, improves pain, palpable muscle spasm, neck function, quality of life in patients with MPS.
Collapse
|
37
|
Naja AS, Madi N, Tfayli Y, Ziade F, Haber G, Kanawati S, Naja Z. Deep Cervical Plexus Block for Neck and Shoulder Pain Due to Myofascial Pain: A Randomized Clinical Trial. Clin J Pain 2021; 37:133-139. [PMID: 33273276 DOI: 10.1097/ajp.0000000000000904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/17/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Myofascial pain is one of the most common causes of regional pain with no definitive treatment. This randomized clinical trial was conducted to assess the efficacy of deep cervical plexus block versus placebo injection (sham block) for the treatment of myofascial neck and shoulder pain in terms of analgesic consumption and pain during a follow-up period of 2 weeks after the block. MATERIALS AND METHODS Patients were randomly divided into 2 groups. Group I (block) received deep cervical plexus block and group II (placebo) received normal saline. A total of 66 patients were included in the study, 34 patients in the block group and 32 patients in the placebo group. RESULTS Two weeks after the intervention, the average pain duration was significantly lower in the block group: 1.38±1.39 versus 5.25±1.72 for the block and placebo groups, respectively (P<0.0001). Pain intensity was significantly less in the block group such that 2.9% of patients in the block group had severe pain compared with 53.1% of patients in the placebo group (P<0.0001). Two weeks after receiving the block, the mean opioid consumption calculated as tramadol equivalent was 21.1±44.2 mg compared with 166.1±118.8 mg for the block and placebo groups, respectively. Multivariate analysis showed that patients with a longer history of pain had a higher pain score after 2 weeks. The possibility of recovery is affected by pain duration as patients with a history of chronic pain were least affected by the block. DISCUSSION This technique could be an alternative to pharmacological and other nonpharmacological treatments for myofascial pain.
Collapse
Affiliation(s)
- Ahmad S Naja
- Orthopedic Division, American University of Beirut Medical Center
| | - Naji Madi
- Orthopedic Department, Duke University Medical Center, Durham, NC
| | - Yehia Tfayli
- Orthopedic Division, American University of Beirut Medical Center
| | - Fouad Ziade
- Faculty of Public Health, Lebanese University
| | - Georges Haber
- Orthopedic Division, Mount Lebanon Hospital, Hazmiyeh, Lebanon
| | - Saleh Kanawati
- Anesthesia and Pain Management Department, Makassed General Hospital, Beirut
| | - Zoher Naja
- Anesthesia and Pain Management Department, Makassed General Hospital, Beirut
| |
Collapse
|
38
|
Benito-de-Pedro M, Becerro-de-Bengoa-Vallejo R, Elena Losa-Iglesias M, Rodríguez-Sanz D, López-López D, Palomo-López P, Mazoteras-Pardo V, Calvo-Lobo AC. Effectiveness of Deep Dry Needling vs Ischemic Compression in the Latent Myofascial Trigger Points of the Shortened Triceps Surae from Triathletes on Ankle Dorsiflexion, Dynamic, and Static Plantar Pressure Distribution: A Clinical Trial. PAIN MEDICINE 2021; 21:e172-e181. [PMID: 31502640 DOI: 10.1093/pm/pnz222] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the immediate efficacy of a single session of deep dry needling (DDN) vs ischemic compression (ICT) in a latent myofascial trigger point (MTrP) of the shortened triceps surae from triathletes for ankle dorsiflexion and redistribution of plantar pressures and stability. DESIGN A randomized simple blind clinical trial (NCT03273985). SETTING An outpatient clinic. SUBJECTS Thirty-four triathletes with a latent MTrP in the shortened gastrocnemius. METHODS Triathletes were randomized to receive a single session of DDN (N = 17) or ICT (N = 17) in a latent MTrP of the shortened triceps surae. The primary outcome was ankle dorsiflexion range of motion (ROM) by a universal goniometer. Secondary objectives were distribution of dynamic and static plantar pressures by T-Plate platform pressure, with measurements both before and after five, 10, 15, 20, and 25 minutes of treatment. RESULTS There were no statistically significant differences (P > 0.05) for ankle dorsiflexion ROM or dynamic and static plantar pressures between the experimental group treated with DDN and the control group treated with ICT before and after treatment. CONCLUSIONS DDN vs ICT carried out in latent MTrPs of the shortened gastrocnemius of triathletes did not present differences in terms of dorsiflexion ROM of the tibiofibular-talar joint or in static and dynamic plantar pressure changes before and immediately after treatment.
