Comparative study between ischemic compression and dry needling in myofascial pain syndrome: possibilities in health

Introduction: Myofascial Pain Syndrome (MPS) is a neuromuscular regional dysfunction characterized by the presence of sensitive regions in strained muscle bands (trigger points), able to cause local and referred pain, functional losses and change the quality of life (QOL) of affected people. It can be triggered by musculoskeletal injuries, postural imbalances, endocrinal factors and psych emotional disorders. The diagnostic is clinical, the intervention is multidisciplinary and the treatment may involve the use of drugs and several invasive and non-invasive techniques. Objective: Compare the effects of ischemic compression associated to physiotherapy and dry needling associated to pain control and the QOL of people with MPS. Methods: 40 subjects took part of the study. They were of both genders, aged from 20 to 60 years old, with MPS, divided into 2 groups with 20 participants each. The first group receives ischemic compression and physiotherapy and the second, dry needling and physiotherapy. The statistical analysis involves proportions for categorical variables, significance and standard deviation for continuous variables. In order to evaluate the change in the pain and QOL perception of subjects, the Student’s t-test (p<0.05). Results: The best results were verified in the dry needling and physiotherapy group. Conclusion: Both ischemic compression and physiotherapy as dry needling and physiotherapy can promote pain relief and better QOL in subjects suffering from MPS.

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Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome

Rheumatology International ◽

10.1007/s00296-004-0485-6 ◽

2004 ◽

Vol 25 (8) ◽

pp. 604-611 ◽

Cited By ~ 185

Author(s):

A. Kamanli ◽

A. Kaya ◽

O. Ardicoglu ◽

S. Ozgocmen ◽

F. Ozkurt Zengin ◽

...

Keyword(s):

Botulinum Toxin ◽

Myofascial Pain ◽

Botulinum Toxin Injection ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Dry Needling ◽

Lidocaine Injection

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Probable Mechanisms of Needling Therapies for Myofascial Pain Control

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/705327 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 36

Author(s):

Li-Wei Chou ◽

Mu-Jung Kao ◽

Jaung-Geng Lin

Keyword(s):

Animal Studies ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Dry Needling ◽

Myofascial Trigger Points ◽

Appropriate Treatment ◽

Clinical Pain ◽

Hormonal System

Myofascial pain syndrome (MPS) has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP) can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM) theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed.

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

Revista Fisioterapia Invasiva ◽

10.1055/s-0039-3402788 ◽

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.

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Ultrasound Guided Trigger Point Injections in Myofascial Pain Syndrome

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-26-3-82 ◽

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.

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Dry needling versus ultrasonic in treating cervical myofascial pain syndrome

QJM ◽

10.1093/qjmed/hcaa064.005 ◽

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.

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The Effects of Ultrasound-guided Dry Needling on Patients With Myofascial Pain Syndrome

Iranian Rehabilitation Journal ◽

10.32598/irj.18.4.133.3 ◽

2020 ◽

Vol 18 (4) ◽

pp. 369-376

Author(s):

Ismail Ebrahimi Takamjani ◽

◽

Kamran Ezzati ◽

Saemeh Khani ◽

Javad Sarrafzadeh ◽

...

Keyword(s):

Myofascial Pain ◽

Tissue Injury ◽

Insertion Site ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Needle Insertion ◽

