1
|
De Nordenflycht D, Figueroa K, Muñoz J, De la Torre Canales G. Ultrasonographic characteristics of myogenous temporomandibular disorders: A scoping review. J Oral Rehabil 2024; 51:2209-2219. [PMID: 39003577 DOI: 10.1111/joor.13801] [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: 05/27/2024] [Revised: 06/22/2024] [Accepted: 07/03/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE To identify the available evidence on the ultrasonographic characteristics of masticatory muscles in subjects with myogenous TMD, as well as the potential use of ultrasonography as a diagnostic and treatment assessment outcomes tool. METHOD An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'ultrasonography', 'ultrasound', 'masseter', 'temporal', 'masticatory muscles', 'temporomandibular disorders', 'temporomandibular joint disorders'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. RESULTS Thirteen articles were included for analysis: one comparative cross-sectional study, five case-control studies, six clinical trials and one randomised clinical trial. Main ultrasonographic characteristic assessed were local cross-sectional dimension and intramuscular ultrasonographic appearance. Retrieved studies reported the use ultrasonography for diagnosis or treatment assessment purposes showing heterogeneous results. For diagnosis purposes, the results of local cross-sectional dimension are not consistent; therefore, its diagnostic value for myogenous TMD diagnosis is weak. However, more homogeneous results were observed for intramuscular ultrasonographic appearance showing a higher prevalence of type-II pattern in myogenous TMD subjects than non-TMD subjects. On the other hand, for treatment assessment purposes, muscles were observed thinner after treatment compared to pre-treatment. Also, results of intramuscular ultrasonographic appearance show disappearance or reduction of anechoic areas, higher prevalence of type-II pattern and significant distinction of echogenic bands were observed after treating TMD subjects. CONCLUSION Ultrasonography cannot be considered as a diagnostic instrument, but maybe as a complementary tool for treatment assessment of myogenous TMD subjects, even though future research is required to confirm its utility.
Collapse
Affiliation(s)
| | | | | | - Giancarlo De la Torre Canales
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal
- Department of Dental Medicine, Karolinska Institutet and the Scandinavian Network for Orofacial Neurosciences (SCON), Huddinge, Sweden
| |
Collapse
|
2
|
Korkmaz M, Ceylan CM, Korkmaz MD. Is cervical sagittal alignment associated with pain and disability in myofascial pain syndrome?: A cross-sectional study. Clin Neurol Neurosurg 2024; 245:108458. [PMID: 39079289 DOI: 10.1016/j.clineuro.2024.108458] [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: 05/21/2024] [Revised: 07/08/2024] [Accepted: 07/13/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVE To elucidate the role of cervical sagittal alignment in the pathophysiology of cervical myofascial pain syndrome(MFPS) and its impact on pain levels and disability status among patients. METHODS This prospective cross-sectional study included participants aged 18-64 years experiencing neck pain for more than 3 months and diagnosed with MFPS. Cervical sagittal parameters (C0-2 cervical lordosis(CL) angle, C2-7 CL angle, cervical sagittal vertical axis (cSVA), T1 slope, T1 slope minus CL mismatch(T1S-CL), and cervical tilt) were measured using Surgimap software by an expert physiatrist. Pain levels were assessed using the Numerical Pain Rating Scale(NRS), and neck disability was evaluated using the Neck Bournemouth Questionnaire(NBQ). RESULTS Out of 200 initially assessed participants with cervical MFPS, 133 were included after excluding ineligible individuals. The mean age of the participants was 35.3±8.2 years. Participants categorized by pain severity (moderate vs. severe) showed no significant differences in cervical range of motion, C0-2 angle, cSVA, T1 slope and T1S-CL. However, significant differences were observed in C2-7 angle (p=0.008), cervical tilt (p=0.006), and NBQ scores (p<0.001) between the two pain severity groups. Grouping based on T1S-CL compliance showed no significant differences in pain and disability effects. Correlation analysis revealed weak negative correlations between pain levels and C2-7 Cobb angle (p=0.009, r=0.226) as well as cervical tilt (p=0.005, r=0.243). No correlations were found between cervical sagittal parameters and NBQ scores. CONCLUSIONS Decreased C2-7 CL angle and cervical tilt angle are associated with increased pain levels; however, cervical sagittal alignment was not found to be associated with disability.
Collapse
Affiliation(s)
- Murat Korkmaz
- Department of Orthopedics and Traumatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkiye.
| | - Cansin Medin Ceylan
- Department of Physical Medicine and Rehabilitation, Istanbul Physical Therapy and Rehabilitation Training and Research Hospital, Istanbul, Turkiye.
| | - Merve Damla Korkmaz
- Department of Physical Medicine and Rehabilitation, Biruni University Faculty of Medicine, Istanbul, Turkiye.
| |
Collapse
|
3
|
Valera-Calero JA, Varol U, Ortega-Santiago R, Navarro-Santana MJ, Díaz-Arribas MJ, Buffet-García J, Plaza-Manzano G. MyofAPPcial: Construct validity of a novel technological aid for improving clinical reasoning in the management of myofascial pain syndrome. Eur J Clin Invest 2024:e14313. [PMID: 39239962 DOI: 10.1111/eci.14313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/28/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Physiotherapists encounter challenges in diagnosing myofascial trigger points (MTrPs), which are crucial for managing myofascial pain but difficult due to their complex referred pain patterns. We aimed to assess if an interactive software (MyofAPPcial) can enhance the ability of physical therapists specialized in musculoskeletal disorders (as clinicians and as researchers and educators) to identify referred pain patterns associated with specific MTrPs and to explore their opinion about incorporating this technology regularly into their professional setting. METHODS After developing the app, a descriptive cross-sectional survey study was conducted. Participants were asked about their demographic characteristics, professional experience, two knowledge tests (first without and later with MyofAPPcial support) and the 18-item mHealth app usability questionnaire. RESULTS Fifty-nine participants completed the survey (47.5% clinicians and 62.5% researchers/educators). Groups were comparable in terms of age, gender and professional experience (p > .05). However, clinicians coursed shorter specific MPS trainings (p = .007) and handle more cases a week (p < .001). In the first knowledge test, participants in both the groups were more accurate in identifying pain maps of highly prevalent MTrPs than those with a moderate or low prevalence (p < .001), with no differences between the groups for individual items (all, p > .05) nor the total score (p > .05). In the second knowledge test, perfect scores were obtained for all items in both the groups. Finally, MyofAPPcial scored high satisfaction and app usefulness, with no difference between clinicians and researchers/educators (except greater convenience of use for researchers/educators p = .02). CONCLUSIONS MyofAPPcial enhances physiotherapists' ability to accurately identify MTrPs, with a good acceptation among clinicians and researchers/educators.
