scholarly journals Experienced versus Inexperienced Interexaminer Reliability on Location and Classification of Myofascial Trigger Point Palpation to Diagnose Lateral Epicondylalgia: An Observational Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Raquel Mora-Relucio ◽  
Susana Núñez-Nagy ◽  
Tomás Gallego-Izquierdo ◽  
Alma Rus ◽  
Gustavo Plaza-Manzano ◽  
...  
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Strong Association ◽  
Trigger Points ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Myofascial Trigger Points ◽  
Lateral Epicondylalgia ◽  
Interexaminer Reliability

The purpose was to evaluate the interexaminer reliability of experienced and inexperienced examiners on location and classification of myofascial trigger points (MTrPs) in two epicondylar muscles and the association between the MTrP found and the diagnosis of lateral epicondylalgia (LE). Fifty-two pianists (some suffered LE) voluntarily participated in the study. Three physiotherapists (one inexperienced in myofascial pain) examined, located, and marked MTrPs in the extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) muscles. Forearms were photographed and analyzed to establish the degree of agreement on MTrPs diagnosis. Data showed 81.73% and 77.88% of agreement on MTrP classification and 85.58% and 72.12% on MTrP location between the expert evaluators for ECRB and EDC, respectively. The agreement on MTrP classification between experienced and inexperienced examiners was 54.81% and 51.92% for ECRB and 50.00% and 55.77% for EDC. Also, agreement on MTrP location was 54.81% and 60.58% for ECRB and 48.08% and 48.08% for EDC. A strong association was found between presence of relevant MTrPs, LE diagnosis, and forearm pain when the examiners were experts. The analysis of location and classification of MTrPs in the epicondylar muscles through physical examination by experienced evaluators is reliable, reproducible, and suitable for diagnosing LE.

Association of myofascial trigger points in neck and shoulder region with depression, anxiety and stress among university students

2021 ◽  
pp. 1-11
Author(s):  
Muhammad Kashif ◽  
Shahira Tahir ◽  
Faiqa Ashfaq ◽  
Sania Farooq ◽  
Wizra Saeed ◽  
...  
Keyword(s):  
University Students ◽  
Myofascial Pain ◽  
Neck Region ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Cross Sectional Study ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Myofascial Trigger Points

Abstract Objective: To determine the prevalence of myofascial trigger points in the shoulder and neck region, and to assess association with depression, anxiety and stress. Method: The cross-sectional study was conducted from January to September 2019 at Riphah International University, Faisalabad, Pakistan, and comprised students from different universities in Faisalabad. Myofascial trigger points were identified among the subjects using palpation method by a therapist. Depression anxiety stress scale was used to determine the level of depression, anxiety and stress. Data was analysed using SPSS 20. Results: Of the 2000 subjects, 970(49%) were male and 1030(52%) were female. The overall age range was 18-25 years. Myofascial trigger points were present in 1727(86.4%) subjects and absent in 273(13.7%). The trigger points had significant association with depression, anxiety and stress (p<0.001). Conclusion: Myofascial trigger points were quite common among university students and were associated with depression, anxiety and stress. Key Words: Anxiety, Depression, Myofascial trigger points, Myofascial pain syndrome, Stress, Students. Continuous...

Allodynia is associated with a higher prevalence of depression in migraine patients

Cephalalgia ◽  
2014 ◽  
Vol 34 (14) ◽  
pp. 1187-1192 ◽  
Author(s):  
MA Louter ◽  
KJ Wardenaar ◽  
G Veen ◽  
WPJ van Oosterhout ◽  
FG Zitman ◽  
...  
Keyword(s):  
Migraine Attack ◽  
Strong Association ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Specific Factor ◽  
Attack Frequency ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Specific Factors

