Dry Needling Versus Sham Needling for Myofascial Pain Syndrome: A Critically Appraised Topic

2020 ◽  
Vol 25 (6) ◽  
pp. 289-293
Author(s):  
Melissa Jack ◽  
Ryan Tierney ◽  
Jamie Mansell ◽  
Anne Russ
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Clinical Question ◽  
Myofascial Trigger Point ◽  
Dry Needling ◽  
Bottom Line

Focused Clinical Question: In patients with myofascial trigger point pain, does dry needling result in greater decreases in pain compared to sham needling? Clinical Bottom Line: The evidence supporting dry needling as more effective than sham needling in reducing patients’ pain is mixed.

CLINICAL-NEURO-PHYSIOLOGICAL CHARACTERISTICS OF MYOFASCIAL PAIN SYNDROME IN A PATIENT WITH LEFT HEMYPLEGIA AFTER INTRACEREBRAL HEMORRHAGIC STROKE

2021 ◽  
pp. 147-151
Author(s):  
S. L. Popel ◽  
T. P. Vasylyk ◽  
I. M. Boiko ◽  
S. L. Anokhina ◽  
M. V. Koval
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Motor Units ◽  
Myofascial Pain Syndrome ◽  
Healthy People ◽  
Physiological Characteristics ◽  
Myofascial Trigger Point ◽  
Characteristic Symptom ◽  
Symptom Complex

Myofascial pain syndrome (MFPS) is one of the most common comorbid pathological processes that develops in skeletal muscle in patients with stroke, which is manifested by local seals and pain in various parts of the muscle. Despite the fact that the interest in MFPS arose in the last century, the intimate mechanisms of its development and course remain to be fully explored. It was found that the main manifestations of MFPS were the presence of miofascial trigger point in the area of palpation of the corresponding muscle with local pain and hypersensitivity within the palpated cord-segmentes, the characteristic pattern of reflected pain and reflected autonomic phenomenon, local convulsive response during transverse palpation. It is accompanied by muscle fatigue and significant muscle weakness without severe atrophy. Attention is drawn to the clear recurrence-reproducibility of pain, ie the so-called "recognizable" pain. All of the above symptoms constitute a general pattern of the disease, which has diagnostic value and is proposed for use as prognostic parameters with the obligatory use of the results of electromyographic examination. Diagnosis of active and latent MTP was performed on the basis of generally accepted l signs. The greatest discomfort for the patient is the presence of active MTP with characteristic spontaneously reproducing pain. Latent MTP is detected in up to 90% of cases among healthy people, and adverse factors only contribute to their transition to an active state with a characteristic symptom complex. The presence of an active myofascial trigger point with a characteristic spontaneously reproducing pain is the most painful manifestation. Latent MTP is also detected in most cases among healthy people, and unfavorable factors only contribute to their transition to an active state with a characteristic symptom complex. The study of the number of turns of the adhesive part of the potential in the zone of active ICC showed that there is a concentration of fibers in the zone of one motor units (MU). The average value of this indicator increases in the early stages of the process by 2 times. Even a small degree of desynchronization of the potentials of individual MU causes an increase in the number of rounds, which reflects the number of fibers involved in the generation of MC PMU. Absence of spontaneous muscle fibers (MF) activity, registration of end plate (EP) activity, PMU parameters such as amplitude decrease, shift of neurohistogram of potential distribution by duration towards smaller values or high percentage of polyphasicity, due to increase in number of turns, and also change  their adhesive part, increase of MF density in zone MTP - they all determine changes in structural and functional parameters by muscle type. The work is devoted to the clinical, neuro-physiological characteristics of a patient with MFPS on the background of intracerebral hemorrhage and left hemyplegia based on the analysis of the neuro-functional organization of the motor units of the back muscles. Substantiated genesis and possible mechanism of development and formation of myofascial trigger point in such patients.

Concomitant Sympathetically Mediated Pain and Myofascial Trigger Point Pain

1994 ◽  
Vol 12 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Peter Baldry
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Myofascial Trigger Point ◽  
Sympathetically Maintained Pain ◽  
Myofascial Trigger Points ◽  
Release Of Noradrenaline ◽  
Genetically Determined