Collapse
Affiliation(s)
- Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Umut Varol
- Escuela Internacional de Docotorado, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - María José Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jorge Buffet-García
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| |
Collapse
|
4
|
Pavlović B, Toskić L, Cicović V, Cicović B, Stanković V. The Effects of Dry-Needling Therapy on the Quality of Life in Athletes with Myofascial Pain Syndrome: Repeated Measures Design Study. J Clin Med 2024; 13:4969. [PMID: 39274182 PMCID: PMC11395707 DOI: 10.3390/jcm13174969] [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: 07/18/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 09/16/2024] Open
Abstract
Background: This study aims to investigate the effects of dry-needling treatment on the quality of life in athletes with myofascial pain syndrome (MPS). Methods: The participants included in the study were 50 athletes (38 males and 12 females) diagnosed with MPS. The treatments were carried out in four sessions, 5/7 days apart on 55 muscles in total. A 36-item health survey (SF-36) was implemented to determine the participants' quality of life. The chi-square test was used to determine the differences between measurements. Results: Dry-needling treatment has a positive influence on self-perspective of physical functioning (p = 0.011, on average), physical problems (p = 0.001, on average), emotional problems (p = 0.004, on average), social functioning (p = 0.001, on average), pain (p = 0.001, on average), and mental health and vitality (p = 0.001, on average) in athletes with MPS. The only quality-of-life dimension not influenced by the dry-needling treatment is the general health perception (p = 0.340, on average). Conclusions: Dry-needling therapy has positive effects on the perception of quality of life in athletes with MPS.
Collapse
Affiliation(s)
- Bojan Pavlović
- Faculty of Physical Education and Sport, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina
| | - Lazar Toskić
- Faculty of Sport and Physical Education, University of Priština-Kosovska Mitrovica, 38218 Leposavić, Serbia
- Faculty of Sport, University "Union-Nikola Tesla", 11000 Belgrade, Serbia
| | - Vanja Cicović
- Faculty of Physical Education and Sport, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina
| | - Borislav Cicović
- Faculty of Physical Education and Sport, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina
| | - Veroljub Stanković
- Faculty of Sport and Physical Education, University of Priština-Kosovska Mitrovica, 38218 Leposavić, Serbia
| |
Collapse
|
5
|
Kawasaki N, Ishiki H, Arakawa S, Satomi E, Matsuoka H, Hasuo H. Myofascial pain syndrome in patients with cancer: a narrative review. BMJ Support Palliat Care 2024:spcare-2024-005064. [PMID: 39147404 DOI: 10.1136/spcare-2024-005064] [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: 06/29/2024] [Accepted: 07/16/2024] [Indexed: 08/17/2024]
Abstract
PURPOSE Myofascial pain syndrome (MPS) is a chronic musculoskeletal pain syndrome. The purpose of this review is to describe the epidemiological and treatment evidence and to address the future research agenda in patients with cancer. METHODS A narrative review of previous reports investigating the prevalence and treatment of MPS in the oncology field is presented. The target population is patients with cancer and cancer survivors. RESULTS There have been three prospective and two retrospective studies investigating the prevalence of MPS. MPS is as high as 38%-45% in patients with advanced or incurable cancer and 11.9%-44.8% in cancer survivors. A total of nine reports investigated the efficacy of the following interventions: trigger point injection (TPI), myofascial techniques and ischaemic compression. TPI has been reported to be effective in four observational studies. One randomised study reported the efficacy of myofascial techniques, but two randomised studies reported no added beneficial effects of it in breast cancer survivors. Two randomised studies investigated the efficacy of ischaemic compression, but the obtained results were contradictory. CONCLUSIONS MPS is highly prevalent. We should know that non-cancer pain is also common in both patients with cancer and survivors. In treating such pain, careful physical examination is essential. Then, non-pharmacological treatment should be considered as well as pharmacotherapy. As evidence regarding MPS in the oncology field is scarce, further research is warranted.
Collapse
Affiliation(s)
- Naruaki Kawasaki
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Sayaka Arakawa
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psychooncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hideaki Hasuo
- Psychosomatic Medicine, Kansai Medical University, Hirakata, Osaka, Japan
| |
Collapse
|
6
|
Beausejour JP, Knowles KS, Wilson AT, Mangum LC, Hill EC, Hanney WJ, Wells AJ, Fukuda DH, Stout J, Stock MS. Innovations in the Assessment of Skeletal Muscle Health: A Glimpse into the Future. Int J Sports Med 2024; 45:659-671. [PMID: 38198822 DOI: 10.1055/a-2242-3226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Skeletal muscle is the largest organ system in the human body and plays critical roles in athletic performance, mobility, and disease pathogenesis. Despite growing recognition of its importance by major health organizations, significant knowledge gaps remain regarding skeletal muscle health and its crosstalk with nearly every physiological system. Relevant public health challenges like pain, injury, obesity, and sarcopenia underscore the need to accurately assess skeletal muscle health and function. Feasible, non-invasive techniques that reliably evaluate metrics including muscle pain, dynamic structure, contractility, circulatory function, body composition, and emerging biomarkers are imperative to unraveling the complexities of skeletal muscle. Our concise review highlights innovative or overlooked approaches for comprehensively assessing skeletal muscle in vivo. We summarize recent advances in leveraging dynamic ultrasound imaging, muscle echogenicity, tensiomyography, blood flow restriction protocols, molecular techniques, body composition, and pain assessments to gain novel insight into muscle physiology from cellular to whole-body perspectives. Continued development of precise, non-invasive tools to investigate skeletal muscle are critical in informing impactful discoveries in exercise and rehabilitation science.
