scholarly journals The efficacy of intramuscular electrical stimulation in the management of patients with myofascial pain syndrome: a systematic review

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Monavar Hadizadeh ◽  
Abbas Rahimi ◽  
Mohammad Javaherian ◽  
Meysam Velayati ◽  
Jan Dommerholt
Keyword(s):  
Systematic Review ◽  
Electrical Stimulation ◽  
Myofascial Pain ◽  
Pressure Pain Threshold ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Preliminary Evidence ◽  
Control Group ◽  
Chronic Muscle Pain ◽  
Analgesic Use

Abstract Introduction Myofascial pain syndrome (MPS) is one of the most common disorders causing chronic muscle pain. Almost one-third of patients with musculoskeletal complaints meet the MPS criteria. The aim of this study is to evaluate the effectiveness of intramuscular electrical stimulation (IMES) in patients with MPS through a systematic review method. Methods PubMed, Scopus, Embase, ProQuest, PEDro, Web of Science, and CINAHL were systematically searched to find out the eligible articles without language limitations from 1990 to December 30, 2020. All relevant randomized controlled trials that compared the effectiveness of IMES with sham-IMES, dry needling, or exercise therapy in patients with MPS were included. Full texts of the selected studies were critically appraised using Revised Cochrane risk-of-bias tool for randomized trials (RoB2). Results Six studies (out of 397) had met our inclusion criteria (involving 158 patients) and were entered to the systematic review. Outcome measures examined in these studies included pain, range of motion, pressure pain threshold, biochemical factors, disability, and amount of analgesic use. In the most studies, it has been shown that IMES is more effective than the control group in improving some outcome measurements such as pain. Conclusion There is preliminary evidence from a few small trials suggesting the efficacy of IMES for the care of myofascial pain syndrome. The data support the conduct of larger trials investigating the efficacy of IMES.

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
Keyword(s):  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Effective Rate ◽  
Primary Treatment ◽  
Control Group ◽  
Ultrasound Guided ◽  
Vas Score ◽  
Significant Difference ◽  
Muscle Fascia

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.

Evaluation of the Analgesic Effect of Combination Therapy on Chronic Plantar Pain Through the Myofascial Trigger Points Approach

2018 ◽  
Vol 108 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Rocío Melero-Suárez ◽  
José Antonio Sánchez-Santos ◽  
Gabriel Domínguez-Maldonado
Keyword(s):  
Combination Therapy ◽  
Analgesic Effect ◽  
Myofascial Pain ◽  
Pressure Pain Threshold ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Adductor Muscle ◽  
Rank Test ◽  
Myofascial Trigger Points

Background: Closely related pathologic disorders sometimes manifest with the same symptoms, making for a complex differential diagnosis. This is the situation in plantar fasciitis (PF) and myofascial pain syndrome (MPS) with myofascial trigger points (MTPs) in the sole of the foot. This research assessed the analgesic effect on plantar pain of combination therapy with interferential current stimulation therapy (ICST), treating MTPs in the great toe adductor muscle and the short flexor muscles of the toes in patients whose diagnosis was compatible with PF or MPS. Methods: This study included 22 feet of 17 patients with a diagnosis compatible with PF or MPS with MTP. Participants received combination therapy with ICST for 15 sessions, and the decrease in pain was measured with an algometer and the visual analog scale. Both measurements were taken before and after every fifth session. The pressure pain threshold (PPT) results obtained with the Student t test and the pain intensity perception (PIP) results obtained with the Wilcoxon signed rank test were analyzed by comparing the measurements taken before the treatment and after the fifth, tenth, and 15th sessions. Results: The decrease in PIP was significant after the fifth, tenth, and 15th sessions (P &lt; .001). The increase in PPT was also significant after the fifth (P = .010), tenth (P = .023), and 15th (P = .001) sessions (P &lt; .05). Conclusions: The suggested combination therapy of ultrasound with ICST is clinically significant for reducing plantar pain after 15 treatment sessions, with a 6.5-point reduction in mean PIP and a 4.6-point increase in PPT.

scholarly journals Effect of Taping on Spinal Pain and Disability: Systematic Review and Meta-Analysis of Randomized Trials

2015 ◽  
Vol 95 (4) ◽  
pp. 493-506 ◽  
Author(s):  
Carla Vanti ◽  
Lucia Bertozzi ◽  
Ivan Gardenghi ◽  
Francesca Turoni ◽  
Andrew A. Guccione ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Myofascial Pain ◽  
Data Extraction ◽  
Meta Analysis ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Spinal Pain ◽  
Controlled Trials ◽  
Cochrane Central Register

Background Taping is a widely used therapeutic tool for the treatment of musculoskeletal disorders, nevertheless its effectiveness is still uncertain. Purpose The purpose of this study was to conduct a current review of randomized controlled trials (RCTs) concerning the effects of elastic and nonelastic taping on spinal pain and disability. Data Sources MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, ISI Web of Knowledge, and SPORTDiscus databases were searched. Study Selection All published RCTs on symptomatic adults with a diagnosis of specific or nonspecific spinal pain, myofascial pain syndrome, or whiplash-associated disorders (WAD) were considered. Data Extraction Two reviewers independently selected the studies and extracted the results. The quality of individual studies was assessed using the PEDro scale, and the evidence was assessed using GRADE criteria. Data Synthesis Eight RCTs were included. Meta-analysis of 4 RCTs on low back pain demonstrated that elastic taping does not significantly reduce pain or disability immediately posttreatment, with a standardized mean difference of −0.31 (95% confidence interval=−0.64, 0.02) and −0.23 (95% confidence interval=−0.49, 0.03), respectively. Results from single trials indicated that both elastic and nonelastic taping are not better than placebo or no treatment on spinal disability. Positive results were found only for elastic taping and only for short-term pain reduction in WAD or specific neck pain. Generally, the effect sizes were very small or not clinically relevant, and all results were supported by low-quality evidence. Limitations The paucity of studies does not permit us to draw any final conclusions. Conclusion Although different types of taping were investigated, the results of this systematic review did not show any firm support for their effectiveness.

