Example Myofascial Pain Case: Quadratus Lumborum Trigger Point and Chronic Low Back Pain

2020 ◽  
pp. 261-274
Author(s):  
Bonnie Huang Hall
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Low Back ◽  
Quadratus Lumborum

Association of Myofascial Pain in Patients with Thoracolumbar Scoliosis, Kyphoscoliosis or Spinal Deformity Attending a Tertiary Care Hospital in Uttar Pradesh, India

2021 ◽  
Vol 8 (27) ◽  
pp. 2392-2398
Author(s):  
Sanjay Kumar ◽  
Sandeep Khuba ◽  
Sujeet Gautam ◽  
Anil Agarwal ◽  
Muralidharan Vittobaraju ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Deformity ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Care Hospital ◽  
Low Back ◽  
Vas Score ◽  
Quadratus Lumborum ◽  
Cobb’S Angle

BACKGROUND Scoliotic spine puts undue strain on the back musculature which may lead to the production of myofascial pain syndrome (MPS). The purpose of this study was to find out the association of myofascial pain of iliopsoas and quadratus lumborum in scoliotic patients and to look for any correlation between the degree of deformity (Cobb’s angle) and severity of myofascial pain. METHODS A total of 60 patients of low back pain with spinal deformity were enrolled in the study. The severity of the spinal deformity and pain was calculated with Cobb’s angle and visual analogue scale (VAS) pain scale (0 - 100) respectively. Patients with iliopsoas and quadratus myofascial pain underwent trigger point therapy along with regimen of stretching exercises. VAS scores were recorded at 0 - hour, 2 - hour, 2 - weeks, 1 month and 3 months after the procedure. RESULTS Forty-four patients out of 60 had myofascial pain of iliopsoas or quadratus lumborum or both. 15, 31 and 12 patients had Cobb’s angle of 10 - 20, 21 - 30 and 31 - 40 degree, respectively. Trigger point injections were performed in 38 patients. The pre-procedure median VAS score was 70, at 0 hour 45, at 2 hour 40, at 2 weeks 30, at 1 month 30 and at 3 months 30. A significant reduction (P < 0.001) in VAS score was observed till 3 months. CONCLUSIONS The myofascial pain of iliopsoas and quadratus lumborum is an important source of low back pain in patients with scoliosis. There is no correlation between the degree of scoliosis and severity of low back pain. KEYWORDS Scoliosis, Kyphoscoliosis, Thoraco-Lumbar Spinal Deformity, Myofascial Pain, Iliopsoas, Psoas Major, Quadratus Lumborum, Low Back Pain

Local and Remote Sustained Trigger Point Therapy for Exacerbations of Chronic Low Back Pain

Spine ◽  
1997 ◽  
Vol 22 (7) ◽  
pp. 786-797 ◽  
Author(s):  
Francisco M. Kovacs ◽  
Víctor Abraira ◽  
Francisco Pozo ◽  
David G. Kleinbaum ◽  
Juan Beltrán ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Trigger Point ◽  
Low Back ◽  
Trigger Point Therapy

scholarly journals LOW BACK PAIN;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Bilal Khan ◽  
Khalid Khanzada ◽  
Sajjad Ullah ◽  
Usman Haqqani
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Radiological Examination ◽  
Low Back ◽  
Inclusion Criteria ◽  
Female Ratio

Objectives: To know about the efficacy of trigger point injections in low back pain. Study Design: Prospective observational study. Setting: Out-patient Department of Naseer Teaching Hospital, Peshawar, and private clinic of the author. Period: March 2016 to January 2017. Materials and Methods: All patients with low back pain were evaluated. Inclusion criteria was; all patients with low back pain greater than 3 months duration whether operated or not, patients with non-radiating symptoms, patients with acceptable radiology (no listhesis, obvious stenosis/disk, albeit some degree of degeneration was acceptable), further helping points were morning exacerbations and elicitation of tender spot by the patient. The exclusion criteria was Low back pain with less than 3 months duration, obvious pathology on radiological examination, radiating symptoms, generalized low back pain without any point tenderness elicitation. The patients were sent home on medications and asked to avoid strenuous activity for a couple of weeks, they were followed after one month and asked about their pain satisfaction. Results: Approximately 2800 patients were evaluated for low back pain and of them 237 (8.46%) patients were upto the inclusion criteria, only 112 patients had agreed to have a TPI, which showed an acceptance rate of 47.25%. There were 65 males and 58 females, with a male to female ratio approaching almost 1:1. The age range was from 18 to 48 years, and the mean age was 32 years. The minimum duration of pain was 3 months and the maximum duration was 4 years, 4 patients had undergone back surgery. Almost all patients pointed out the pain spot, but a typical trigger point was elicited in 58(51.78%) patients, while morning exacerbation was present in 43(38.38%). Radiological examination was performed on all patients in the form of simple xrays and Magnetic resonance imaging scans, it was acceptable in 67%, as patients with radiating symptoms were already excluded. 10.71% (n=12) patients had some problems. Conclusion: In patients with chronic low back pain due to Myofascial Pain Syndrome (MPS) eliciting the trigger points by either elaboration through history or physical examination and treating them with a TP injection with lignocaine and a steroids has good short term results.