Introduction There is a strong association between migraine and depression. The aim of this study is to identify migraine-specific factors involved in this association. Methods We conducted a cross-sectional study in a large, well-defined cohort of migraine patients ( n = 2533). We assessed lifetime depression using validated questionnaires, and diagnosed migraine based on the International Classification of Headache Disorders III-beta criteria. Multivariate regression analyses were conducted. Results Of the 2533 migraineurs that were eligible, 1137 (45%) suffered from lifetime depression. The following independent factors were associated with an increased depression prevalence: i) migraine-specific risk factors: high migraine attack frequency and the presence of allodynia, ii) general factors: being a bad sleeper, female gender, high BMI, being single, smoking, and a low alcohol consumption. Conclusion This study identified allodynia, in addition to high migraine attack frequency, as a new migraine-specific factor associated with depression.

scholarly journals Ultrasound-Guided Trigger Point Injections in the Cervicothoracic Musculature: A New and Unreported Technique

2008 ◽  
Vol 6;11 (12;6) ◽  
pp. 885-889 ◽  
Author(s):  
Kenneth P. Botwin
Keyword(s):  
Ultrasound Guidance ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Trigger Points ◽  
Target Tissue ◽  
Obese Patients ◽  
Needle Placement ◽  
Ultrasound Guided ◽  
Myofascial Trigger Points ◽  
Point Injection

Background: Myofascial pain is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The myofascial pain syndrome is one of the largest groups of under diagnosed and under treated medical problems encountered in clinical practice. Trigger points are commonly seen in patients with myofascial pain which is responsible for localized pain in the affected muscles as well as referred pain patterns. Correct needle placement in a myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point injection to help reduce or relieve myofascial pain. In obese patients, these injections may not reach the target tissue. In the cervicothoracic spine, a misguided or misplaced injection can result in a pneumothorax. Here, we describe an ultrasound-guided trigger point injection technique to avoid this potential pitfall. Office based ultrasound-guided injection techniques for musculoskeletal disorders have been described in the literature with regard to tendon, bursa, cystic, and joint pathologies. For the interventionalist, utilizing ultrasound yields multiple advantages technically and practically, including observation of needle placement in real-time, ability to perform dynamic studies, the possibility of diagnosing musculoskeletal pathologies, avoidance of radiation exposure, reduced overall cost, and portability of equipment within the office setting. To our knowledge, the use of ultrasound guidance in performing trigger point injection in the cervicothoracic area, particularly in obese patients, has not been previously reported. Methods: A palpable trigger point in the cervicothoracic musculature was localized and marked by indenting the skin with the tip of a plastic needle cover. The skin was then sterile prepped. Then, using an ultrasound machine with sterile coupling gel and a sterile latex free transducer cover, the musculature in the cervicothoracic spine where the palpable trigger point was detected was visualized. Then utilizing direct live ultrasound guidance, a 25-gauge 1.5 inch needle connected to a 3 mL syringe was placed into the muscle at the exact location of the presumed trigger point. This guidance helps confirm needle placement in muscle tissue and not in an adipose tissue or any other non-musculature structure. Results: The technique is simple to be performed by a pain management specialist who has ultrasound system training. Conclusion: Ultrasound-guided trigger point injections may help confirm proper needle placement within the cervicothoracic musculature. The use of ultrasound-guided trigger point injections in the cervicothoracic musculature may also reduce the potential for a pneumothorax by an improperly placed injection. Key words: Trigger point injection, myofascial pain, ultrasound

scholarly journals Prevalence of Myofascial Trigger Points in Poststroke Patients With Painful Shoulders: A Cross‐Sectional Study

PM&R ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1077-1082 ◽  
Author(s):  
Jorge H. Villafañe ◽  
Maria P. Lopez‐Royo ◽  
Pablo Herrero ◽  
Kristin Valdes ◽  
Raquel Cantero‐Téllez ◽  
...  
Keyword(s):  
Trigger Points ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Myofascial Trigger Points

scholarly journals Myofascial Pain Syndrome: A Concise Update on Clinical, Diagnostic and Integrative and Alternative Therapeutic Perspectives