Dry Needling ◽

Ultrasound Guided ◽

Muscle Involvement

Objectives: Dry Needling (DN) is a novel and effective intervention for patients with Myofascial Pain Syndrome (MPS). Some characteristics, such as needle penetration depth, needle insertion into the target muscle, and trigger points must be identified in this intervention. The Ultrasound (US)-guided DN is a technique that involves needle insertion at the site of injury and the simulation of tissue injury and inflammation under US guidance; it indicates the needle insertion site to ensure that it does not penetrate the adjacent tissues. The current study aimed to review previous studies regarding the effects of US-guided DN on MPS. Methods: A search was performed in PubMed, Scopus, Cochrane, Google Scholar, Springer, and Science Direct databases to retrieve studies published from 2010 to March 2020. We included investigations regarding the effects of US-guided DN on the treatment of MPS. The following keywords and MeSH terms were used in the search process: “ultrasound-guided, musculoskeletal ultrasonography, myofascial pain syndrome, trigger points, and dry needling.” Results: A total of 47 relevant articles were retrieved. However, based on the inclusion and exclusion criteria of the review, 11 articles were finally selected. All studies reported significant pain relief following the use of US-guided DN in patients with MPS. Discussion: Considering the precise visualization of the site of muscle involvement, precise needle insertion, and reduction of the risk of further injury in US-guided DN may be a useful approach for MPS management in short-term and long-term studies.

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Poster 199 Vibration Elastography to Assess the Effect of Dry Needling on Myofascial Trigger Points in Patients Affected by Myofascial Pain Syndrome

PM&R ◽

10.1016/j.pmrj.2014.08.592 ◽

2014 ◽

Vol 6 (9) ◽

pp. S255

Author(s):

Diego Turo ◽

Paul R. Otto ◽

Murad Hossain ◽

William Rosenberger ◽

Hui Shao ◽

...

Keyword(s):

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Dry Needling ◽

Myofascial Trigger Points

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Faculty Opinions recommendation of Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome: a Meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726199055.793524808 ◽

2016 ◽

Author(s):

Josimari Melo DeSantana

Keyword(s):

Pain Intensity ◽

Myofascial Pain ◽

Meta Analysis ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Dry Needling

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Granisetron vs. lidocaine injection to trigger points in the management of myofascial pain syndrome: a double-blind randomized clinical trial

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0154 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Zahra Rezasoltani ◽

Hanna Ehyaie ◽

Reza Kazempour Mofrad ◽

Fatemeh Vashaei ◽

Reza Mohtasham ◽

...

Keyword(s):

Neck Pain ◽

Myofascial Pain ◽

Neck Disability Index ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Double Blind ◽

Upper Trapezius ◽

Disability Scale ◽

Neck Disability

Abstract Objectives Granisetron and lidocaine injections have been used for the management of myofascial pain syndrome. This study was aimed to compare the efficacy of granisetron and lidocaine injections to trigger points of upper trapezius in the management of myofascial pain syndrome. Methods We performed a double-blind randomized clinical trial in an outpatient clinic of physical medicine and rehabilitation at a teaching hospital. A total of 40 patients aged ≥18 with neck pain due to myofascial pain syndrome were included. They had pain for at least one month with the intensity of at least 30 mm on a 100 mm visual analog scale. Each participant received a single dose of 1 mL lidocaine 2% or 1 mg (in 1 mL) granisetron. The solutions were injected into a maximum of three trigger points of the upper trapezius. We instructed all patients to remain active while avoiding strenuous activity for three or four days, and to perform stretch exercise and massage of their upper trapezius muscles. We assessed the patients before the interventions, and one month and three months post-injection. The primary outcome was the Neck Disability Index and the secondary outcome was the Neck Pain and Disability Scale. Results Both interventions were successful in reducing neck pain and disability (all p-values <0.001). However, the neck pain and disability responded more favorably to lidocaine than granisetron (p=0.001 for Neck Disability Index, and p=0.006 for Neck Pain and Disability Scale). No significant side-effect was recognized for both groups. Conclusions Both lidocaine and granisetron injections to trigger points are effective and safe for the management of the syndrome and the benefits remain at least for three months. However, lidocaine is more effective in reducing pain and disability. The injections are well-tolerated, although a transient pain at the site of injections is a common complaint. One mL of lidocaine 2% is more effective than 1 mg (in 1 mL) granisetron for injecting into the trigger points of the upper trapezius in myofascial pain syndrome.

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