Collapse
Affiliation(s)
- María Benito-de-Pedro
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences. Faculty of Nursing and Podiatry, Universidade da Coruña, Coruña, Spain
| | - Patricia Palomo-López
- Department of Nursing, University Center of Plasencia, University of Extremadura, Extremadura, Spain
| | - Victoria Mazoteras-Pardo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - And César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
39
|
Ranker A, Oergel M, Aschoff HH, Jaiman A, Krettek C, Schiller J, Liodakis E. Preoperative femoral abduction angle correlates with initial postoperative lateral hip pain after transcutaneous osseointegrated prosthetic system (TOPS) in transfemoral amputees. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2021; 31:1225-1233. [PMID: 33471264 DOI: 10.1007/s00590-021-02872-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To analyse whether a preoperative femoral abduction angle (FAA) correlates with postoperative initial lateral hip pain (LHP) in above-knee amputees (AKA) treated with transcutaneous osseointegrated prosthetic system (TOPS). METHODS Pre- and postoperative long-leg radiographs of eighteen unilateral AKA (mean age 51.55y ± 12.16) were retrospectively measured. FAA was measured on both sides. Pain intensity of LHP was measured by numeric rating scale (NRS) preoperatively and every week for four weeks from the first day of weight loading. Pearson's r was calculated for correlation. Furthermore, odds ratio for LHP ≥ 5/10 NRS and relative FAA > 13° was calculated. RESULTS FAA significantly decreased in the postoperative period (pre/post. 15.33° ± 4.22; p < 0.001). Median LHP was 0/10 NRS (min.0, max.3) preoperatively and 4/10 NRS (min.2, max. 7, p < 0.001) postoperatively after first loading. Interestingly, it decreased within four weeks to a median of 0.5/10 NRS (min.0, max. 3) without intervention. A strong correlation was seen on the amputated side between preoperative FAA and LHP after loading (r = 0.835, p < 0.001), as well as the relative FAA to LHP after loading (r = 0.732, p < 0.001) and between the gap of pre- to postoperative FAA and LHP. Odds ratio for LHP ≥ 5/10 and relative FAA > 13° was 6.4 (95%CI = 0.55; 74.89). CONCLUSION The preoperative FAA strongly correlates with postoperative LHP. Surgeons should be aware of high risk of LHP that can limit prosthetic training. High preoperative FAAs should be realised in the decision meeting of TOPS implantation and pre-rehabilitative reduction of the FAA should be taken into consideration.
Collapse
Affiliation(s)
- Alexander Ranker
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. .,Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Marcus Oergel
- Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Horst-Heinrich Aschoff
- Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Ashish Jaiman
- Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Christian Krettek
- Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jörg Schiller
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Emmanouil Liodakis
- Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| |
Collapse
|
40
|
Zmyślna A, Żurawski AŁ, Śliwiński G, Śliwiński ZW, Kiebzak WP. Assessment of Body Posture of Children With Chest Pain. Front Pediatr 2021; 9:704087. [PMID: 34485195 PMCID: PMC8416038 DOI: 10.3389/fped.2021.704087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/14/2021] [Indexed: 12/26/2022] Open
Abstract
Objective: An increase in the appearance of chest pain among children is observed globally. The authors present various reasons for their appearance. As can be seen from numerous observations, the majority of cases are not related to the pathology of the circulatory system. Increasingly, studies on the causes of chest pain in children show their association with musculoskeletal disorders. Aim: of the work was assessment of body posture in children with chest pain using the Diers Formetric 4D system. Methods: The study involved a group of 184 female and male children, aged 7-12 years. The study group consisted of 64 patients with chest pain. The children from this group were diagnosed with functional chest pain by a cardiologist. The control group consisted of 120 patients without chest pain. The study included the assessment of body posture using the DIERS Formetric system. Results: The analysis of the results obtained during the study showed that among the children with chest pain, there are statistically significant irregularities in the parameters determining body posture compared to the control group. Comparing the study group with the control group, there is a statistically significant difference in the lateral deviation of VPDM (rms) (mm) (p = 0.001). Both children from the test group aged 9-10 and 11-12 obtained higher results than their peers from the control group. In the group of the youngest children in terms of the lateral deviation of VPDM (rms) (mm), increasing the number of children under study would contribute to significant differences in this variable. In the study group, among children aged 9-10 years, there were also statistically significant abnormalities regarding trunk imbalance and pelvic skewness compared to the children of the same age in the control group. Conclusions: Irregularities in the parameters determining body posture may cause chest pain in children.