2019 ◽  
pp. 1-14 ◽  
Author(s):  
Naseem A. Qureshi ◽  
Hamoud A. Alsubaie ◽  
Gazzaffi I. M. Ali
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Muscle Twitch ◽  
Myofascial Trigger Points ◽  
Pain Syndromes ◽  
Clinical Diagnostic ◽  
Regional Pain Syndromes

Background: Myofascial pain syndrome is a common multifactorial condition that presents with key manifestations and comorbid with many systemic diseases and regional pain syndromes. Objective: This study aims to concisely review clinical, diagnostic and integrative therapeutic aspects of myofascial pain syndrome. Methods: E-searches (2000-2019) using keywords and Boolean operators were made and using exclusion and inclusion criteria, 50 full articles that focused on myofascial pain syndrome were retained for this review. Results: Myofascial pain syndrome is a multidimensional musculoskeletal disorder with ill-understood etiopathogenesis and pathophysiology and characterized by tender taut muscle with myofascial trigger points, muscle twitch response, specific pattern of referred pain and autonomic symptoms. A variety of pharmacological and nonpharmacological therapies with variable efficacy are used in myofascial pain syndrome, the latter modalities such as education, stretching and exercises, moist hot and cold packs, dry needling and myofascial massage or myofascial trigger point massage are used as first line options. Conclusion: Myofascial pain syndrome and trigger points initiated by repeated strains and injuries co-occur with diverse physical diseases and regional pain syndromes, which need comprehensive diagnostic evaluation using multiple methods. Several interventions are used in patients with myofascial pain syndrome who effectively respond to myofascial massage. This study calls for exploring etiopathogenesis and basic pathophysiological mechanisms underlying myofascial pain syndrome in future.

scholarly journals The Relationship Between The Body Mass Index and The Pain Threshold in Myofascial Pain Syndrome: A Cross-sectional Study

2017 ◽  
Vol 6 (01) ◽  
pp. 8
Author(s):  
Ibrahim Agung ◽  
Nyoman Murdana ◽  
Herdiman Purba
Keyword(s):  
Pain Threshold ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Cross Sectional Study ◽  
The Body ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Relationship

Introduction: The obesity on the myofascial pain syndrome (MPS) was reduced the pain thresholds, leads todecreasing of physical functioning and quality of life. The obese group was more sensitive to pain due to the proinflammatorycondition. This study aimed to examined the relationship between the Body Mass Index (BMI)and the pain threshold in MPS patients.Methods and Materials: This study was a cross-sectional study, conducted in an outpatient clinic of MedicalRehabilitation Department of Dr. Cipto Mangunkusumo Hospital, Jakarta. The subjects recruited consecutively.The pain intensity was assessed subjectively by the Visual Analogue Scale (VAS) score from 0 to 10. Thenumber of the trigger points (TP) were examined palpation manually. The pain threshold was evaluated by thealgometer (Kg) on the upper trapezius muscles.Results: The study has recruited 30 patients, aged 40,5 (20-54). The BMI was 24.97 ± 3.39 Kg/M2. The VASscore was 6 (5-8). The number of the TP was 5.83 ± 1.74. The pain threshold was 2.48 ± 0.52 Kg/ cm2. Most ofthe subjects have overweight (20%) and obesity (47%). There was no correlation between the BMI with the painintensity (r=-0.076, p=0.689), with the number of trigger points (r=0.256, p=0.171) and with the pain threshold(r=0.189, p=0.316).Conclusions: Therefore the BMI was not related to the pain intensity, the number of trigger points as wellas with the threshold of pain in the MPS patients. However, the number of the TP tends to increase, and thethreshold of pain has the tendency to reduced in the obese subjects.Keywords: Obesity; Myofascial Pain Syndrome; VAS; Pain Threshold

scholarly journals Clinical criteria for the application of dry needling in myofascial pain Syndrome: An expert consensus document and a cross-sectional study among physical therapists