Collapse
Affiliation(s)
- Jonathan P Beausejour
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Kevan S Knowles
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Abigail T Wilson
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - L Colby Mangum
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Ethan C Hill
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - William J Hanney
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Adam J Wells
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - David H Fukuda
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - JeffreyR Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Matt S Stock
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| |
Collapse
|
7
|
Moreau N, Korai SA, Sepe G, Panetsos F, Papa M, Cirillo G. Peripheral and central neurobiological effects of botulinum toxin A (BoNT/A) in neuropathic pain: a systematic review. Pain 2024; 165:1674-1688. [PMID: 38452215 DOI: 10.1097/j.pain.0000000000003204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/07/2023] [Indexed: 03/09/2024]
Abstract
ABSTRACT Botulinum toxin (BoNT), a presynaptic inhibitor of acetylcholine (Ach) release at the neuromuscular junction (NMJ), is a successful and safe drug for the treatment of several neurological disorders. However, a wide and recent literature review has demonstrated that BoNT exerts its effects not only at the "periphery" but also within the central nervous system (CNS). Studies from animal models, in fact, have shown a retrograde transport to the CNS, thus modulating synaptic function. The increasing number of articles reporting efficacy of BoNT on chronic neuropathic pain (CNP), a complex disease of the CNS, demonstrates that the central mechanisms of BoNT are far from being completely elucidated. In this new light, BoNT might interfere with the activity of spinal, brain stem, and cortical circuitry, modulating excitability and the functional organization of CNS in healthy conditions. Botulinum toxins efficacy on CNP is the result of a wide and complex action on many and diverse mechanisms at the basis of the maladaptive plasticity, the core of the pathogenesis of CNP. This systematic review aims to discuss in detail the BoNT's mechanisms and effects on peripheral and central neuroplasticity, at the basis for the clinical efficacy in CNP syndromes.
Collapse
Affiliation(s)
- Nathan Moreau
- Laboratoire de Neurobiologie oro-faciale, EA 7543, Université Paris Cité, Paris, France
| | - Sohaib Ali Korai
- Division of Human Anatomy, Laboratory of Morphology of Neuronal Networks & Systems Biology, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanna Sepe
- Division of Human Anatomy, Laboratory of Morphology of Neuronal Networks & Systems Biology, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fivos Panetsos
- Neurocomputing & Neurorobotics Research Group, Universidad Complutense de Madrid, Instituto de Investigaciones Sanitarias (IdISSC), Hospital Clinico San Carlos de Madrid, Silk Biomed SL, Madrid, Spain
| | - Michele Papa
- Division of Human Anatomy, Laboratory of Morphology of Neuronal Networks & Systems Biology, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Cirillo
- Division of Human Anatomy, Laboratory of Morphology of Neuronal Networks & Systems Biology, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
8
|
Yu H, Zhao H, Liu D, Dong Y, Nai M, Song Y, Liu J, Wang L, Li L, Li X. Prediction of myofascial pelvic pain syndrome based on random forest model. Heliyon 2024; 10:e31928. [PMID: 38868063 PMCID: PMC11167342 DOI: 10.1016/j.heliyon.2024.e31928] [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: 01/31/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/14/2024] Open
Abstract
Objective The objective is to construct a random forest model for predicting the occurrence of Myofascial pelvic pain syndrome (MPPS) and compare its performance with a logistic regression model to demonstrate the superiority of the random forest model. Methods We retrospectively analyze the clinical data of female patients who underwent pelvic floor screening due to chronic pelvic pain at the Pelvic Floor Rehabilitation Center of the Third Affiliated Hospital of Zhengzhou University from January 2021 to December 2023. A total of 543 female patients meeting the study's inclusion and exclusion criteria are randomly selected from this dataset and allocated to the MPPS group. Furthermore, 702 healthy female patients who underwent pelvic floor screening during routine physical examinations within the same timeframe are randomly selected and assigned to the non-MPPS group. Chi-square test and rank-sum test are used to select demographic variables, pelvic floor pressure assessment data variables, and modified Oxford muscle strength grading data for logistic univariate analysis. The selected variables are further subjected to multivariate logistic regression analysis, and a random forest model is also established. The predictive performance of the two models is evaluated by comparing their accuracy, sensitivity, specificity, precision, receiver operating characteristic (ROC) curve, and area under the curve (AUC) area. Results Based on a dataset of 1245 cases, we implement the random forest algorithm for the first time in the screening of MPPS. In this investigation, the Logistic regression model forecasts the accuracy, sensitivity, specificity, and precision of MPPS at 69.96 %, 57.46 %, 79.63 %, and 68.57 % respectively, with an AUC of the ROC curve at 0.755. Conversely, the random forest prediction model exhibits accuracy, sensitivity, specificity, and precision rates of 87.11 %, 90.66 %, 90.91 %, and 83.51 % respectively, with an AUC of the ROC curve at 0.942. The random forest model showcases exceptional predictive performance during the initial screening of MPPS. Conclusion The random forest model has exhibited exceptional predictive performance in the initial screening evaluation of MPPS disease. The development of this predictive framework holds significant importance in refining the precision of MPPS prediction within clinical environments and elevating treatment outcomes. This research carries profound global implications, given the potentially elevated misdiagnosis rates and delayed diagnosis proportions of MPPS on a worldwide scale, coupled with a potential scarcity of seasoned healthcare providers. Moving forward, continual refinement and validation of the model will be imperative to further augment the precision of MPPS risk assessment, thereby furnishing clinicians with more dependable decision-making support in clinical practice.
