Diagnostics and treatment of myofascial syndrome in the ENT-clinic: analysis of ﬁve-year experience of L. I. Sverzhevskiy Otorhinolaryngology Research Clinical Institute

Goal of research - to evaluate the role of myofascial syndrome developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders. The myofascial syndrome manifests itself in the development of pain phenomena, cochlear and vestibular symptoms similar to the symptoms of the diseases of the ENT organs.Materials and methods. We have analyzed the results of several studies conducted in 2012-2017 at L. I. Sver-zhevsky Otorhinolaryngology Research Clinical Institute, which involved more than 3 000 people with neck and head pain and/or cochleovestibular symptoms in combination with myofascial pain syndrome (MFPS), developing on the background of cervical pathology, dysfunction of the temporomandibular joint or occlusive disorders.Results. Patterns of development of the MFPS in head and neck regions, as well as peculiarities of diagnostics of trigger points with pain and non-pain manifestations (buzzing in ears, ear fullness, loss of hearing, dizziness) were deﬁ ned. The principles of MFPS treatment with pain and non-pain manifestations and therapy options used in L. I. Sverzhevsky Otorhinolaryngology Research Clinical Institute were described. The effect of pathogenetic therapy is shown in the collaborative work of doctors of different specialties: ENT specialist, neurologist, physiotherapist and dentist.Conclusion. Myofascial syndrome of the pericranial muscles can be one of the causes of face and neck pain imitating diseases of ENT organs and dental pathologies. Treatment of such clinical forms should be the subject of an interdisciplinary approach. It should include pharmaceutical and non-pharmaceutical methods: analgesia, relaxation and stretching of the corresponding muscles.

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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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Myofascial pain syndrome and trigger points

Current Opinion in Supportive and Palliative Care ◽

10.1097/spc.0000000000000445 ◽

2019 ◽

Vol 13 (3) ◽

pp. 270-276 ◽

Cited By ~ 4

Author(s):

Marco Barbero ◽

Alessandro Schneebeli ◽

Eva Koetsier ◽

Paolo Maino

Keyword(s):

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points

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Intramuscular and nerve root stimulation vs lidocaine injection to trigger points in myofascial pain syndrome

Acta Dermato Venereologica ◽

10.2340/16501977-0058 ◽

2007 ◽

Vol 39 (5) ◽

pp. 374-378 ◽

Cited By ~ 45

Author(s):

H Ga ◽

HJ Koh ◽

JH Choi ◽

CH Kim

Keyword(s):

Nerve Root ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Lidocaine Injection ◽

Root Stimulation

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Early results of supervised versus unsupervised rehabilitation of patients with cervical pain

The International Journal of Artificial Organs ◽

10.1177/0391398819853296 ◽

2019 ◽

Vol 42 (12) ◽

pp. 695-703

Author(s):

Juliusz Huber ◽

Przemysław Lisiński

Keyword(s):

Myofascial Pain ◽

Sensory Perception ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Maximal Contraction ◽

Degenerative Spine ◽

Degenerative Spine Disease ◽

Spine Disease

Purpose: Comparison of early effects of supervised (led by physiotherapist) and unsupervised rehabilitation protocols in patients with myofascial pain syndrome, disk-root conflict and degenerative spine disease at cervical level. Methods: Three groups of patients (n = 60 each) with clinically and neurophysiologically confirmed myofascial pain syndrome, disk-root conflict and degenerative spine disease were randomly subdivided to supervised and unsupervised treatment subgroups (n = 30 each). Thirty healthy subjects with similar demographic and anthropometric properties as patients were enrolled to control group. Patients were examined before and after rehabilitation with visual analog scale of pain, Spurling’s test, painful passive elongation and active trigger points detection in trapezius muscle, sensory perception studies and surface electromyography (at rest, during maximal contraction) and electroneurography. Results: Supervised treatment resulted in decrease of pain intensity (P = .001) and Spurling’s symptoms incidence (P = .008) in patients from disk-root conflict group. Painful elongation and incidence of trigger points in trapezius muscle were the least observed at P = .009 after supervised therapy of myofascial pain syndrome. Supervised therapy resulted in decrease of resting electromyography amplitude and increase of maximal contraction electromyography amplitude from trapezius muscle (P = .02) in myofascial pain syndrome patients and from biceps and abductor pollicis brevis muscles of patients from other groups (P from .05 to .001). Median nerve electroneurography and sensory perception results improved at P = .05 after supervised treatment in disk-root conflict group. Conclusions: Twenty-day supervised rehabilitation provides better therapeutic effects than unsupervised one in treatment of muscle dysfunctions in patients with myofascial pain syndrome, degenerative changes and disk-root conflict at cervical spine.

