scholarly journals Ultrasound-Guided Inactivation of Trigger Points Combined with Muscle Fascia Stripping by Liquid Knife in Treatment of Postherpetic Neuralgia Complicated with Abdominal Myofascial Pain Syndrome: A Prospective and Controlled Clinical Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Xiang-Hong Lu ◽  
Xiao-Lan Chang ◽  
Si-Lan Liu ◽  
Jing-Ya Xu ◽  
Xiao-Jun Gou

Objective. To evaluate ultrasound-guided inactivation of myofascial trigger points (MTrPs) combined with abdominal muscle fascia stripping by liquid knife in the treatment of postherpetic neuralgia (PHN) complicated with abdominal myofascial pain syndrome (AMPS). Methods. From January 2015 to July 2018, non-head-and-neck PHN patients in the Pain Department, The First Affiliated Hospital of Soochow University, were treated with routine oral drugs and weekly paraspinal nerve block for two weeks. Patients with 2 < VAS (visual analogue scale) score < 6 were subjects of the study. They were assigned into control group 1 (C1, n = 33) including those with PHN and without myofascial pain syndrome (MPS) and control group 2 (C2, n = 33) including those with PHN complicated with MPS and observation group 1 (PL, n = 33) including those with PHN complicated with limb myofascial pain syndrome (LMPS) and observation group 2 (PA, n = 33) including those with PHN complicated with AMPS. All groups received zero-grade treatment: routine oral drugs and weekly paraspinal nerve block. PL and PA groups were also treated step by step once a week: primary ultrasound-guided inactivation of MTrPs with dry needling, secondary ultrasound-guided inactivation of MTrPs with dry and wet needling, and tertiary ultrasound-guided dry and wet needling combined with muscle fascia stripping by liquid knife. At one week after primary treatment, patients with a VAS score > 2 proceeded to secondary treatment. If the VAS score was <2, the treatment was maintained, and so on, until the end of the four treatment cycles. Pain assessment was performed by specialized nurses at one week after each treatment, including VAS score, McGill pain questionnaire (MPQ) score, pressure pain sensory threshold (PPST), and pressure pain tolerance threshold (PPTT). VAS score was used as the main index and VAS <2 indicated effective treatment. At 3 months after treatment, outpatient and/or telephone follow-up was performed. The recurrence rate was observed and VAS > 2 was regarded as recurrence. Results. At one week after primary treatment, the effective rate was 66.7% in PL group, significantly higher than that in PA group (15.2%, P<0.05). At one week after secondary treatment, the effective rate was 100% and 37.5% in PL and PA groups, respectively, with significant difference between the groups (P<0.05). The effective rate increased to 90.6% in PA group at one week after tertiary treatment. At one week after the end of treatment cycles, the scores of VAS and MPQ were significantly lower in C1, PL, and PA groups than in C2 group (P<0.05), while PPST and PPTT were significantly higher than in C2 group (P<0.05). There was no significant difference between C1 group and PL group (P>0.05). At follow-up at 3 months after treatment, the recurrence rate was low in each group, with no significant difference between the groups (P>0.05). Conclusion. About 57% of PHN patients with mild to moderate pain are complicated with MPS, and ultrasound-guided inactivation of MTrPs with dry and wet needling can effectively treat PHN patients complicated with LMPS. However, patients with PHN complicated with AMPS need to be treated with ultrasound-guided MTrPs inactivation combined with muscle fascia stripping by liquid knife as soon as possible.

2021 ◽  
Author(s):  
Hideaki Hasuo ◽  
Hideya Oomori ◽  
Kohei Yoshida ◽  
Mikihiko Fukunaga

Abstract Background: Expectations for treatment have a favorable effect on the subsequent course of pain and behavior in patients. It is not known whether receiving interfascial injection while patients view their ultrasound image with doctors (visual feedback) is associated with positive treatment expectations. Methods: This was a prospective, multicenter, observational clinical trial. We evaluated whether visual feedback during ultrasound-guided interfascial injection affects treatment expectations and the subsequent course of pain in patients with myofascial pain syndrome. Treatment expectations were set as mediators of pain using path analysis. The primary endpoint was the proportion of patients who showed improvement in pain numerical rating scale score by 50% or more 14 days after initiation of treatment. Results: During 2019 and 2020, 136 outpatients received ultrasound-guided interfascial injection for myofascial pain syndrome. Of these, 65 (47.8%) patients received visual feedback during ultrasound-guided interfascial injection. Compared with the non-visual feedback group, the visual feedback group had higher expectations for treatment, immediately after interfascial injection, and their expectations were maintained at day 14 of treatment (p < .001). In the visual feedback group, 67.7% of patients showed improvement in pain numerical rating scale score by 50% or more at day 14 (95% confidence interval: 56.5–78.9), whereas such improvement was observed in only 36.6% of the non-visual feedback group (95% confidence interval: 25.3–47.9; p < .001). Path analysis revealed that visual feedback had the largest influence on pain numerical rating scale reduction at 14 days, which was indirectly via higher expectations for treatment (β = 0.434).Conclusions: Visual feedback during ultrasound-guided interfascial injection had a positive effect on the subsequent course of pain in patients with myofascial pain syndrome by increasing patients’ treatment expectations.Trial registration: UMIN000043160. Registered 28 January 2021 (registered retrospectively).