Collapse
Affiliation(s)
- Hang Yu
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Hongguo Zhao
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Dongxia Liu
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Yanhua Dong
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Manman Nai
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Yikun Song
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Jiaxi Liu
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Luwen Wang
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Lei Li
- The Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China
| | - Xinbin Li
- School of Marine Science and Technology, Northwestern Polytechnical University, Xi'an, 710072, PR China
| |
Collapse
|
9
|
Tsai PF, Edison JL, Wang CH, Gramlich MW, Manning KQ, Deshpande G, Bashir A, Sefton J. Characteristics of patients with myofascial pain syndrome of the low back. Sci Rep 2024; 14:11912. [PMID: 38789439 PMCID: PMC11126576 DOI: 10.1038/s41598-024-61319-5] [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: 10/17/2023] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
The objective of this study is to determine characteristics of patients with myofascial pain syndrome (MPS) of the low back and the degree to which the low back pain in the patients examined can be attributed to MPS. Twenty-five subjects with myofascial trigger point(s) [MTrP(s)] on the low back participated in this cross-sectional study. The location, number, and type of selected MTrPs were identified by palpation and verified by ultrasound. Pain pressure threshold, physical function, and other self-reported outcomes were measured. Significant differences were found in Group 1 (Active), 2 (Latent), 3 (Atypical, no twitching but with spontaneous pain), and 4 (Atypical, no twitching and no spontaneous pain) of participants in the number of MTrPs, current pain, and worst pain in the past 24 h (p = .001-.01). There were interaction effects between spontaneous pain and twitching response on reports of physical function, current pain, and worst pain (p = .002-.04). Participants in Group 3 reported lower levels of physical function, and higher levels of current pain and worst pain compared to those in Group 4. Participants in Group 1 and 2 had similar levels of physical function, current pain, and worst pain. The number of MTrPs is most closely associated with the level of pain. Spontaneous pain report seems to be a decisive factor associated with poor physical function; however, twitching response is not.
Collapse
Affiliation(s)
- Pao-Feng Tsai
- College of Nursing, Auburn University, 710 S Donahue Dr, Auburn, AL, 36849, USA.
| | | | | | | | | | - Gopikrishna Deshpande
- Auburn University Neuroimaging Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, United States
- Department of Psychological Sciences, Auburn University, Auburn, AL, United States
- Alabama Advanced Imaging Consortium, Birmingham, AL, United States
- Center for Neuroscience, Auburn University, Auburn, AL, United States
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
- Department of Heritage Science and Technology, Indian Institute of Technology, Hyderabad, India
| | - Adil Bashir
- Samuel Ginn College of Engineering, Auburn University, Auburn, AL, USA
| | - JoEllen Sefton
- School of Kinesiology, Auburn University, Auburn, AL, USA
| |
Collapse
|
10
|
Avendaño-López C, Megía-García Á, Beltran-Alacreu H, Serrano-Muñoz D, Arroyo-Fernández R, Comino-Suárez N, Avendaño-Coy J. Efficacy of Extracorporeal Shockwave Therapy on Pain and Function in Myofascial Pain Syndrome: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Am J Phys Med Rehabil 2024; 103:89-98. [PMID: 37205742 DOI: 10.1097/phm.0000000000002286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
OBJECTIVE The aim of the study is to examine the effectiveness of extracorporeal shockwave therapy in reducing pain, improving functionality, joint range of motion, quality of life, fatigue, and health status self-perception in people with myofascial pain syndrome. METHODS PubMed, the Cochrane Library, CINAHL, the Physiotherapy Evidence Database, and SPORTDiscus were systematically searched for only randomized clinical trials published up to June 2, 2022. The main outcome variables were pain, as reported on the visual analog scale and pressure pain threshold, and functionality. A quantitative analysis was conducted using the inverse variance method and the random effects model. RESULTS Twenty-seven studies were included ( N = 595 participants in the extracorporeal shockwave therapy group). The effectiveness of extracorporeal shockwave therapy for relieving pain was superior for the extracorporeal shockwave therapy group compared with the control group on the visual analog scale (MD = -1.7 cm; 95% confidence interval = -2.2 to -1.1) and pressure pain threshold (mean difference = 1.1 kg/cm 2 ; 95% confidence interval = 0.4 to 1.7) and functionality (standardized mean difference = -0.8; 95% confidence interval = -1.6 to -0.04) with high heterogeneity. However, no differences were found between extracorporeal shockwave therapy and other interventions as dry needling, exercises, infiltrations, and lasers interventions. CONCLUSIONS Extracorporeal shockwave therapy is effective in relieving pain and improving functionality in patients with myofascial pain syndrome compared with control and ultrasound therapy. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES Upon completion of this article, the reader should be able to: (1) Determine the effectiveness of radial and focal extracorporeal shockwaves on pain perception, the pressure pain threshold, and functionality in people with myofascial pain syndrome; (2) Describe the intervention protocol of extracorporeal shockwave therapy to improve pain perception in people with myofascial pain syndrome; and (3) Describe the advantages and disadvantages of extracorporeal shockwave therapy versus other intervention such as dry needling. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Collapse
Affiliation(s)
- Carlos Avendaño-López
- From the Centre Hospitalier de Niort, Niort, France (CA-L); Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain (ÁM-G, HB-A, DS-M, NC-S, JA-C); Biomechanical and Technical Aids Unit, National Hospital for Paraplegia, Finca La Peraleda, Spain (ÁM-G); and Water & Health Research Group (GIAS), Spain (RA-F)
| | | | | | | | | | | | | |
Collapse
|
11
|
Varol U, Valera-Calero JA, Sánchez-Jiménez E, Fernández-de-las-Peñas C, Ortega-Santiago R, Kobylarz MD, Navarro-Santana MJ. Levator Scapulae Stiffness Measurement Reliability in Individuals with and without Chronic Neck Pain by Experienced and Novel Examiners. SENSORS (BASEL, SWITZERLAND) 2024; 24:277. [PMID: 38203140 PMCID: PMC10781297 DOI: 10.3390/s24010277] [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: 11/07/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
The levator scapulae muscle is a key structure in the etiopathology of neck and shoulder musculoskeletal pain. Although previous studies used shear-wave elastography (SWE) for characterizing this muscle elasticity, limited evidence assessed the inter-examiner reliability of this procedure. This study aimed to analyze the inter-examiner reliability for calculating Young's modulus and shear wave speed in a cohort of participants with and without chronic neck pain. A diagnostic accuracy study was conducted, acquiring a set of SWE images at the C5 level in participants with and without neck pain (n = 34 and 33, respectively) by two examiners (one experienced and one novel). After blinding the participants' identity, examiner involved, and side, the stiffness indicators were calculated by an independent rater in a randomized order. Intra-class correlation coefficients (ICC), standard error of measurement, minimal detectable changes, and coefficient of variation were calculated. Both cohorts had comparable sociodemographic characteristics (p > 0.05). No significant levator scapulae elasticity differences were found between genders, sides, or cohorts (all, p > 0.05). Inter-examiner reliability for calculating Young's modulus and shear wave speed was moderate-to-good for assessing asymptomatic individuals (ICC = 0.714 and 0.779, respectively), while poor-to-moderate in patients with neck pain (ICC = 0.461 and 0.546, respectively). The results obtained in this study support the use of this procedure for assessing asymptomatic individuals. However, reliability estimates were unacceptable to support its use for assessing elasticity in patients with chronic neck pain. Future studies might consider that the shear wave speed is more sensitive to detect real changes in comparison with Young's modulus.