It is not sufficiently well recognised that the reflex sympathetic dystrophy syndrome (RSDS) and the myofascial pain syndrome (MPS) may develop concomitantly. This happens because they have similar aetiological factors, with trauma being by far the commonest. Everyone is liable to develop nociceptor pain as a result of trauma-induced activation and sensitisation of C afferent skin and Group IV muscle nociceptors; also A-β mediated pain as a result of the sensory afferent barrage produced by these nociceptors giving rise to sensitisation of dorsal horn transmission neurones. With most people these neural changes lead only to the development of MPS. In a minority of people, possibly those with a genetically determined predisposition, this sensory afferent barrage also causes changes to take place in the sympathetic nervous system, with the development of a characteristic burning type of sympathetically mediated pain. This may develop alone or in association with myofascial trigger point pain. There is much controversy concerning the mechanisms for development of RSDS pain. One theory is that the pain develops as a result of the nociceptor-induced sensory afferent barrage setting up aberrant sympathetic efferent activity. This results in the release of noradrenaline which binds to α-1 adrenoreceptors in the walls of the nociceptors, exciting them further. Much research, however, still has to be done before the development of sympathetically maintained pain can be adequately explained. It is stressed that for the successful treatment of RSDS early diagnosis is essential. Treatment involves sympathetic blockade either by the injection of local anaesthetic into a sympathetic ganglion, or by the regional infusion of a catecholamine depleting drug. Sympathetically maintained pain is morphine resistant and is therefore unlikely to be relieved by acupuncture, the analgesic effect of which is mediated by opioid peptides. The main place for acupuncture is in the treatment of concomitant myofascial trigger point pain. It is emphasised that in all cases of RSDS it is essential to search for myofascial trigger points and, when present, to deactivate these by means of acupuncture stimulation of A-δ nerve fibres present in the skin and subcutaneous tissues at the trigger point sites.

Ultrasound Guided Trigger Point Injections in Myofascial Pain Syndrome

2015 ◽  
Vol 26 (3) ◽  
pp. 82-84
Author(s):  
Shiva Prasad ◽  
Vijay LNU ◽  
Gururaj Bangari ◽  
Priyanka Patil ◽  
Spurti N Sagar
Keyword(s):  
Skeletal Muscles ◽  
Ultrasound Guidance ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Dry Needling ◽  
Deep Tissue ◽  
Repetitive Trauma

Abstract Trigger points as a cause of musculoskeletal or myofascial pain syndrome is well documented. Trigger points (Tr Ps) are tender and hypersensitive nodules seen in skeletal muscles which develop as a result of sudden or repetitive trauma to the muscles. They cause contractile state of a muscle with local or radiating pain. Active trigger points cause intense pain with limitation of movements of the muscles. The treatment involves deactivating the trigger points, usually done by various methods. Most common practice is myotherapy which involves deep tissue massage which is painful and time consuming. Dry needling and needling with anaesthetic injaection have been successfully used by many. Recently, ultrasound guidance is used to locate the trigger points and to accurately place the needle in to them to deactivate, thus preventing complications of blind procedures.

scholarly journals Dry needling versus ultrasonic in treating cervical myofascial pain syndrome

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Ali ◽  
A K Elzohiery ◽  
M M Arafa ◽  
N A Elkadery
Keyword(s):  
Skeletal Muscles ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Trapezius Muscle ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Ultrasonic Waves ◽  
Dry Needling ◽  
Myofascial Trigger Points

Abstract Background Myofascial pain syndrome (MPS) is a complex pain syndrome characterized by myofascial trigger points (MTrPs) in skeletal muscles. Ultrasound (US) therapy is one of the main devices used in physical therapy, for the treatment of MTrPs in MPS. Dry needling is skilled technique also used in the treatment of MTrPs in MPS. Purpose This study aimed to compare the effect of dry needling with the effect of ultrasonic waves in the treatment of cervical myofascial pain. Subjects a sample of 30 patients with myofascial trigger points in trapezius muscle was randomly chosen and divided into 2 groups each contains 15 patients. Methods the first group was treated by ultrasonic waves in a pulsed mode (1MHz, 1W/cm², 1:1 ratio) 5 min to each trigger point and the second group was treated with deep dry needling (peppering technique) to each trigger point with a rate of 3 times per week for 3 weeks. Results All patients shows significant improvement (P > 0.001) immediately after treatment period with disappearance of trigger points, increasing in cervical ROM and decreasing in VAS ; but 3 weeks later trigger points reappeared, ROM decreased and VAS increased again. Conclusion both modalities of treatment were considered effective in treating myofascial pain syndrome.

scholarly journals The effectiveness of myofascial trigger point therapy on myofascial pain syndrome trigger points

1994 ◽  
Author(s):  
◽  
Andrew D Jones
Keyword(s):  
Back Pain ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Controlled Trial ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Myofascial Trigger Point ◽  
Trigger Point Therapy ◽  
Single Blind

The efficacy of myofascial trigger point therapy in treatment of myofasciitis was evaluated in a single blind, randomised, placebo controlled trial. The patient population consisted of twenty individuals who presented with one of the following: upper-back pain, shoulder pain, and neck-pain and or headaches and who were diagnosed as having myofasciitis.

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