scholarly journals Intramuscular Neural Distribution of the Serratus Anterior Muscle: Guidelines to the Injective Method for Treating Myofascial Pain Syndrome

2021 ◽  
Author(s):  
Kyu-Ho Yi ◽  
Ji-Hyun Lee ◽  
Kyle K Seo ◽  
Hee-Jin Kim
Keyword(s):  
Botulinum Neurotoxin ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Serratus Anterior Muscle ◽  
Serratus Anterior ◽  
Injection Point ◽  
Posterior Axillary Line ◽  
Optimal Injection

Abstract The serratus anterior muscle is commonly involved in myofascial pain syndrome and is treated with many different injective methods. Currently, there is no definite injection point for the muscle. This study provides an ideal injection point for the serratus anterior muscle considering the intramuscular neural distribution using the whole mount staining method. A modified Sihler method was applied to the serratus anterior muscles (15 specimens). The intramuscular arborization areas were identified in terms of the anterior (100%), middle (50%), posterior axillary line (0%), and from the first to the ninth ribs. The intramuscular neural distribution for the serratus anterior muscle had the largest arborization patterns in the 5th to 9th rib portion between 50% and 70%, and the 1st to 4th rib portion had between 20% and 40%. Clinicians can administer safe and effective treatments with botulinum neurotoxin injections and other types of injections, following the methods in our study. We propose optimal injection sites in relation to the external anatomical line for the frequently injected facial muscles to facilitate the efficiency of botulinum neurotoxin injections. Lastly, these guidelines would assist practice more accurately without the harmful side effects of trigger point injections and botulinum neurotoxin injections.

scholarly journals Peripheral EphrinB1/EphB1 signalling attenuates muscle hyperalgesia in MPS patients and a rat model of taut band-associated persistent muscle pain

2020 ◽  
Vol 16 ◽  
pp. 174480692098407
Author(s):  
Feihong Jin ◽  
Lianying Zhao ◽  
Qiya Hu ◽  
Feng Qi
Keyword(s):  
Muscle Pain ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Numerical Rating Scale ◽  
Protein Microarray ◽  
Trapezius Muscle ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Peripheral Sensitization

Background Myofascial pain syndrome (MPS) is an important clinical condition that is characterized by chronic muscle pain and a myofascial trigger point (MTrP) located in a taut band (TB). Previous studies showed that EphrinB1 was involved in the regulation of pathological pain via EphB1 signalling, but whether EphrinB1-EphB1 plays a role in MTrP is not clear. Methods The present study analysed the levels of p-EphB1/p-EphB2/p-EphB3 in biopsies of MTrPs in the trapezius muscle of 11 MPS patients and seven healthy controls using a protein microarray kit. EphrinB1-Fc was injected intramuscularly to detect EphrinB1s/EphB1s signalling in peripheral sensitization. We applied a blunt strike to the left gastrocnemius muscles (GM) and eccentric exercise for 8 weeks with 4 weeks of recovery to analyse the function of EphrinB1/EphB1 in the muscle pain model. Results P-EphB1, p-EphB2, and p-EphB3 expression was highly increased in human muscles with MTrPs compared to healthy muscle. EphB1 (r = 0.723, n = 11, P < 0.05), EphB2 (r = 0.610, n = 11, P < 0.05), and EphB3 levels (r = 0.670, n = 11, P < 0.05) in the MPS group were significantly correlated with the numerical rating scale (NRS) in the MTrPs. Intramuscular injection of EphrinB1-Fc produces hyperalgesia, which can be partially prevented by pre-treatment with EphB1-Fc. The p-EphB1 contents in MTrPs of MPS animals were significantly higher than that among control animals (P < 0.01). Intramuscular administration of the EphB1 inhibitor EphB1-Fr significantly suppressed mechanical hyperalgesia. Conclusions The present study showed that the increased expression of p-EphB1/p-EphB2/p-EphB3 was related to MTrPs in patients with MPS. This report is the first study to examine the function of EphrinB1-EphB1 signalling in primary muscle afferent neurons in MPS patients and a rat animal model. This pathway may be one of the most important and promising targets for MPS.