Collapse
Affiliation(s)
- Anna Zmyślna
- Collegium Medicum, Department of Health Sciences, Jan Kochanowski University, Kielce, Poland.,Centre for Pediatrics, Regional Hospital in Kielce, Kielce, Poland
| | - Arkadiusz Łukasz Żurawski
- Collegium Medicum, Department of Health Sciences, Jan Kochanowski University, Kielce, Poland.,Centre for Pediatrics, Regional Hospital in Kielce, Kielce, Poland
| | - Grzegorz Śliwiński
- Faculty of Electrical and Computer Engineering, Institute of Biomedical Engineering, Technische Universität Dresden, Dresden, Germany
| | | | - Wojciech Piotr Kiebzak
- Collegium Medicum, Department of Health Sciences, Jan Kochanowski University, Kielce, Poland.,Centre for Pediatrics, Regional Hospital in Kielce, Kielce, Poland
| |
Collapse
|
41
|
Vichiansiri R, Johns NP, Thankham A, Padumanonda T. Comparative Effectiveness of Thai Herbal Formula (Thor-Ra-Nee-San-Tha-Kat) Versus Naproxen for Chronic Myofascial Pain: A Pilot Randomized-Controlled Trial. J Altern Complement Med 2020; 27:73-79. [PMID: 33216613 DOI: 10.1089/acm.2020.0270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: Myofascial pain syndrome (MPS) is a painful musculoskeletal condition. The prevalence of MPS ranges from 5.9% to 38.7% in the general population. "Thor-ra-nee-san-tha-kat" (TRK) is a traditional formula included in the Thailand National List of Essential Medicines for the treatment for muscle pain caused by abdominal rigidity and for severe constipation. Objectives: The authors employed a pilot single-blind, randomized-controlled trial to compare the effectiveness of TRK and naproxen for the treatment of chronic upper trapezius MPS. Materials and Methods: Seventy-six male and female subjects, ages 25-55 years, who met the inclusion criteria were equally randomized into two groups to receive either two 500 mg capsules of TRK once daily before bed or two 250 mg naproxen tablets twice a day after meals for 14 days. Subjects assessed their level of pain using the numerical rating scale. Cervical range of motion (CROM) was determined using a goniometer, and pressure pain threshold (PPT) was assessed using an algometer. Adverse drug reactions were recorded and all items were compared within and between groups, before and after treatment. Results: The results revealed that patient pain scores after 14 days of treatment were much improved with mean differences exceeding the reference minimum clinically important difference (MCID) in both groups. However, the changes in CROM and PPT values were small and did not surpass their respective reference MCIDs except for the right lateral bending CROM for naproxen treatment. The adverse drug reactions were mild, with watery stools reported by 47% of patients in the TRK-treated group and constipation reported by 24% of those in the naproxen group. Conclusion: The administration of TRK formula for 14 days was safe and as effective as naproxen at providing short-term relief of pain in patients with chronic upper trapezius pain.