scholarly journals Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part II: Myofascial Pain

Pain Medicine ◽  
2015 ◽  
Vol 16 (7) ◽  
pp. 1282-1289 ◽  
Author(s):  
Anthony J. Lisi ◽  
Paula Breuer ◽  
Rollin M. Gallagher ◽  
Eric Rodriguez ◽  
Michelle I. Rossi ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Older Adult ◽  
Chronic Low Back Pain ◽  
Myofascial Pain ◽  
Low Back

Trigger Point Acupuncture Treatment of Chronic Low Back Pain in Elderly Patients – a Blinded Rct

2004 ◽  
Vol 22 (4) ◽  
pp. 170-177 ◽  
Author(s):  
Kazunori Itoh ◽  
Yasukazu Katsumi ◽  
Hiroshi Kitakoji
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Acupuncture Treatment ◽  
Trigger Point ◽  
Trigger Points ◽  
Acupuncture Group ◽  
Low Back ◽  
Superficial Needling

Objective There is some evidence for the efficacy of acupuncture in chronic low back pain, but it remains unclear which acupuncture modes are most effective. Our objective was to evaluate the effects of two different modes of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared to standard acupuncture treatment. Methods Thirty five consecutive out-patients (25 women, 10 men; age range: 65–81 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to one of three groups over 12 weeks. Each group received two phases of acupuncture treatment with an interval between them. Nine patients dropped out during the course of the study. The standard acupuncture group (n=9) received treatment at traditional acupuncture points for low back pain, while the other acupuncture groups received superficial (n=9) or deep (n=9) treatments on trigger points. Outcome measures were VAS pain intensity and Roland Morris Questionnaire. Results After treatment, the group that received deep needling to trigger points reported less pain intensity and improved quality of life compared to the standard acupuncture group or the group that received superficial needling to trigger points, but the differences were not statistically significant. There was a significant reduction in pain intensity between the treatment and interval in the group that received deep needling to trigger points (P<0.01), but not in the standard acupuncture group or the group that received superficial needling to trigger points. Conclusion These results suggest that deep needling to trigger points may be more effective in the treatment of low back pain in elderly patients than either standard acupuncture therapy, or superficial needling to trigger points.

scholarly journals Acupuncture for Chronic Pain in Japan: A Review

2007 ◽  
Vol 4 (4) ◽  
pp. 431-438 ◽  
Author(s):  
Kazunori Itoh ◽  
Hiroshi Kitakoji
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Animal Studies ◽  
Pain Treatment ◽  
Trigger Point ◽  
Case Reports ◽  
Low Back ◽  
Acupuncture And Moxibustion

Many Japanese reports of acupuncture and moxibustion for chronic pain are not listed in medical databases such as Medline. Therefore, they are not easily accessible to researchers outside of Japan. To complement existing reviews of acupuncture and moxibustion for chronic pain and to provide more detailed discussion and analysis, we did a literature search using ‘Igaku Chuo Zasshi Wed’ (Japana Centra Revuo Medicina) and ‘Citation Information by National Institute of Information’ covering the period 1978–2006. Original articles and case reports of acupuncture and moxibustion treatment of chronic pain were included. Animal studies, surveys, and news articles were excluded. Two independent reviewers extracted data from located articles in a pre-defined structured way, and assessed the likelihood of causality in each case. We located 57 papers written in Japanese (20 full papers, 37 case reports). Conditions examined were headache (12 trials), chronic low back pain (9 trials), rheumatoid arthritis (8 trials), temporomandibular dysfunction (8 trials), katakori (8 trials) and others (12 trials). While 23 were described as clinical control trials (CCTs), 11 employed a quasi-random method. Applying the 5-point Jadad quality assessment scoring system, the mean score was 1.5 ± 1.3 (SD). Eleven (52%) of the CCTs were conducted to determine a more effective procedure for acupuncture; these compared a certain type of acupuncture with another type of acupuncture or specific additional points. In particular, the trigger point acupuncture was widely used to treat chronic low back pain in Japan. Many reports of chronic pain treatment by acupuncture and moxibustion are listed in Japanese databases. From the data, we conclude that there is limited evidence that acupuncture is more effective than no treatment, and inconclusive evidence that trigger point acupuncture is more effective than placebo, sham acupuncture or standard care.

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