scholarly journals Acute Effects of Tecar Therapy on Skin Temperature, Ankle Mobility and Hyperalgesia in Myofascial Pain Syndrome in Professional Basketball Players: A Pilot Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8756
Author(s):  
Mireia Yeste-Fabregat ◽  
Luis Baraja-Vegas ◽  
Juan Vicente-Mampel ◽  
Marcelino Pérez-Bermejo ◽  
Iker J. Bautista González ◽  
...  
Keyword(s):  
Myofascial Pain ◽  
Intervention Group ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Absolute Temperature ◽  
Medial Gastrocnemius ◽  
Control Group ◽  
Basketball Players ◽  
Myofascial Trigger Points ◽  
Professional Basketball

(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.

A Review of Myofascial Pain and Fibromyalgia – Factors that Promote Their Persistence

2005 ◽  
Vol 23 (3) ◽  
pp. 121-134 ◽  
Author(s):  
Robert D Gerwin
Keyword(s):  
Muscle Pain ◽  
Myofascial Pain ◽  
Visceral Pain ◽  
Treatment Plan ◽  
Specific Treatment ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Difficult Problem ◽  
Chronic Muscle Pain

Chronic muscle pain (myalgia) is a common problem throughout the world. Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain. The two common muscle pain conditions are fibromyalgia and myofascial pain syndrome. Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis. Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle. The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying cause(s) of persistent or chronic muscle pain in order to develop a specific treatment plan. Chronic myalgia may not improve until the underlying precipitating or perpetuating factor(s) are themselves managed. Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypomobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency. Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition.

scholarly journals Serum inflammatory and oxidative stress biomarkers levels are associated with pain intensity, pressure pain threshold and quality of life in myofascial pain syndrome

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Seyed Kazem Shakouri ◽  
Neda Dolatkhah ◽  
Sepideh Omidbakhsh ◽  
Alireza Pishgahi ◽  
Maryam Hashemian
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Myofascial Pain ◽  
Pressure Pain Threshold ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Oxidative Stress Biomarkers ◽  
Hs Crp ◽  
And Oxidative Stress

Abstract Objectives We aimed to determine the serum concentrations of some inflammatory and oxidative stress biomarkers in relation with pain intensity and quality of life in patients with myofascial pain syndrome (MPS) compared to healthy controls. This study is a case–control study. The participants were selected from MPS patients who referred to rehabilitation outpatient clinics of the Tabriz University of Medical Sciences, Iran. Results Serum hs-CRP (4.68 ± 4.36 vs. 2.92 ± 4.55 g/mlµ respectively, p = 0.011), phospholipase A2 (PLA2) (6.81 ± 2.22 vs. 4.73 ± 2.97 pg/ml respectively, p < 0.001) and malondialdehyde (MDA) (2.63 ± 0.71 vs. 1.98 ± 0.90 nmol/ml respectively, p < 0.001) levels were significantly higher and serum total antioxidant capacity (TAC) (2.46 ± 0.49 vs. 2.83 ± 0.82 mmol/L respectively, p = 0.011) and superoxide dismutase (SOD) (78.89 ± 37.93 vs. 154.25 ± 115.93 U/ml respectively, p < 0.001) levels were significantly lower in the MPS patients compared to healthy controls. Serum high-sensitivity C-reactive protein (hs-CRP) level was significantly and positively associated with resting (r = 0.349, p = 0.019), activity (r = 0.295, p = 0.049) and night pain (r = 0.304, p = 0.043) intensities, pressure pain threshold (PPT) (r = 0.210, p = 0.047) and pain duration (r = 0.283, p = 0.007). Serum TAC level was significantly and negatively associated with resting pain intensity (r = −0.312, p = 0.037). Some scales and subscales of quality of life were positively correlated with serum TAC level and negatively associated with serum hs-CRP and PLA2 levels.

scholarly journals Scoping Review and Interpretation of Myofascial Pain/Fibromyalgia Syndrome: An Attempt to Assemble a Medical Puzzle

2021 ◽  
Author(s):  
shiloh plaut
Keyword(s):  
Scoping Review ◽  
Myofascial Pain ◽  
Empirical Studies ◽  
Pressure Pain Threshold ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Modern Medicine ◽  
Pathological State ◽  
Scoping Reviews

Introduction: Myofascial Pain Syndrome (MPS) is a common overlooked and underdiagnosed condition, and with significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. Methods: Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro and medrXiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. Findings: 734 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. Interpretation: MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue, or "fascial armoring", which may explain pain, distribution of pain, decreased pressure/pain threshold, and other phenomena eg, occasional complete resolution after surgery. Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. MPS should no longer be overlooked but solidified in the domain of common modern medicine.

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