Collapse
Affiliation(s)
- Ratana Vichiansiri
- Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Amonwat Thankham
- Department of Thai Traditional Medicine, Faculty of Science, Udonthani Rajabhat University, Udonthani, Thailand
| | - Tanit Padumanonda
- Division of Pharmacognosy and Toxicology, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
42
|
Chiu YC, Manousakas I, Kuo SM, Shiao JW, Chen CL. Influence of quantified dry cupping on soft tissue compliance in athletes with myofascial pain syndrome. PLoS One 2020; 15:e0242371. [PMID: 33211769 PMCID: PMC7676738 DOI: 10.1371/journal.pone.0242371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/30/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study aimed to develop a quantitative dry cupping system that can monitor negative pressure attenuation and soft tissue pull-up during cupping to quantify soft tissue compliance. METHODS Baseball players with myofascial pain syndrome were recruited to validate the benefits of cupping therapy. Nine of 40 baseball players on the same team were diagnosed with trapezius myofascial pain syndrome; another nine players from the same team were recruited as controls. All participants received cupping with a negative pressure of 400 mmHg for 15 minutes each time, twice a week, for 4 weeks. Subjective perception was investigated using upper extremity function questionnaires, and soft tissue compliance was quantified objectively by the system. RESULTS During the 15-minute cupping procedure, pressure attenuation in the normal group was significantly greater than that in the myofascial group (p = 0.017). The soft tissue compliance in the normal group was significantly higher than that in the myofascial group (p = 0.050). Moreover, a 4-week cupping intervention resulted in an obvious increase in soft tissue lift in the myofascial pain group (p = 0.027), although there was no statistical difference in the improvement of soft tissue compliance. Shoulder (p = 0.023) and upper extremity function (p = 0.008) were significantly improved in both groups, but there was no significant difference between the two groups. CONCLUSION This quantitative cupping monitoring system could immediately assess tissue compliance and facilitate the improvement of soft tissues after cupping therapy. Hence, it can be used in athletes to improve their functional recovery and maintain soft tissues health during the off-season period.
Collapse
Affiliation(s)
- Yen-Chun Chiu
- Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
- Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Ioannis Manousakas
- Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Shyh Ming Kuo
- Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Jen-Wen Shiao
- Center for General Education, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Liang Chen
- Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan
- * E-mail:
| |
Collapse
|
43
|
Bagcier F, Yurdakul OV, Temel MH. Quality and readability of online information on myofascial pain syndrome. J Bodyw Mov Ther 2020; 25:61-66. [PMID: 33714513 DOI: 10.1016/j.jbmt.2020.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/22/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The reliability of the information on the Internet, which people use as an easy and practical solution about diseases, is essential for public health. Our aim in this study is to evaluate the quality and readability of websites related to myofascial pain syndrome. METHODS On April 4, 2020, websites were searched on the Google search engine using the term "myofascial pain syndrome". The typologies, quality, readability, and content parameters of the sites were analyzed. Websites were divided into eight categories according to typology. To evaluate the quality, we evaluated the websites according to the JAMA scoring system or a HONcode certificate existence. Flesch-Kincaid grade and the Simple Measure of Gobbledygook was used to evaluate readability. Content analysis was performed for etiology, symptoms, diagnosis, and treatment. RESULTS 56 of the 151 websites evaluated were classified as high-quality websites. It was determined that the quality scores of scientific publications and professional websites were high. Comparing the readability parameters of the websites in terms of quality, there was no significant difference between high-quality websites and low-quality websites (p = 0.391 and 0.746 respectively). The content was focused on etiology on scientific websites, while on commercial and professional websites, the content was focused on treatment. CONCLUSION High-quality websites did not offer an advantage in readability parameters. These results show that online information about MPS should be questioned and more extensive studies are required.
Collapse
Affiliation(s)
- Fatih Bagcier
- Department of Physical Medicine and Rehabilitation, Biruni University Faculty of Medicine, İstanbul, Turkey.
