scholarly journals Clinical and Neurophysiological Criteria for Evaluation of Effectiveness of Osteopatic Treatment of Myofascial Pain

Author(s):  
A. A. Safiullina ◽  
A. A. Zainullina ◽  
A. R. Gajnutdinov

Goal of research - the study aims to examine the clinical and neurophysiological criteria for evaluating the effectiveness of osteopathic treatment for patients with myofascial pain.Materials and methods. The authors conducted a complex clinical and instrumental examination of 40 people of working age with myofascial pain syndrome of the humeroscapular region. The control group included 20 presumably healthy volunteers of the same age and sex as the main group of subjects of the study. Each patient was subjected to clinical and neurological examinations, neuro-orthopedic and osteopathic examinations, and psychological testing. The electro-neurophysiological part of the work consisted in the study of somatosensory evoked potentials, and polysynaptic refl ex excitability.Results. The authors determined a correlation between the data of the psychological study, the parameters of the blinking refl ex and somatosensory evoked potentials.Conclusion. The data obtained from the complex clinical and neurophysiological examination allow substantiating the pain syndrome before and after treatment. The data can be used as one of the criteria for diagnosis and effectiveness of the treatment of myofascial, in particular, humeroscapular, pain syndrome.

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.


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.


2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Monavar Hadizadeh ◽  
Abbas Rahimi ◽  
Mohammad Javaherian ◽  
Meysam Velayati ◽  
Jan Dommerholt

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.


Author(s):  
M. N. Urvant ◽  
D. S. Lebedev

Introduction. From 30 to 92 % of reproductive age women suffer from menstrual pain (algomenorrhea). The effectiveness of drug treatment of this suffering does not exceed 50–70 %. Moreover, it is temporary and accompanied by a high incidence of side effects. Dysfunction of the autonomic nervous system is the basis of the algomenorrhea pathogenesis; it is resulting from chronic exposure to psychogenic factor and adaptive mechanisms decrease in thalamus and hypothalamus which is leading to the nociceptive system excitation. Currently, there are scientifi c studies showing the effectiveness of osteopathic correction of autonomic dysfunction that can eliminate menstrual pain.Goal of research — to justify the osteopathic treatment effectiveness for patients with primary algomenorrhea.Materials and methods. The study included 30 women aged from 15 to 29 years who applied to the gynecological offi ce, diagnosed with primary algomenorrhea and a disease period of 3 to 16 years. They were randomly divided into 2 groups: experimental and control, of 15 people each. The patients of experimental group received osteopathic treatment, the patients of control group received drug therapy only. Osteopathic status was determined in all patients before and after treatment. Pain intensity was assessed by using a visual analogue scale (VAS), the direction of autonomic dysfunction — by using the Kerdo index and the severity of autonomic dysfunction — according to the Wayne questionnaire.Results. Dura mater RBN S (93 % of patients) and RBN in the visceral chest region (70 %) were specifi c regional somatic dysfunctions. The remaining regional somatic dysfunctions were common less than in 50 % of patients. Specifi c local somatic dysfunctions (LD) in patients with algomenorrhea were uterus LD (73 %) and mediastinum LD (70 %). Due to osteopathic treatment, the number of regional and local somatic dysfunctions was decreased in the experimental group. Autonomic dysfunction severity and pain syndrome intensity were decreased as well.Conclusion. The results of the study allow us to recommend osteopathic treatment for patients with primary algomenorrhea.


Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 118 ◽  
Author(s):  
Jung Kang ◽  
Jungin Kim ◽  
Seunghun Park ◽  
Sungwoo Paek ◽  
Tae Kim ◽  
...  

We compared the feasibility of ultrasound (US)-guided myofascial trigger point (MTrP) injection with that of a blind injection technique following the use of shear wave elastography (SWE) for the measurement of stiffness at the MTrPs in patients with trapezius myofascial pain syndrome (MPS). A total of 41 patients (n = 41) were randomized to either the trial group (n = 21, SWE combined with US-guided injection) or the control group (n = 20, SWE combined with blind injection). At baseline and four weeks, they were evaluated for the manual muscle test (MMT), the range of motion (ROM), pain visual analogue scale (VAS) scores, Shoulder Pain and Disability Index (SPADI) scores and Neck Disability Index (NDI) scores during the abduction, adduction, flexion, extension, external rotation and internal rotation of the shoulder joint. Differences in changes in pain VAS scores, NDI scores and SPADI scores at four weeks from baseline between the two groups reached statistical significance (p = 0.003, 0.012, and 0.018, respectively). US-guided MTrP injection is a more useful modality as compared with a blind injection in patients with MPS.


2014 ◽  
Vol 27 (4) ◽  
pp. 515-522 ◽  
Author(s):  
Rebeka Borba da Costa Santos ◽  
Maíra Izzadora Souza Carneiro ◽  
Déborah Marques de Oliveira ◽  
Adriana Baltar do Rêgo Maciel ◽  
Kátia Karina do Monte-Silva ◽  
...  

Introduction Musculoskeletal pain is a common clinical condition and about 10% of the population have musculoskeletal disorder. Objective The aim of this study was to evaluate whether ischemic pressure and dry needling techniques are able to reduce the pain of patients with myofascial pain syndrome. Method 22 patients aged 20-75 years were randomized into 3 groups: ischemic pressure (IPG = 8), dry needling (DNG = 7) and control (CG = 7). Patients in the IPG and DNG were assessed before and after 10 intervention sessions, which occurred 3 times per week. The CG was assessed initially and reassessed three weeks later. The assessment of pain was done through Visual Analogic Scale (VAS) and quality of life through WHOQOL-BREF (5 domains: global, physical, psychological, social and environmental). Results There was no significant difference for clinical and demographic data of all groups at baseline, except for age (p = 0.042). The results of the VAS expressed that IPG had pain relief in most sessions, the same was not observed for DNG. Comparing the 2 groups was obtained difference in the 4th and 8th sessions. The results of the WHOQOL-BREF showed that the three groups had a significant increase in the psychological domain. The same was not true for global domains, physical, environmental and social. Conclusion Ischemic pressure and dry needling were able to reduce the pain of patients and also change their quality of life, specifically the psychological aspect.


Author(s):  
Ümit Yalçın

BACKGROUND: Although studies examined kinesiological taping (KT) and extracorporeal shock wave therapy (ESWT) in myofascial pain syndrome (MPS), no study has yet compared these two treatments. OBJECTIVE: This study aimed to compare the efficacy of KT and ESWT on pain, pain threshold, functional level and neck movements in the treatment of MPS, which is an important cause of disability and constitutes 50–80% of chronic painful diseases. METHODS: Two hundred and sixty-two patients diagnosed with MPS in the upper part of the unilateral trapeze muscle were included in the study. The patients were divided into three groups according to the treatment they received: Group 1 (n= 75): ESWT + exercise, Group 2 (n= 82): KT + exercise, Group 3 (n= 105) and the latter receiving only exercise therapy (control group). Visual analog scale (VAS), pain threshold with algometer, Neck Disability Index (NDI), and neck contralateral lateral flexion angle were assessed before and three months after treatment. RESULTS: VAS, pain threshold, NDI and contralateral flexion angle values after treatment improved significantly in the ESWT and KT groups (p< 0.05) compared to the control group. The level of improvement in the ESWT group was higher (p< 0.05) than in the KT group in terms of VAS, pain threshold and NDI scores. CONCLUSION: Exercise, KT and ESWT applications in MPS were effective in all of the parameters examined. However, the ESWT + exercise therapy was more effective in terms of pain, pain threshold and disability.


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