Ultrasound-Guided Trigger Point Injection for Serratus Anterior Muscle Pain Syndrome

2015 ◽  
Vol 5 (6) ◽  
pp. 99-102 ◽  
Author(s):  
Grisell Vargas-Schaffer ◽  
Michal Nowakowsky ◽  
Marzieh Eghtesadi ◽  
Jennifer Cogan
Keyword(s):  
Muscle Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Serratus Anterior Muscle ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Point Injection

scholarly journals Trigger Point Injection Therapy in the Management of Myofascial Pain Syndrome in the Maxillofacial Area

2020 ◽  
Vol 28 (6) ◽  
pp. 694-701
Author(s):  
I.A. Arsenova ◽  
◽  
I.O. Pohodenko-Chudakova ◽  
M.A. Lar’kina ◽  
◽  
...  
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Injection Therapy ◽  
Point Injection

Цель. Оценить эффективность инъекций в триггерные точки при лечении миофасциального болевого синдрома челюстно-лицевой области. Материал и методы. С 2014-2017 гг. было пролечено 124 человека с миофасциальным болевым синдромом лица, из них 76 женщин и 48 мужчин в возрасте от 19 до 62 лет. Кроме клинических и рентгенологических методов диагностики всем пациентам выполняли электромиографию и тестирование болей по визуальной аналоговой шкале боли (VAS). С целью купирования миофасциального болевого синдрома применялись методы традиционной терапии: шиновая терапия, коррекция окклюзии, медикаментозная и физиотерапия. При неэффективности традиционных методов выполнялись инъекции «Лимфомиозот» и «Траумель С» в триггерные точки по методике J. Kersschot (2010). Контрольные осмотры проводились через 1, 3, 6, 12 и 18 и 24 месяца после выполнения манипуляции. При контрольных осмотрах обращали внимание на жалобы пациентов, определяли интенсивность боли по VAS. Критерием положительных результатов лечения являлось отсутствие болей в покое и при функциях. Результаты. При стандартном лечении положительные результаты были получены у 86 из 124 человек (69,4%). Инъекции в триггерные точки, выполняемые при недостаточной эффективности лечения у 38 человек, привели к прекращению боли у 32 (84,2%) пациентов. Как показали наши наблюдения, длительный период без боли (в течение двух лет) наблюдали у 12 (37,6%) человек. Продолжительный эффект в течение периода времени до полутора лет был констатирован у 8 пациентов (25%), до 1 года – у 7 человек (21,8%), до 6 месяцев – у 5 (15,6%). Заключение. Инъекции в триггерные точки повышают эффективность терапии и обеспечивают длительный период ремиссии заболевания, что проявляется в отсутствии болевых приступов и ощущения дискомфорта. Научная новизна статьи Впервые для лечения миофасциального болевого синдрома (МБС) лица была использована методика с применением инъекций «Лимфомиозот» и «Траумель С» в триггерные точки. Установлено, что данная методика инъекций в триггерные точки является эффективным методом лечения МБС лица в независимости от причины, его вызвавшей. Показано, что применение инъекций в триггерные точки при миофасциальном болевом синдроме лица способствовало быстрому купированию болей и длительному безболевому периоду сроком наблюдения до двух лет.

scholarly journals Comparison of the Effect of Bicarbonate, Hyaluronidase, and Lidocaine Injection on Myofascial Pain Syndrome

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Mahshid Ghasemi ◽  
Faramarz Mosaffa ◽  
Behnam Hoseini ◽  
Faranak Behnaz
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Trapezius Muscle ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
The Body ◽  
Lidocaine Injection ◽  
Permanent Effect

Background: Myofascial pain syndrome is a chronic syndrome that occurred in a local or focal part of the body. The basis for myofascial pain syndrome is the presence of myofascial trigger point or points, producing pain in clinical examinations. Objectives: This study aimed to compare the effect of injection of bicarbonate, hyaluronidase, and lidocaine on myofascial pain syndrome. Methods: The patients were randomly allocated to three groups of bicarbonate, hyaluronidase, and lidocaine. The injection was done at two painful regions of trapezius muscle with a sonography guide for each patient. The values of visual analogue scale (VAS), pre-injection range of motion (ROM), immediately after injection, second and fourth week were measured. Results: The analysis showed that there were no significant differences between the three groups for age, gender, BMI, and height (P > 0.05). Repeated measures one-way ANOVA (week * group) 4 * 3 was used to compare the effect of bicarbonate, hyaluronidase, and lidocaine on VAS and range of motion (ROM) before injection, immediately after injection, second and fourth week. The results showed that the main effect of group and week is significant for VAS (P < 0.05). This study showed that the values of VAS were significantly different between the three groups during the fourth weeks of the study. Moreover, the patients experienced more pain decline in the hyaluronidase group during weeks before injection, after injection, second and fourth week, which indicated the permanent effect of this medication on pain decline. Conclusions: Injection of lidocaine leads to a significant reduction in pain immediately after injection; however, the decline was not permanent and disappeared in the following four weeks. But VAS reduction in hyaluronidase group more than bicarbonate and lidocaine groups.

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