Collapse
Affiliation(s)
- Umut Varol
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Mateusz D. Kobylarz
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 29222 Alcorcón, Spain; (U.V.); (M.D.K.)
- Akademia Terapii Manualnej i Igłoterapii Suchej (ATMIS), 34-400 Nowy Targ, Poland
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (M.J.N.-S.)
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| |
Collapse
|
12
|
Dach F, Ferreira KS. Treating myofascial pain with dry needling: a systematic review for the best evidence-based practices in low back pain. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1169-1178. [PMID: 38157883 PMCID: PMC10756779 DOI: 10.1055/s-0043-1777731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/28/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a common source of pain in primary care or pain clinics. There are many different ways to manage and treat MPS, such as physical exercise, trigger points massage, and dry needling. OBJECTIVE The objective of this overview is to highlight and discuss the evidence-based treatment of myofascial pain by dry needling in patients with low back pain. METHODS A systematic review was made based on meta-analysis (MA) and randomized controlled trials (RCTs) related to dry needling treatment for myofascial pain in patients with lumbar pain, published from 2000 to 2023. RESULTS A total of 509 records were identified at first. Seventy were published before 2000, so they were excluded. From the remaining 439 studies, ninety-two were RCTs or MA, of which 86 additional studies were excluded for the following reasons: not related to dry needling treatment (n = 79), not published in English (n = 4), duplicated (n = 1), project protocol (n = 1), and not related to myofascial pain (n = 1). So, this review was based on 4 RCTs and two MA. These studies compared dry needling efficacy to other treatments, such as acupuncture, sham dry needling, laser therapy, physical therapy, local anesthetic injection, ischemic compression, and neuroscience education. Despite outcomes and follow-up period varied between them, they showed that dry needling can decrease post-intervention pain intensity and pain disability. CONCLUSION Dry needling is an effective procedure for the treatment of myofascial pain in patients with acute and chronic low back pain. Further high-quality studies are needed to clarify the long-term outcomes.
Collapse
Affiliation(s)
- Fabíola Dach
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
| | - Karen S. Ferreira
- Suroit Hospital, Department of Neurology, Salaberry-de-Valleyfield, Quebec, Canada
| |
Collapse
|
13
|
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
|
14
|
Hamzoian H, Zograbyan V. Trigger Point Injections Versus Medical Management for Acute Myofascial Pain: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e43424. [PMID: 37706133 PMCID: PMC10497070 DOI: 10.7759/cureus.43424] [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: 08/12/2023] [Indexed: 09/15/2023] Open
Abstract
Myofascial pain is a common problem resulting in musculoskeletal pain characterized by myofascial trigger points. These trigger points can cause substantial discomfort and functional limitations. This meta-analysis aims to assess the effectiveness and safety of trigger point injections versus medical management alone in treating acute onset myofascial pain. A thorough search was conducted across four databases, namely, PubMed, SCOPUS, Web of Science (WOS), and Cochrane Library, to identify randomized controlled trials that compared the effectiveness of trigger point injections versus medical management for the treatment of acute myofascial pain. The search encompassed articles published from the databases' inception until June 2023. The relevant data were extracted and analyzed using the standardized mean difference (SMD) and 95% confidence interval (CI). Of the 1151 records identified, four met the inclusion criteria for the systematic review, and all were included in the meta-analysis. The analysis of four randomized controlled trials (RCTs) showed that trigger point injections were effective in reducing pain scores compared to medical treatment (SMD = -2.09 (95% CI: -3.34 to -0.85, P = 0.001)). The data revealed a negative standardized mean difference, which was significant and consistent in favor of trigger point injections. Overall, these findings highlight the beneficial impact of trigger point injections in reducing acute myofascial pain when compared to isolated medical management.
Collapse
Affiliation(s)
- Haroutiun Hamzoian
- Neurology, Orlando Health / Orlando Regional Medical Center, Orlando, USA
| | - Vahe Zograbyan
- Emergency Medicine, Eisenhower Health, Palm Springs, USA
| |
Collapse
|
15
|
Zagury JG, Ananthan S, Quek SYP, Subramanian G. Myofascial Temporomandibular Disorders at a Turning Point: Pragmatic or Evidence-Based Management? Dent Clin North Am 2023; 67:335-348. [PMID: 36965935 DOI: 10.1016/j.cden.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Unvalidated theories have been proposed for the etiopathogenesis of masticatory myofascial temporomandibular disorders (mTMD). Modalities such as cone-beam computed tomography/computed tomography and MRI contributes little to the diagnosis of mTMD. Diagnosing mTMD is based on the recognition of "familiar pain" presentation in the masticatory myofascial tissue. This assessment tool contributes little our understanding of the underlying disease process. Thus, management of mTMD is empirical and arbitrary. Exploring emerging technologies to identify biomarkers and objectively assess myofascial tissue physiology in disease and health may be key in moving the diagnosis of mTMD from the pragmatic paradigm to an evidence-based paradigm.