2018 ◽  
Vol 6 (2) ◽  
pp. 26
Author(s):  
Putu Ayu Sita Saraswati ◽  
Ni Komang Juni Antari ◽  
Anak Agung Gede Angga Puspa Negara

ABSTRACT``Myofascial pain syndrome in upper trapezius muscle is a muscle pain that implicated by one or somemyofascial trigger points in upper trapezius muscle. Working with static position in long time stimulating the presence ofmyofascial trigger points that causing pain and movement limitation of the neck that stimulate neck disability. Physicaltherapy’s intervention for reducing pain in this case could be integrated neuromuscular inhibition technique or contractrelax stretching combined with ultrasound modality. Purpose: to compare the both interventions in reducing neckdisability of myofascial pain syndrome in upper trapezius muscle. Method: this was an experimental study withRandomized Pre and Post Test Group Design. Samples were divided into 2 treatment group that consist 12 samplesfor each group. The first group treated with integrated neuromuscular inhibition technique with ultrasound while thesecond group treated with contract relaxes stretching with ultrasound. The data was collected by measuring neck rangeof motion using goniometer at the time before and after treatment. Result: the 1st group showed that the Neck ROMincrease 5.083±1.0840 (p<0.001) and the 2nd group showed that the Neck ROM increase 3.333±0.7780(p<0.001). Itmeans there were significant effect of each treatment in both groups. The results of independent t-test showed p<0.001,so that there was significant difference of increased Neck ROM between these groups. The result of independent t-testshowed p value 0.001, so there was significant difference between two groups at increasing neck ROM. Conclusion:combination integrated neuromuscular inhibition technique is more effective than contract relax stretching to ultrasoundmodality in increasing neck range of motion of myofascial syndrome in upper trapezius muscle.Keywords: myofascial, neck disability, trapezius, INIT, ultrasound, stretching


Author(s):  
Mireia Yeste-Fabregat ◽  
Luis Baraja-Vegas ◽  
Juan Vicente-Mampel ◽  
Marcelino Pérez-Bermejo ◽  
Iker J. Bautista González ◽  
...  

(1) Background: Myofascial pain syndrome (MPS) is a clinical condition characterized by localized non-inflammatory musculoskeletal pain caused by myofascial trigger points. Diathermy or Tecar therapy (TT) is a form of noninvasive electro-thermal therapy classified as deep thermotherapy based on the application of electric currents. This technique is characterized by immediate effects, and its being used by high performance athletes. (2) Methods: A total of thirty-two participants were included in the study who were professional basketball players. There was a 15-person Control Group and a 17-person Intervention Group. TT was applied in the Intervention Group, while TT with the device switched off (SHAM) was applied in the Control Group. The effects were evaluated through the Lunge test, infrared thermography, and pressure threshold algometry at baseline, 15, and 30 min after the intervention. (3) Results: the Intervention Group exhibited a greater increase in absolute temperature (F[1,62] = 4.60, p = 0.040, η2p = 0.13) compared to the Control Group. There were no differences between the groups in the Lunge Test (F[1.68,53.64] = 2.91, p = 0.072, η2p = 0.08) or in pressure algometry (visual analog scale, VAS) (F[3.90] = 0.73, p = 0.539, η2p = 0.02). No significant short-term significant differences were found in the rest of the variables. (4) Conclusions: Diathermy can induce changes in the absolute temperature of the medial gastrocnemius muscle.


2007 ◽  
Vol 25 (4) ◽  
pp. 130-136 ◽  
Author(s):  
Hyuk Ga ◽  
Ji-Ho Choi ◽  
Chang-Hae Park ◽  
Hyun-Jung Yoon

Aim To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients. Methods Thirty nine participants with myofascial pain syndrome of one or both upper trapezius muscles were randomised to treatment with either acupuncture needling (n=18) or 0.5% lidocaine injection (n=21) at all the trigger points on days 0, 7 and 14, in a single-blinded study. Pain scores, range of neck movement, pressure pain intensity and depression were measured up to four weeks from the first treatment. Results Local twitch responses were elicited at least once in 94.9% of all subjects. Both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point up to one month. Overall, the range of cervical movement improved in both groups, apart from extension in the acupuncture needling group. Changes in depression showed only trends. Conclusion There was no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating myofascial pain syndrome in elderly patients.


Sign in / Sign up

Export Citation Format

Share Document