| | - Ozan Volkan Yurdakul
- Department of Physical Medicine and Rehabilitation, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - Mustafa Huseyin Temel
- Department of Physical Medicine and Rehabilitation, Haydarpaşa Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
44
|
Zhu S, Xiong J, Chen J, Tang G, Zhong Z, Lu L, Zhou X, Guo H, Fan H. The effectiveness of moxibustion for treating of low back pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22522. [PMID: 33120742 PMCID: PMC7581088 DOI: 10.1097/md.0000000000022522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Low back pain is a common clinical chronic disease with symptoms of back soreness, numbness, and pain. The incidence of low back pain is high, and gradually increases with age. It is mainly middle-aged and has a high recurrence rate. It is considered to be one of the common diseases with the highest disability rate. The aim of this systematic review is to assess the effectiveness and safety of moxibustion therapy for low back pain. METHODS Two reviewers will electronically search the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL);PubMed; EMBASE; China National Knowledge Infrastructure (CNKI); Chinese Biomedical Literature Database (CBM); Chinese Scientific Journal Database (VIP database); and Wan-Fang Database from the inception, without restriction of publication status and languages. Additional searching including researches in progress, the reference lists and the citation lists of identified publications. Study selection, data extraction, and assessment of study quality will be performed independently by 2 reviewers. If it is appropriate for a meta-analysis, RevMan 5.4 statistical software will be used; otherwise, a descriptive analysis will be conducted. Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. The results will be presented as risk ratio (RR) with 95% confidence intervals (CIs) for dichotomous data and weight mean difference (WMD) or standard mean difference (SMD) 95% CIs for continuous data. RESULTS This study will provide a comprehensive review of the available evidence for the treatment of moxibustion with low back pain. CONCLUSIONS The conclusions of our study will provide an evidence to judge whether moxibustion is an effective and safe intervention for patients with low back pain. TRIAL REGISTRATION NUMBER INPLASY202080027.
Collapse
Affiliation(s)
- Siyuan Zhu
- Jiangxi University of Traditional Chinese Medicine
| | - Jun Xiong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jun Chen
- Jiangxi University of Traditional Chinese Medicine
| | - Genhua Tang
- Jiangxi University of Traditional Chinese Medicine
| | | | - LunBin Lu
- Jiangxi University of Traditional Chinese Medicine
| | | | - Han Guo
- Jiangxi University of Traditional Chinese Medicine
| | - Hao Fan
- Jiangxi University of Traditional Chinese Medicine
| |
Collapse
|
45
|
Day of peak pain reduction by a single session of dry needling in the upper trapezius myofascial trigger points: A 14 daily follow-up study. J Bodyw Mov Ther 2020; 24:7-12. [PMID: 33218567 DOI: 10.1016/j.jbmt.2020.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 05/18/2020] [Accepted: 06/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Dry needling (DN) is commonly used to inactivate myofascial trigger points (MTrPs). However, a daily report of pain reduction has not been determined. OBJECTIVE The aim was to evaluate the time of the greatest pain relief after performing a single session of DN in MTrPs of the upper trapezius muscle. METHODS A patient who had MTrPs in the upper trapezius muscle was enrolled into a prospective descriptive study. Each patient received a single session of DN, using a fast-in-fast-out technique, with needle retention for 30 min. Numerical rating scale (NRS) scores were collected daily for 14 days. The mean difference of pain and an effect size were calculated. The 1-5 satisfaction score was a secondary outcome. RESULTS Sixty-seven subjects completed the intervention. The mean duration of the symptom was 27.32 months. The mean baseline NRS score was 5.30. The pain decreased significantly between immediate post-procedure and 1 day after the DN treatment from 5.16 to 3.40 (mean difference 1.76, p < 0.01, effect size = 0.87). The pain continuously reduced until day 10 and then it gradually rose. The pain on day 10 was compared with the baseline that revealed the largest effect size of 3.08 (mean difference 4.67, p < 0.01). Eighty-eight percent of the subjects were very satisfied with their treatment. CONCLUSIONS A single session of DN treatment in the upper trapezius MTrPs combined with self-stretching exercises could greatly reduce pain between immediate post-procedure and 1 day after DN treatment. The peak effect on pain reduction occurred on day 10.