Collapse
Affiliation(s)
- Julyana Gomes Zagury
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, USA
| | - Sowmya Ananthan
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, USA
| | - Samuel Y P Quek
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, USA.
| | - Gayathri Subramanian
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, USA
| |
Collapse
|
16
|
Tang F, Jiang C, Chen J, Wang L, Zhao F. Global hotspots and trends in Myofascial Pain Syndrome research from 1956 to 2022: A bibliometric analysis. Medicine (Baltimore) 2023; 102:e33347. [PMID: 36961168 PMCID: PMC10036018 DOI: 10.1097/md.0000000000033347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/02/2023] [Indexed: 03/25/2023] Open
Abstract
Myofascial Pain Syndrome (MPS) is a prevalent disease, and the related literature research has been increasing in recent years. However, there is a lack of scientific and comprehensive bibliometric analyses in the MPS research field. This study aimed to summarize and visualize the literature distribution laws, research hotspots and development trends in MPS based on bibliometric methods. Relevant literature on MPS research from 1956 to 2022 was retrieved from the Web of Science Core Collection database. Quantitative and visual analyses of the collected literature were performed using Microsoft Office 2021, Bibliometrics, VOSviewer, and CiteSpace. A total of 1099 papers were included, and the number of papers in this research field is generally upward. The USA has the most publications (270), and Univ Sao Paulo is the institution with the most publications (31). Hong CZ and Calvo-Lobo C have the same number of publications and are the authors with the most publications (20), and Simons DG is the author with the most co-citations (1078). Journal of Musculoskeletal Pain is the journal with the most publications (61), and Pain is the journal with the most co-cited papers (2598) and the highest impact factor (7.926). Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response is the reference with the highest number of co-citations (136). The top 5 keywords in this period are myofascial pain syndrome (571), trigger points (218), pain (97), myofascial pain (92), and myofascial trigger point (80). The keywords of recent bursts are dry needling (2016-2022), efficacy (2020-2022), validity (2020-2022), temporomandibular joint disorder (2020-2022), and orofacial pain (2020-2022). This study summarizes and visualizes the evolution, research hotspots, and future trends of the global MPS domain from 1956 to 2022. It is helpful for scholars to understand the general situation of MPS research quickly and provide a reference for clinical decision-making and future research directions.
Collapse
Affiliation(s)
- Fei Tang
- Department of Pain Medicine, Suiyang County Hospital of Traditional Chinese Medicine, Guizhou, PR China
| | - Changgui Jiang
- Department of Pain Medicine, Suiyang County Hospital of Traditional Chinese Medicine, Guizhou, PR China
| | - Jun Chen
- Department of Pain Medicine, Suiyang County Hospital of Traditional Chinese Medicine, Guizhou, PR China
| | - Liangyong Wang
- Department of Pain Medicine, Suiyang County Hospital of Traditional Chinese Medicine, Guizhou, PR China
| | - Fukun Zhao
- Department of Clinical Pharmacy, Zunyi First People’s Hospital (The Third Affiliated Hospital of Zunyi Medical University), Guizhou, PR China
| |
Collapse
|
17
|
Zhou X, Li X, Wang Z, Huang D. Preliminary evidence of safety and effectiveness of Loxoprofen Sodium Cataplasm combined with physiotherapy for myofascial pain syndrome treatment: A randomized controlled pilot clinical trial. Front Neurol 2022; 13:998327. [PMID: 36484021 PMCID: PMC9724624 DOI: 10.3389/fneur.2022.998327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/31/2022] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is one of the most common causes of chronic skeletal muscle pain, which is closely related to skeletal muscle myofascial trigger point (MTRP). Since there is no first-line treatment for MPS, we investigated Loxoprofen Sodium Cataplasm combined with physiotherapy as a non-invasive therapy in patients at different levels to a protocol with superior efficacy that is safe and easy to promote. Moreover, this treatment could represent an alternative therapeutic strategy for low-income patients to a safer, more convenient, and more economical treatment scheme. METHODS A randomized clinical study was aimed at evaluating the safety and efficacy of Loxoprofen Sodium Cataplasm combined with physiotherapy in patients diagnosed with MPS in the pain clinic. We screened 100 patients with MPS, and using a computer-generated random allocation sequence, we stratified patients in a ratio of 2:1:1:1 (A: B: C: D) to one of the four treatment groups. Group A received Loxoprofen Sodium Cataplasm combined with extracorporeal shock wave therapy (ESWT) and transcutaneous electrical nerve stimulation (TENS). Group B received Loxoprofen Sodium Cataplasm alone. Group C received physiotherapy alone. Group D received Flurbiprofen Cataplasm combined with physiotherapy. After 2 weeks of treatment, the overall efficiency and secondary assessment indicators, including visual analog scale (VAS) scores, chronic soft tissue injury (CSTI) scores, Oswestry Disability Index (ODI) scores, or Northwick Park Neck Pain Questionnaire (NPQ) scores, were evaluated before and after treatment to analyze the difference in efficacy of each group. RESULTS All groups were well tolerated with no reported adverse events. Significant treatment differences in the change from baseline in overall efficiency (primary efficacy endpoint) (P = 0.0078) were observed in subjects of groups A and C. CONCLUSION Showing valuable data of efficacy in primary and secondary endpoints, Loxoprofen Sodium Cataplasm combined with physiotherapy is superior in the treatment of MPS. TRIAL REGISTRATION NUMBER https://www.chictr.org.cn/ (ChiCTR2100054756).
Collapse
Affiliation(s)
- Xuewen Zhou
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Xuelian Li
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Ziyang Wang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
- Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dong Huang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
- Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
| |
Collapse
|
18
|
Xiao J, Cao BY, Xie Z, Ji YX, Zhao XL, Yang HJ, Zhuang W, Sun HH, Liang WM. Clinical efficacy of electromagnetic field therapy combined with traditional Chinese pain-reducing paste in myofascial pain syndrome. World J Clin Cases 2022; 10:11753-11765. [PMID: 36405282 PMCID: PMC9669869 DOI: 10.12998/wjcc.v10.i32.11753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/26/2022] [Accepted: 10/18/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Pulsed electromagnetic field (PEMF) therapy is widely used to treat myofascial pain syndrome (MPS). Damp-clearing and pain-reducing paste (DPP) comprises medical herbs and has been a traditional method of reducing myofascial pain in China for a long time, and it is usually administered with heating. However, the synergistic effect of PEMF therapy on heating-DPP in patients with MPS is unclear.
