scholarly journals Application of Ultrasound-Guided Trigger Point Injection for Myofascial Trigger Points in the Subscapularis and Pectoralis Muscles to Post-Mastectomy Patients: A Pilot Study

2014 ◽  
Vol 55 (3) ◽  
pp. 792 ◽  
Author(s):  
Hyuk Jai Shin ◽  
Ji Cheol Shin ◽  
Wan Sung Kim ◽  
Won Hyuk Chang ◽  
Sang Chul Lee
Keyword(s):  
Pilot Study ◽  
Trigger Point ◽  
Trigger Points ◽  
Ultrasound Guided ◽  
Myofascial Trigger Points ◽  
Point Injection ◽  
Pectoralis Muscles

scholarly journals Ultrasound-Guided Trigger Point Injections in the Cervicothoracic Musculature: A New and Unreported Technique

2008 ◽  
Vol 6;11 (12;6) ◽  
pp. 885-889 ◽  
Author(s):  
Kenneth P. Botwin
Keyword(s):  
Ultrasound Guidance ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Trigger Points ◽  
Target Tissue ◽  
Obese Patients ◽  
Needle Placement ◽  
Ultrasound Guided ◽  
Myofascial Trigger Points ◽  
Point Injection

Background: Myofascial pain is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The myofascial pain syndrome is one of the largest groups of under diagnosed and under treated medical problems encountered in clinical practice. Trigger points are commonly seen in patients with myofascial pain which is responsible for localized pain in the affected muscles as well as referred pain patterns. Correct needle placement in a myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point injection to help reduce or relieve myofascial pain. In obese patients, these injections may not reach the target tissue. In the cervicothoracic spine, a misguided or misplaced injection can result in a pneumothorax. Here, we describe an ultrasound-guided trigger point injection technique to avoid this potential pitfall. Office based ultrasound-guided injection techniques for musculoskeletal disorders have been described in the literature with regard to tendon, bursa, cystic, and joint pathologies. For the interventionalist, utilizing ultrasound yields multiple advantages technically and practically, including observation of needle placement in real-time, ability to perform dynamic studies, the possibility of diagnosing musculoskeletal pathologies, avoidance of radiation exposure, reduced overall cost, and portability of equipment within the office setting. To our knowledge, the use of ultrasound guidance in performing trigger point injection in the cervicothoracic area, particularly in obese patients, has not been previously reported. Methods: A palpable trigger point in the cervicothoracic musculature was localized and marked by indenting the skin with the tip of a plastic needle cover. The skin was then sterile prepped. Then, using an ultrasound machine with sterile coupling gel and a sterile latex free transducer cover, the musculature in the cervicothoracic spine where the palpable trigger point was detected was visualized. Then utilizing direct live ultrasound guidance, a 25-gauge 1.5 inch needle connected to a 3 mL syringe was placed into the muscle at the exact location of the presumed trigger point. This guidance helps confirm needle placement in muscle tissue and not in an adipose tissue or any other non-musculature structure. Results: The technique is simple to be performed by a pain management specialist who has ultrasound system training. Conclusion: Ultrasound-guided trigger point injections may help confirm proper needle placement within the cervicothoracic musculature. The use of ultrasound-guided trigger point injections in the cervicothoracic musculature may also reduce the potential for a pneumothorax by an improperly placed injection. Key words: Trigger point injection, myofascial pain, ultrasound

scholarly journals Electromyographically Guided Trigger Point Injections in the Cervicothoracic Musculature of Obese Patients: A New and Unreported Technique

2007 ◽  
Vol 6;10 (6;11) ◽  
pp. 753-756
Author(s):  
Kenneth P. Botwin
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Trigger Points ◽  
Injection Technique ◽  
Target Tissue ◽  
Obese Patients ◽  
Needle Placement ◽  
Hypodermic Injection ◽  
Myofascial Trigger Points ◽  
Point Injection

Background: Myofascial pain is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The myofascial pain syndrome is one of the largest groups of under-diagnosed and under-treated medical problems encountered in clinical practice. Trigger points are commonly seen in patients with myofascial pain that can be responsible for localized pain in the affected muscles as well as referred pain patterns. Correct needle placement in a myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point injection to help reduce or relieve myofascial pain. In the obese patients, these injections may not reach the target tissue. In the cervicothoracic spine, a misguided or misplaced injection can result in a pneumothorax. Here, we review an electromyographically guided trigger point injection technique to avoid this potential pitfall. Methods: Using a disposable Teflon coated hypodermic injection needle attached to an electromyography (EMG) machine, a trigger point injection can be performed utilizing electromyographic guidance. This guidance by observing motor unit action potentials (MUAPs) on the EMG screen helps confirm the needle placement to be within the muscle tissue and not in an adipose tissue or any other non-musculature structure. Results: The technique is simple when performed by a pain management specialist who has electromyographic training. Conclusion: This technique helps confirm proper needle placement within the cervicothoracic musculature in an obese patient in whom the musculature is not readily palpated. This, thus, reduces the potential for a pneumothorax by an improperly placed injection. Key words: Trigger point injection, myofascial pain, electromyography