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THE INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE IS MORE EFFECTIVE THAN CONTRACT RELAX STRETCHING TO ULTRASOUND MODALITY IN INCREASING NECK RANGE OF MOTION OF MYOFASCIAL SYNDROME IN UPPER TRAPEZIUS MUSCLE

Majalah Ilmiah Fisioterapi Indonesia ◽

10.24843/mifi.2018.v06.i02.p06 ◽

2018 ◽

Vol 6 (2) ◽

pp. 26

Author(s):

Putu Ayu Sita Saraswati ◽

Ni Komang Juni Antari ◽

Anak Agung Gede Angga Puspa Negara

Keyword(s):

Myofascial Pain ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Upper Trapezius ◽

Significant Difference ◽

Upper Trapezius Muscle ◽

Neck Disability ◽

Inhibition Technique

ABSTRACT``Myofascial pain syndrome in upper trapezius muscle is a muscle pain that implicated by one or somemyofascial trigger points in upper trapezius muscle. Working with static position in long time stimulating the presence ofmyofascial trigger points that causing pain and movement limitation of the neck that stimulate neck disability. Physicaltherapy’s intervention for reducing pain in this case could be integrated neuromuscular inhibition technique or contractrelax stretching combined with ultrasound modality. Purpose: to compare the both interventions in reducing neckdisability of myofascial pain syndrome in upper trapezius muscle. Method: this was an experimental study withRandomized Pre and Post Test Group Design. Samples were divided into 2 treatment group that consist 12 samplesfor each group. The first group treated with integrated neuromuscular inhibition technique with ultrasound while thesecond group treated with contract relaxes stretching with ultrasound. The data was collected by measuring neck rangeof motion using goniometer at the time before and after treatment. Result: the 1st group showed that the Neck ROMincrease 5.083±1.0840 (p<0.001) and the 2nd group showed that the Neck ROM increase 3.333±0.7780(p<0.001). Itmeans there were significant effect of each treatment in both groups. The results of independent t-test showed p<0.001,so that there was significant difference of increased Neck ROM between these groups. The result of independent t-testshowed p value 0.001, so there was significant difference between two groups at increasing neck ROM. Conclusion:combination integrated neuromuscular inhibition technique is more effective than contract relax stretching to ultrasoundmodality in increasing neck range of motion of myofascial syndrome in upper trapezius muscle.Keywords: myofascial, neck disability, trapezius, INIT, ultrasound, stretching

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Infrared Thermography – A Tool for Computer Assisted Research in Rehabilitation Medicine

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.772.603 ◽

2015 ◽

Vol 772 ◽

pp. 603-607

Author(s):

Marius Cristian Cojocaru ◽

Ioana Maria Cojocaru ◽

Nida Alexandra Cojan Carlea ◽

Delia Cinteza ◽

Mihai Berteanu

Keyword(s):

Infrared Thermography ◽

Muscle Pain ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Rehabilitation Medicine ◽

Clinical Findings ◽

Computer Assisted ◽

The Central Nervous System

Muscle pain can be elicited by any irritation of the nociceptors in the muscle or central sensitization in the central nervous system and represent a challenge for medical as well as for neurological rehabilitation. The most frequently described muscle pain syndromes are myofascial pain syndrome (MPS) and fibromyalgia syndrome (FMS). The use of infrared thermography in rehabilitation medicine for assessment of musculoskeletal disorders is not well documented in the current literature. This study is focused around MPS due to the more localized manifestations of this syndrome and it’s objective is to asses a correlation between the clinical findings, ultrasound examination and the thermal pattern of trigger points.

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