AIM To investigate the synergistic effect of PEMF therapy plus heating-DPP in lumbar MPS.
METHODS This double-blind, randomized, placebo-controlled trial was conducted on 120 patients with lumbar MPS who were randomly divided into an experimental group (EG, n = 60) and a control group (CG, n = 60). Patients in both groups were treated with heating-DPP combined with PEMF therapy; however, the electromagnetic function of the therapeutic apparatus used in the CG was disabled. Each treatment lasted for 20 min and was applied five times a week for two weeks. The short-form McGill Pain Questionnaire was applied at five time points: pretest, end of the first and second weeks of treatment, and end of the first and fourth week after completing treatment. Visual analog scale (VAS), present pain intensity index (PPI), and pain rating index (PRI; total, affective pain, and sensory pain scores) scores were then analyzed.
RESULTS Compared with the CG, the VAS, PPI and PRI scores (total, affective pain and sensory pain scores) in the EG were significantly lower after treatment and during follow-up.
CONCLUSION PEMF therapy combined with heating-DPP showed better efficacy than heating-DPP alone in reducing the overall intensity of pain and sensory and affective pain.
Collapse
Affiliation(s)
- Jing Xiao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Bing-Yan Cao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Zeng Xie
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Yu-Xuan Ji
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Xing-Li Zhao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Hong-Jie Yang
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Wei Zhuang
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Hai-Hua Sun
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Wen-Ming Liang
- Life Sciences Center, Vilnius University, Vilnius LT-10257, Lithuania
| |
Collapse
|
19
|
Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study. Diagnostics (Basel) 2022; 12:diagnostics12112723. [PMID: 36359567 PMCID: PMC9689409 DOI: 10.3390/diagnostics12112723] [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: 09/20/2022] [Revised: 10/22/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p < 0.01) between the groups, for the Physical Health domain and the total score of the SF-12 questionnaire, and for all the domains of the McGill questionnaire; but no significant differences were found in the data from the WPAI-GH questionnaire. Statistically significant data (p < 0.01) were found for mechanosensitivity in the abdominal area and limbs, but not for the lumbar assessment, within the group, with very few significant intergroup differences. The frequency of active MTrPs is higher in the groups of women with primary dysmenorrhea and during the menstrual phase, with the prevalence of myofascial trigger points of the iliococcygeus muscle being especially high in all examination groups (>50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea.
Collapse
|
20
|
Fitzcharles MA, Cohen SP, Clauw DJ, Littlejohn G, Usui C, Häuser W. Chronic primary musculoskeletal pain: a new concept of nonstructural regional pain. Pain Rep 2022; 7:e1024. [PMID: 35975135 PMCID: PMC9371480 DOI: 10.1097/pr9.0000000000001024] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/25/2022] [Accepted: 04/30/2022] [Indexed: 11/25/2022] Open
|
21
|
A randomized comparative study of traditional Thai massage and Thai boxing exercise on clinical-based outcomes in patients with scapulocostal syndrome. Complement Ther Clin Pract 2022; 48:101604. [DOI: 10.1016/j.ctcp.2022.101604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 11/20/2022]
|
22
|
Paoletta M, Moretti A, Liguori S, Toro G, Gimigliano F, Iolascon G. Efficacy and Effectiveness of Extracorporeal Shockwave Therapy in Patients with Myofascial Pain or Fibromyalgia: A Scoping Review. Medicina (B Aires) 2022; 58:medicina58081014. [PMID: 36013480 PMCID: PMC9416523 DOI: 10.3390/medicina58081014] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
Myofascial pain syndrome (MPS) and fibromyalgia (FM) are underestimated painful musculoskeletal conditions that could impact function and quality of life. A consensus about the most appropriate therapeutic approach is still not reached. Considering the long course of the diseases, prolonged assumption of drugs, such as NSAIDs and pain killers, could increase the risk of adverse events, often leading affected patients and physicians to prefer non-pharmacological approaches. Among these, radial and focused extracorporeal shock waves therapies (ESWT) are widely used in the management of painful musculoskeletal conditions, despite the fact that the mechanisms of action in the context of pain modulation should be further clarified. We performed a scoping review on PubMed using Mesh terms for analyzing the current evidence about the efficacy and effectiveness of ESWT for patients with MPS or FM. We included 19 clinical studies (randomized controlled trials and observational studies); 12 used radial ESWT, and 7 used focused ESWT for MPS. Qualitative analysis suggests a beneficial role of ESWT for improving clinical and functional outcomes in people with MPS, whereas no evidence was found for FM. Considering this research gap, we finally suggested a therapeutic protocol for this latter condition according to the most recent diagnostic criteria.
Collapse
Affiliation(s)
- Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.T.); (G.I.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.T.); (G.I.)
- Correspondence:
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.T.); (G.I.)
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.T.); (G.I.)
| | - Francesca Gimigliano
- Department of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.T.); (G.I.)