Collapse
|
46
|
Kamel FH, Basha M, Alsharidah A, Hewidy IM, Ezzat M, Aboelnour NH. Efficacy of Extracorporeal Shockwave Therapy on Cervical Myofascial Pain Following Neck Dissection Surgery: A Randomized Controlled Trial. Ann Rehabil Med 2020; 44:393-401. [PMID: 32986940 PMCID: PMC7655229 DOI: 10.5535/arm.20055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
Objective To investigate the efficacy of extracorporeal shockwave therapy (ESWT) on cervical myofascial pain following neck dissection in reducing pain and improving cervical range of motion (ROM). Methods Forty-six patients with cervical myofascial pain following neck dissection surgery were recruited and subdivided at random into two equal groups. The ESWT group received ESWT once a week for 4 weeks (0.25 mL/mm2, 1,000 shocks) and a topical non-steroidal anti-inflammatory drug (3 times/day for 4 weeks). The control group received only topical NSAID. The pain assessment was done by using the visual analog scale (VAS) and pressure algometry. A cervical ROM device was used for the assessment of the lateral flexion and rotation of the neck ROM on both sides. All measurements were collected at baseline, 2 weeks, and 4 weeks. Results The ESWT group revealed a significant improvement in all parameters at post I and post II than did the control group (p>0.001), that revealed a statistical decrease only in the VAS score at post I without any statistical difference in the pain threshold and neck ROM. However, there were statistical differences in all parameters at post II compared to those at pre-treatment and post I (p<0.001). Conclusion As a confirmation of the efficacy of ESWT in cervical myofascial pain control following neck dissection, we observed better results with no side effects in the ESWT group (Clinical Trial Registry No. PACTR202002648274347).
Collapse
Affiliation(s)
- FatmaAlzahraa Hassan Kamel
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraidah, Saudi Arabia.,Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Maged Basha
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraidah, Saudi Arabia
| | - Ashwag Alsharidah
- Department of Physiology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | | | - Mohamed Ezzat
- Department of Physical Therapy for Orthopedics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Nancy Hassan Aboelnour
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| |
Collapse
|
47
|
Development and internal validation of prediction models for persistence of self-reported orofacial pain in the follow-up of patients with myofascial pain. Clin Oral Investig 2020; 25:2583-2594. [PMID: 32914270 PMCID: PMC8060172 DOI: 10.1007/s00784-020-03570-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/03/2020] [Indexed: 11/11/2022]
Abstract
Objectives To identify predictors in patient profiles, and to develop, internally validate, and calibrate prediction models for the persistence of self-reported orofacial pain at the 6-month and 12-month follow-up in patients with myofascial pain. Materials and methods A cohort of 63 adult patients with moderate to severe chronic myofascial pain was included. Patient and disease characteristics at baseline were recorded as potential predictors. Patients` presence or absence of improvement of orofacial pain at follow-up was considered the outcome. Binary logistic regression analyses were used to develop the models. The performance and clinical values of the models were determined. Results Forty-three percent and 30% of the patients had persistence of orofacial pain at 6-month and 12-month follow-up, respectively. Pain elsewhere, depression, parafunctional activities, and mandibular function impairment (MFI) were significantly associated with persistence of the pain at 6-month follow-up, whereas depression, parafunctional activities, and MFI were significantly associated with persistence of the pain at 12-month follow-up. Both of the models showed good calibration and discrimination, with shrunken area under the curve (AUC) values of 0.73 and 0.76, respectively. The clinical added predictive values for ruling in the risk of the persistence were 0.30 and 0.31, respectively, and those for ruling it out were 0.25 and 0.20, respectively. Conclusions Potential predictors for prediction of the persistence of self-reported orofacial pain at follow-up were identified. The calibration, discrimination, and clinical values of the models were acceptable. Clinical relevance The models may assist clinicians in decision-making regarding the improvement of orofacial pain of individual patients during follow-up in clinical settings.
Collapse
|
48
|
Chou Y, Chiou HJ, Wang HK, Lai YC. Ultrasound-guided dextrose injection treatment for chronic myofascial pain syndrome: A retrospective case series. J Chin Med Assoc 2020; 83:876-879. [PMID: 32349034 PMCID: PMC7478217 DOI: 10.1097/jcma.0000000000000339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Due to the lack of an evidence-based consensus, managing refractory myofascial pain syndrome is challenging for clinicians. Dextrose injection (dextrose prolotherapy) emerged as a promising, cost-effective treatment. This study evaluated the efficacy of targeted ultrasound-guided dextrose injection for localized myofascial pain syndrome. METHODS We retrospectively reviewed the clinical outcomes of 45 patients with myofascial pain syndrome refractory to alternative treatments with targeted ultrasound-guided dextrose injection. Pretreatment symptom severity and symptomatic response 1 month after treatment were statistically analyzed using a visual analog scale (VAS)-based scoring system. RESULTS Of 45 patients, 8 (24.4%) reported complete resolution of symptoms at the treated site. In total, 36 (80.0%) patients reported greater than 50% improvement in their symptoms. The mean pretreatment and posttreatment VAS scores were 7.0 and 2.44 (p < 0.001), indicating an overall 65.0% reduction in symptom severity. CONCLUSION Targeted ultrasound-guided dextrose injection was remarkably effective for refractory localized myofascial pain syndrome, significantly reducing symptom intensities in the majority of treated patients within 1 month after a single injection.