2019 ◽  
Vol 02 (02) ◽  
pp. 050-054
Author(s):  
Nicolas Secorro ◽  
Rafael Guerra ◽  
Xavi Labraca ◽  
Marc Lari ◽  
Daniel Pecos ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Myofascial Pain ◽  
Panel Discussion ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Dry Needling ◽  
Cross Sectional ◽  
Myofascial Trigger Points ◽  
Clinical Criteria

AbstractPresently, there is no clear consensus on the essential and confirmatory criteria which should govern the application of dry needling (DN) in the treatment of myofascial trigger points. The aim of this study was to generate a consensus on these criteria, via a panel discussion with DN experts which took place at the International Conference of Invasive Physical Therapy held in 2018, including the opinion of the attendees who participated in a live survey on the subject at the conference via an app. The results obtained reveal discrepancies regarding confirmatory criteria such as the elicitation of referred pain; nonetheless, consensus exists on the suitability of the application of individualized and personalized DN treatment and the combination of treatment with other intervention approaches in physical therapy, with the use of ultrasound when required to support a safer clinical practice.

scholarly journals Myofascial Pain in Patients Waitlisted for Total Knee Arthroplasty

2012 ◽  
Vol 17 (5) ◽  
pp. 321-327 ◽  
Author(s):  
Richard Henry ◽  
Catherine M Cahill ◽  
Gavin Wood ◽  
Jennifer Hroch ◽  
Rosemary Wilson ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Short Form ◽  
Trigger Points ◽  
Mcgill Pain Questionnaire ◽  
Myofascial Trigger Points ◽  
Total Knee

BACKGROUND: Knee pain is one of the major sources of pain and disability in developed countries, particularly in aging populations, and is the primary indication for total knee arthroplasty (TKA) in patients with osteoarthritis (OA).OBJECTIVES: To determine the presence of myofascial pain in OA patients waitlisted for TKA and to determine whether their knee pain may be alleviated by trigger point injections.METHODS: Following ethics approval, 25 participants were recruited from the wait list for elective unilateral primary TKA at the study centre. After providing informed consent, all participants were examined for the presence of active trigger points in the muscles surrounding the knee and received trigger point injections of bupivacaine. Assessments and trigger point injections were implemented on the first visit and at subsequent visits on weeks 1, 2, 4 and 8. Outcome measures included the Timed Up and Go test, Brief Pain Inventory, Centre for Epidemiologic Studies Depression Scale, State-Trait Anxiety Inventory and Short-Form McGill Pain Questionnaire.RESULTS: Myofascial trigger points were identified in all participants. Trigger point injections significantly reduced pain intensity and pain interference, and improved mobility. All participants had trigger points identified in medial muscles, most commonly in the head of the gastrocnemius muscle. An acute reduction in pain and improved functionality was observed immediately following intervention, and persisted over the eight-week course of the investigation.CONCLUSION: All patients had trigger points in the vastus and gastrocnemius muscles, and 92% of patients experienced significant pain relief with trigger point injections at the first visit, indicating that a significant proportion of the OA knee pain was myofascial in origin. Further investigation is warranted to determine the prevalence of myofascial pain and whether treatment delays or prevents TKA.

scholarly journals The relative effectiveness of chiropractic manipulation to the level of main segmental nerve supply as opposed to dry needling in the treatment of muscles with myofascial trigger points

2000 ◽  
Author(s):  
◽  
Hayden Clyde Pooke
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Relative Effectiveness ◽  
Trigger Points ◽  
Nerve Supply ◽  
Dry Needling ◽  
Chiropractic Manipulation ◽  
Myofascial Trigger Points ◽  
Medical Disorders ◽  
Segmental Nerve

Myofascial trigger points are a common problem for patients as weJl as physicians. According to some authors Myofascial Pain Syndromes encompass the largest group of unrecognised and under-treated medical disorders. At present, needling techniques seem to be most effective in treating myofascial trigger points, however, many chiropractors claim that manipulation alone is sufficient for trigger point amelioration. The aim of this study was to determine the effectiveness of chiropractic manipulation to the level of main segmental nerve supply versus dry needling in the treatment of selected muscles with myofascial trigger points.

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