| |
Collapse
|
23
|
Central sensitization: clinical utility of a physiological concept for the International Statistical Classification of Diseases and Related Health Problems and for nociplastic pain. Pain 2022; 163:S99-S107. [PMID: 36099342 DOI: 10.1097/j.pain.0000000000002740] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/14/2022] [Indexed: 01/14/2023]
|
24
|
Korkmaz MD, Ceylan CM. Effect of dry-needling and exercise treatment on myofascial trigger point: A single-blind randomized controlled trial. Complement Ther Clin Pract 2022; 47:101571. [DOI: 10.1016/j.ctcp.2022.101571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/27/2022] [Accepted: 03/02/2022] [Indexed: 11/26/2022]
|
25
|
Ishiki H, Hasuo H, Matsuda Y, Matsuoka H, Hiramoto S, Higuchi M, Yoshida K, Tokoro A, Hatano Y, Hori T, Kinkawa J, Nojima M. Prevalence of myofascial pain syndrome and efficacy of trigger point injection in patients with incurable cancer. A multicenter, prospective observational study. (MyCar study). PAIN MEDICINE 2021; 23:1259-1265. [PMID: 34940848 DOI: 10.1093/pm/pnab350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Myofascial pain syndrome (MPS) is caused by overload or disuse of skeletal muscles. Patients with cancer are often forced to restrict their movement or posture for several reasons. The study was conducted to investigate the prevalence and risks of MPS in patients with incurable cancer. The efficacy of trigger point injection (TPI) was also explored. DESIGN AND METHODS This was a multi-center, prospective observational study. Patients with incurable cancer who started receiving specialist palliative care were enrolled. We investigated the MPS in this population and accompanying risk factors for restricting body movement. Pre- and post-TPI pain was also evaluated using a Numerical Rating Scale (NRS) in patients who received TPI. The primary outcome was the prevalence of MPS. RESULTS A total of 101 patients were enrolled from five institutions in Japan. Most of the patients (n = 94, 93.1%) had distant metastases and half of the patients (50, 49.5%) received anticancer treatment. Thirty-nine (38.6%) patients had MPS lesions at 83 sites. Multivariate analysis revealed that the significant risk factor for MPS was poor Performance Status (PS) (odds ratio 3.26, 95% confidence interval 1.18-9.02, p = 0.023).We performed TPI for 40 out of 83 MPS lesions. Mean NRS for MPS before TPI was 7.95, which improved to 4.30 after TPI (p < 0.001). CONCLUSIONS MPS was common in patients with incurable cancer and the risk factor identified in this study was poor performance status. TPI could be a treatment option.
Collapse
Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospiatl Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan.,Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Shuji Hiramoto
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Masaki Higuchi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Kohei Yoshida
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospiatl Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yutaka Hatano
- Department of Palliative Care, Daini Kyoritsu Hospital, Kawanishi, Japan
| | - Tetsuo Hori
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Junya Kinkawa
- Rehabilitation Department, Medical corporation Jinseikai, Chiba, Japan
| | - Masanori Nojima
- Rehabilitation Department, Medical corporation Jinseikai, Chiba, Japan.,Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
26
|
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
|
27
|
Jiang Q, Feng X, Liu D, Li T, Kuang X, Liu X, Li W, Li J. Pressing Intervention Promotes the Skeletal Muscle Repair of Traumatic Myofascial Trigger Points in Rats. J Pain Res 2021; 14:3267-3278. [PMID: 34703302 PMCID: PMC8528472 DOI: 10.2147/jpr.s333705] [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] [Received: 08/17/2021] [Accepted: 09/29/2021] [Indexed: 12/16/2022] Open
Abstract
Objective To observe the effect of pressing intervention on the skeletal muscle repair of myofascial trigger points (MTrPs) in rats and explore the mechanism of pressing intervention on the deactivation of trigger points. Methods Thirty SPF rats were randomly divided into blank group, model group and press group, with 10 rats in each group. The MTrPs models were established by blunt striking plus eccentric exercise, and then evaluated. The press group was given a pressing intervention with a self-made device for 14 days, and the rats in the other two groups were fed normally. Soft tissue tension (STT) D0.2 and pressure pain threshold (PPT) were measured before and after intervention. The skeletal muscle tissue at MTrPs was extracted and assessed by hematoxylin–eosin (HE) and Masson staining. The expression of collagen I, collagen III, α- smooth muscle actin (α-SMA), myosin heavy chain (MHC) and fibronectin (FN) were detected by Western Blotting. Enzyme linked immunosorbent assay (ELISA) was used to evaluate the expression of substance P (SP), 5-hydroxytryptamine (5-HT), cyclooxygenase 2 (COX-2) and prostaglandin E2 (PGE2). Results (1) Compared with the blank group, the PPT and D0.2 reduced (P < 0.05) in the model group; while compared with the model group, the PPT and D0.2 increased (P < 0.05) in the press group. (2) Compared with the blank group, the model group showed obvious spontaneous potentials with higher amplitude and frequency, which were also much higher than those of the press group (P < 0.05). (3) The HE and Masson staining results showed evident fibrosis in the muscle tissue of the model group, with a larger area of collagen fibers relative to that of the press group (P < 0.05). (4) The amount of collagen I, collagen III, FN, α- SMA, SP, 5-HT, COX-2 and PGE2 increased and the content of MHC decreased (P < 0.05) in the model group, as compared to the blank group; while all the substances (P < 0.05), instead of MHC which increased (P < 0.05), in the press group were decreased as compared to the model group. Conclusion Pressing intervention on the MTrPs in rats can alleviate chronic inflammation, inhibit fibrosis, promote skeletal muscle repair and relieve pain.
Collapse
Affiliation(s)
- Quanrui Jiang
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| | - Xiang Feng
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| | - Dan Liu
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| | - Tao Li
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| | - Xiaoxia Kuang
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| | - Xiaowei Liu
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| | - Wu Li
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| | - Jiangshan Li
- College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People's Republic of China
| |
Collapse
|
28
|
Peng BG, Liu YQ, Ma K. Editorial for the special issue of the Chinese Association for the Study of Pain. World J Clin Cases 2021; 9:2022-2026. [PMID: 33850921 PMCID: PMC8017508 DOI: 10.12998/wjcc.v9.i9.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/19/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023] Open
Abstract
The Ministry of Health of China officially issued a document, adding the first level diagnosis and treatment discipline “Algology” in the list of diagnosis and treatment subjects of medical institutions on July 16, 2007. As the most important pain academic organization in China, the Chinese Association for the Study of Pain has made outstanding contributions in promoting the development of pain discipline and in establishing pain standards and disease diagnosis and treatment guidelines. In this special issue, under the leadership of Yan-Qing Liu, Chairman of the 7th Committee of the Chinese Association for the Study of Pain, nine consensus and one guideline were included.
Collapse
Affiliation(s)
- Bao-Gan Peng
- Department of Orthopedics, The Third Medical Center, General Hospital of the Chinese People’s Liberation Army, Beijing 100039, China
| | - Yan-Qing Liu
- Department of Algology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Ke Ma
- Department of Algology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| |
Collapse
|