Collapse
Affiliation(s)
- Yen Chou
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hong-Jen Chiou
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
- Address correspondence. Dr. Hong-Jen Chiou, Department of Radiology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (H.-J. Chiou)
| | - Hsin-Kai Wang
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Chen Lai
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| |
Collapse
|
49
|
Withdrawn: Influence of instrument assisted soft tissue techniques versus active soft tissue therapies on latent trigger point of upper trapezius muscle: Randomized clinical study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 28:e1859. [PMID: 32808409 DOI: 10.1002/pri.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/28/2020] [Accepted: 05/23/2020] [Indexed: 11/11/2022]
Abstract
Withdrawal: Noha Elserty & Dina Othman Shokri Morsi Galal, Influence of instrument assisted soft tissue techniques versus active soft tissue therapies on latent trigger point of upper trapezius muscle: Randomized clinical study, 2020, e1859 (https://onlinelibrary.wiley.com/doi/10.1002/pri.1859). The above article, published online on 18 August 2020 in Wiley Online Library (wileyonlinelibrary.com), has been withdrawn by agreement between the authors, the journal Editor in Chief Dr. Geert Verheyden, and John Wiley & Sons Ltd. The withdrawal has been agreed due to inappropriate and unlicensed use of a registered trademark technique and tool. This article was first retracted on 22 January 2021 but has now been withdrawn to protect the trademark.
Collapse
|
50
|
Zhang G, Lin Y, Zhou Q, Gao L, Zhang L, Yu Y, Shen Y, Huang Y. Silver acupuncture for myofascitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20519. [PMID: 32502001 PMCID: PMC7306356 DOI: 10.1097/md.0000000000020519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND This systematic review aims to evaluate the effectiveness and safety of silver acupuncture in treatment of myofascitis. METHODS Electronic databases of all silver acupuncture for myofascitis will be searched at PubMed, Cochrane Library, Springer, Embase, China National Knowledge Infrastructure, Wanfang, and Chinese Biological Medical disc from inception to March 31, 2020, with language restricted in Chinese and English. The primary outcome is visual analog scale, a short pain scale with sensitivity and comparability. Secondary outcomes included Clinical Assessment Scale for Cervical Spondylosis, Japanese Orthopaedic Association Scores, Oswestry dysfunction index, American Orthopaedic Foot and Ankle Society-Ankle Hindfoot scale, Foot and Ankle Ability Measure, The Cumberland ankle instability tool, Pittsburgh sleep quality index, self-rating anxiety scale, self-depression rating scale, and follow-up relapse rate. The systematic review and searches for randomized controlled trials of this therapy for myofascitis. The Cochrane RevMan V5.3 bias assessment tool is implemented to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference, standard mean deviation, and binary data will be used to represent continuous results. RESULTS This study will provide a comprehensive review and evaluation of the available evidence for the treatment of myofascitis with this therapy. CONCLUSION This study will provide new evidence to evaluate the effectiveness and side effects of silver acupuncture for myofascitis. Due to the data are not personalized, no formal ethical approval is required. ETHICS AND DISSEMINATION There is no requirement of ethical approval and it will be in print or disseminated by electronic copies. PROSPERO REGISTRATION NUMBER CRD42020151476.
Collapse
Affiliation(s)
- Guilong Zhang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
| | - Yanming Lin
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
| | - Qun Zhou
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan
| | - Liang Gao
- Boai Hospital Affiliated to China Rehabilitation Research Center, Beijing
| | - Leixiao Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Yang Yu
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
| | - Yuquan Shen
- The First People's Hospital of Long quanyi District, Chengdu, Sichuan, China
| | - Yong Huang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
| |
Collapse
|