Trigger point injections for axial back pain in adolescents

2021 ◽  
Vol 14 (6) ◽  
pp. e242727
Author(s):  
Elisha Peterson ◽  
Julia Finkel
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Trigger Point ◽  
Trigger Points ◽  
Treatment Delay ◽  
Normal Anatomy ◽  
Myofascial Trigger Points ◽  
Subsequent Decrease ◽  
Musculoskeletal Anatomy

Adolescents who participate in athletics or have abnormal musculoskeletal anatomy have higher incidences of back pain than non-athletic peers with normal anatomy. Significant time and money spent in diagnostic evaluations for axial back pain can result in treatment delay causing a subsequent decrease in quality of life. Myofascial trigger points are a commonly overlooked reason for axial back pain. They develop due to an abnormal myoneural connection in the setting of muscle overuse. Trigger point injections are a technically simple intervention that is both diagnostic and therapeutic in alleviating trigger point-mediated back pain. There are few complications from these injections, and they should be considered prior to surgical referral or fluoroscopic-guided interventions.

scholarly journals Electrical Dry Needling Versus Conventional Physiotherapy in the Treatment of Active and Latent Myofascial Trigger Points in Patients With Nonspecific Chronic Low Back Pain

2021 ◽  
Author(s):  
Inmaculada C. Lara-Palomo ◽  
Esther Gil-Martínez ◽  
Eduardo Antequera-Soler ◽  
Adelaida María Castro-Sánchez ◽  
Manuel Fernández-Sánchez ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Trigger Points ◽  
Low Back ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Conventional Physiotherapy ◽  
The University

Abstract Background: Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of non-specific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Methods and Analysis. This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40, respectively) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 3 sessions will be administered once a week for 3 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength, and lumbar mobility will be recorded at 3 weeks (post-immediate) and 2 months after the end of treatment.Ethics and dissemination. Ethics and Research Committee of the University of Almería (UALBIO2020/044). The results of the study will made available to researchers, clinicians and health professionals through publications in international journals and presentations in conferences.Trial registration number: NCT04804228. Recruiting

Dose Effect of Local Betamethasone Injection in Low Back Pain

2018 ◽  
Vol 69 (9) ◽  
pp. 2382-2384
Author(s):  
Abu Awwad Ahmed ◽  
Radu Prejbeanu ◽  
Dinu Vermesan ◽  
Bogdan Deleanu ◽  
Marius Ionitescu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Clinical Examination ◽  
Trigger Point ◽  
Dose Effect ◽  
Lumbar Region ◽  
Low Back ◽  
Point Injection

The purpose of the study is to show the effects and evolution of patients with back pain treated with a different dose of betamethasone, analyzing both their evolution in terms of pain perception and lifestyle. In this study, 43 patients diagnosed with back pain in the lumbar region were included over a 12-month period. Patients were divided into two categories, depending on the dose of betamethasone administered. At 1 month control after the last injection, the first group of patients, a total of 22, given the local injection of betamethasone, trigger point injection, administering the usual dose: 1 ampoule of betamethasone 1 mL + 1 ampoule 1% xyline, at the clinical examination, they claimed that pain was reduced by about 70%, sustaining the improvement of the quality of life. The same group of patients, called for the final evaluation, at 3 month, claimed the pain was reduced by about 95%, as compared to the initial pain before starting the treatment. In the second category, where 21 patients were treated by local injections, trigger point injection, administering the modified dose of betamethasone: � ampoule of betanethasone 0.5 mL + 1 ampule 1% xyline, at 1 month control after the last injection, at the clinical examination they claimed thtat the pain was reduced with just 40%, sustaining an average quality of life. Even if a low dose of betamethasone shows significantly less systemic effects, a higher dose is required in the treatment of low back pain to have the desired effect and to significantly improve the quality of life of the patient.

scholarly journals Effectiveness of Bupivacaine Trigger Points Injections in the Treatment of Myofascial Pain Syndrome

2020 ◽  
Vol 1 (1) ◽  
pp. 23-28
Author(s):  
Rabiu Mohammed Bashir ◽  
Afeez Abdulrahman ◽  
Zakari Suleiman
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Hypodermic Needle ◽  
Myofascial Trigger Points ◽  
Pain Disability

Background: Myofascial pain syndrome is a regional or widespread muscular pain associated with tenderness localized to linear or nodular hardening, trigger points in one or group of muscles. It is a major cause of time loss from work and low quality of life. Injections of myofascial trigger points either with local anaesthetics, steroid, normal saline or without any agent have been proven to provide pain relief. This study aims to determine the effectiveness of trigger point injection with bupivacaine in treatment of myofascial pain syndrome and improvement in quality of life. Methods: After Institutional Ethical Committee approval, forty one patients aged 16 years and above with myofacial pain syndrome had 0.5mls of 0.25% plain bupivacaine trigger points injections with size 26G 11 /2 inch hypodermic needle. Pain was assessed using Numerical Rating Scale and Pain disability questionnaire was administered to all the patients before the procedures and 1 month post-intervention (follow-up visits) to assessed functional and psychological component of pain disability scale and their response to treatment. Results:

scholarly journals Effectiveness of a Home Program of Ischemic Pressure Followed by Sustained Stretch for Treatment of Myofascial Trigger Points

