Effect of Visual Feedback During Ultrasound-Guided Interfascial Injection for Myofascial Pain Syndrome: A Prospective, Multicenter, Observational Clinical Trial

2021 ◽  
Author(s):  
Hideaki Hasuo ◽  
Hideya Oomori ◽  
Kohei Yoshida ◽  
Mikihiko Fukunaga
Keyword(s):  
Visual Feedback ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Numerical Rating Scale ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Ultrasound Guided ◽  
Feedback Group ◽  
Treatment Expectations ◽  
Numerical Rating

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).

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.

scholarly journals Pengaruh Post Isometric Relaxation pada Kasus Myofascial Pain Syndrome Upper Trapezius terhadap Penurunan Nyeri di Ar – Rohmah Islamic Boarding School Malang

2020 ◽  
Vol 4 (1) ◽  
pp. 1-8
Author(s):  
Safun Rahmanto ◽  
Kurnia Putri Utami ◽  
Eka Yanti Sri Utami
Keyword(s):  
Rating Scale ◽  
Myofascial Pain ◽  
Numerical Rating Scale ◽  
Trapezius Muscle ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Boarding School ◽  
Wilcoxon Test ◽  
Upper Trapezius ◽  
Time To Learn

ABSTRACT Background: Myofascial pain syndrome is the situation of taut pain and tenderness pain, this syndrome is often found in trapezius muscle. The result of Preliminary study shows that the tahfidz program students in Ar – Rohmah Islamic Boarding School Malang spent time to learn Al – Qur’an for 6-8hour/day with static situation and complained about the pain in the neck. Purpose: To find out the effect of Post Isometric Relaxation on decrease pain of myofascial pain syndrome of the upper trapezius in Ar – Rohmah Islamic Boarding School Malang. Method: This study uses Pre-experimental one group pretest and posttest design. The respondents in this study are 26 students of thafidz program in Ar – Rohmah Islamic Boarding School Malang with technique of purposive sampling and were given intervention 3 times in a week for 2 weeks. Instrument of this research is Numerical Rating Scale (NRS) and the data analysis is using Wilcoxon test. Result: It shows 0,000 (α < 0,05) and show there is decrease pain from 0,742 to 0,633. Conclusion: There is an effect of post isometric relaxation on decrease the pain of myofascial pain syndrome of upper the trapezius in Ar – Rohmah Islamic Boarding School Malang.

scholarly journals Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Deng ◽  
Xiao-min Hou ◽  
Xu-yan Zhou ◽  
Qing-he Zhou
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Prospective Randomized Controlled Trial ◽  
Numerical Rating ◽  
Intercostal Block ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery. Methods Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups. Results The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons). Conclusion Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.

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.

scholarly journals Radial extarcorporeal shock waves: therapeutic myofascial protocol

2021 ◽  
pp. 1-5
Author(s):  
Barassi Giovanni ◽  
Guglielmi Vito ◽  
Della Rovere Franco ◽  
Di Iulio Antonella ◽  
Licameli Marco ◽  
...  
Keyword(s):  
Shock Waves ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Numerical Rating Scale ◽  
Trigger Points ◽  
Upper Trapezius ◽  
Significant Difference ◽  
Before And After ◽  
Numerical Rating ◽  
Base Of Support

The purpose of this study is to evaluate the effectiveness of radial shock waves in myofascial upper trapezius syndrome following the global treatment scheme of key trigger points. Materials and methods 26 patients treated with rESWT (Radial shock wave therapy) after a global postural and myofascial assessment of the patient and the identification of the key trigger points. At the end of the treatment each subject was re-evaluated through the Numerical Rating Scale - NRS and through the examination with Electronic Baropodometer. In this study, we compared the values of NRS and the values of postural biometrics before and after 2 sessions of rESWT, and a statistically significant difference (P <0.05) in all measurements emerged in the values measured with NRS. In the static percentage load, a statistically significant reduction in the percentage load differences (right / left) (P <0.05) was observed in all three evaluation moments (T0, T1, T2). The percentage and statistically significant improvement (P <0.05) were recorded at time T2 in the surface of the ellipse. Greater control of balance and greater awareness of the base of support was found in the calculation of the sway path, in particular with closed eyes. Based on this experience, the use of radial shock waves in pathologies related to myofascial pain with postural implications would be desirable.

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