2000 ◽  
Vol 80 (10) ◽  
pp. 997-1003 ◽  
Author(s):  
William P Hanten ◽  
Sharon L Olson ◽  
Nicole L Butts ◽  
Aimee L Nowicki
Keyword(s):  
Back Pain ◽  
Pain Intensity ◽  
Trigger Point ◽  
Pressure Pain Threshold ◽  
Trigger Points ◽  
Analysis Of Covariance ◽  
Control Treatment ◽  
Myofascial Trigger Points ◽  
Home Program ◽  
Pressure Algometer

Abstract Background and Purpose. Myofascial trigger points (TPs) are found among patients who have neck and upper back pain. The purpose of this study was to determine the effectiveness of a home program of ischemic pressure followed by sustained stretching for the treatment of myofascial TPs. Subjects. Forty adults (17 male, 23 female), aged 23 to 58 years (X̄=30.6, SD=9.3), with one or more TPs in the neck or upper back participated in this study. Methods. Subjects were randomly divided into 2 groups receiving a 5-day home program of either ischemic pressure followed by general sustained stretching of the neck and upper back musculature or a control treatment of active range of motion. Measurements were obtained before the subjects received the home program instruction and on the third day after they discontinued treatment. Trigger point sensitivity was measured with a pressure algometer as pressure pain threshold (PPT). Average pain intensity for a 24-hour period was scored on a visual analog scale (VAS). Subjects also reported the percentage of time in pain over a 24-hour period. A multivariate analysis of covariance, with the pretests as the covariates, was performed and followed by 3 analyses of covariance, 1 for each variable. Results. Differences were found between the treatment and control groups for VAS scores and PPT. No difference was found between the groups for percentage of time in pain. Conclusion and Discussion. A home program, consisting of ischemic pressure and sustained stretching, was shown to be effective in reducing TP sensitivity and pain intensity in individuals with neck and upper back pain. The results of this study indicate that clinicians can treat myofascial TPs through monitoring of a home program of ischemic pressure and stretching.

Disability and quality of life in patients with low back pain: Focus on sex and gender: A cross-sectional study

2021 ◽  
pp. 1-8
Author(s):  
Yen-Mou Lu ◽  
Chung-Hwan Chen ◽  
Yi-Jing Lue
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Gender Identity ◽  
Gender Role ◽  
Low Back ◽  
Sex And Gender ◽  
Cross Sectional ◽  
And Gender

BACKGROUND: Sex and gender affect responses to pain, but little is known about disability and quality of life. OBJECTIVES: To investigate the effects of sex and gender on disability and health-related quality of life (HRQOL) in patients with low back pain. METHODS: Ninety-three patients with low back pain were included in this cross-sectional survey study. Disability, HRQOL and gender identity were respectively assessed with the Oswestry Disability Index, Short Form-36 and Bem Sex Role Inventory. The participants were classified into four gender role orientations (masculinity, femininity, androgyny and undifferentiated). One-way analysis of variance was used to analyze both the sex and the gender role orientation. RESULTS: Females had higher disability than males (p< 0.05), but in gender identity, no significant difference was found. Seven domains of HRQOL were lower than the healthy norms. Males experienced greater impacts than females on vitality and mental health (p< 0.05). For gender identity, five domains of HRQOL had significant differences (p< 0.05). Masculinity orientation had the least impact on four domains (p< 0.05), while undifferentiated orientation had the largest impact on all domains. CONCLUSION: Sex and gender effects can be used to analyze disability and HRQOL in patients with low back pain. Females have higher disability, while HRQOL is greatly influenced by different gender role orientations.

scholarly journals The Automatization of a New Thermography Method Using Invasive Nociceptive Stimulation to Confirm an Autonomic Phenomenon within a Trigger Point Referred Pain Zone

2021 ◽  
Vol 11 (7) ◽  
pp. 893
Author(s):  
Elżbieta Skorupska ◽  
Tomasz Dybek ◽  
Michał Rychlik ◽  
Marta Jokiel ◽  
Paweł Dobrakowski
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Trigger Point ◽  
Invasive Procedure ◽  
Trigger Points ◽  
International Classification Of Diseases ◽  
Referred Pain ◽  
Low Back ◽  
Classification Of Diseases ◽  
Software Utility

The trigger points (TrPs) related to chronic low back pain that mimic sciatica have been lately recognized and included in the International Classification of Diseases, 11th Revision. This study examined the MATLAB software utility for the objective stratification of low back pain patients using the Minimally Invasive Procedure (MIP). The two diagnostic MIP parameters were: average temperature (ΔTavr) and autonomic referred pain (AURP). Chronic sciatica patients with TrPs (n = 20) and without TrPs (n = 20) were examined using the MIP. A significant increase in both parameters was confirmed for the thigh ROI of the TrP-positive patients, with ΔTavr being the leading parameter (p = 0.016, Exp(β) = 2.603). A continued significance of both parameters was confirmed from 6′00″ to 15′30″ (p < 0.05). The maximum AURP value was confirmed at 13′30″ (p < 0.05) (TrPs(+) 20.4 ± 19.9% vs. TrPs(-) 3.77 ± 9.14%; p = 0.000; CI (0.347,0.348)).

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