scholarly journals DRY NEEDLING SEBAGAI TERAPI NYERI MIOFASIAL SERVIKAL

2020 ◽  
Vol 37 (4) ◽  
Author(s):  
Hanik Badriyah Hidayat ◽  
Annisa Oktavianti
Keyword(s):  
Trigger Point ◽  
Trigger Points ◽  
Myofascial Trigger Point ◽  
Dry Needling ◽  
Myofascial Trigger Points

Nyeri miofasial servikal (NMS) merupakan sumber nyeri umum pada individu dengan nyeri leher kronik nonspesifik. Nyeri dapat bersifat lokal, regional dan dapat juga memiliki banyak titik pemicu nyeri (myofascial trigger points/MTrPs). NMS menyebabkan nyeri di daerah otot servikal maupun fasia di sekitarnya. Nyeri leher menurunkan kualitas hidup, menurunkan produktivitas dan menyebabkan disabilitas sehingga berpengaruh secara sosioekonomi terhadap penderita dan masyarakat.Pengobatan sindrom nyeri miofasial servikal masih belum memuaskan terkait kronisitasnya. Dry needling (DN) adalah salah satu pilihan terapi nonfarmakologi yang bisa diterapkan pada NMS. DN akan mengurangi sensitisasi perifer dan sentral dengan menghilangkan sumber nosisepsi perifer (area MTrPs), memodulasi aktifitas kornu dorsalis dan mengaktifkan jalur inhibisi nyeri sentral.Neurolog sering menangani kasus NMS dan perkembangan DN akhir-akhir ini semakin pesat sebagai manajemen nyeri. Namun, keefektifan terapi DN masih belum jelas. Oleh karena itu, pengetahuan tentang peran DN pada NMS ini penting untuk diketahui oleh para neurolog. Artikel kami akan membahas tentang peran DN pada sindrom nyeri miofasial servikal.Kata kunci: Dry needling, nyeri miofasial servikal, terapi, myofascial trigger point

scholarly journals EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRIGGER POINTS FOR REDUCTION OF PAIN AND SPASM OF TRAPEZIUS MUSCLE

2018 ◽  
Vol 7 (1) ◽  
pp. 21-27
Author(s):  
Mubarra Rao ◽  
Sadia Shafaq
Keyword(s):  
Trigger Point ◽  
Trapezius Muscle ◽  
Trigger Points ◽  
Ultrasound Therapy ◽  
Myofascial Trigger Point ◽  
Myofascial Trigger Points ◽  
Reduction Of Pain ◽  
Group A ◽  
Group B ◽  
Hot Pack

Myofascial trigger point is a hyperirritable nodule present in a palpable taut band of skeletal muscle, often results from muscle injury or repetitive strain that cause pain and tightness. Myofascial trigger points are one of the most common causes of chronic neck pain. This study aims to determine the efficacy of ischemic compression in comparison with myofascial stretching on trigger points of trapezius muscle for reduction of pain and spasm. Randomized Control Trial. The study was conducted in Ziauddin Hospital. 96 participants were enrolled in the study. Participants were divided into two groups equally and randomly, Group (A) an intervention group treated with hot pack, ultrasound therapy and ischemic compression, Group (B) a control group treated with hot pack, ultrasound therapy and myofascial stretching. This regime was followed thrice a week for three weeks. Statistically significant (P < 0.05) changes in the values were found in Group A and Group B for Visual Analog scale and Penn spasm frequency scale post treatment. The results showed that there is significant difference found after both interventions for the treatment of pain and spasm caused by myofascial trigger point. It cannot be said that ischemic compression is more effective than myofascial stretching for the treatment of myofascial trigger points of trapezius muscle.

scholarly journals Dry needling of the gastrocnemius muscle. Overlap between trigger point area and the presence of blood vessels

2019 ◽  
Vol 02 (02) ◽  
pp. 063-063
Author(s):  
Velasco Fernández P. ◽  
Valera Garrido F.
Keyword(s):  
Blood Vessels ◽  
Gastrocnemius Muscle ◽  
Trigger Point ◽  
Trigger Points ◽  
Medial Gastrocnemius ◽  
Dry Needling ◽  
Lateral Gastrocnemius ◽  
Myofascial Trigger Points ◽  
Gastrocnemius Muscles ◽  
Venous Pattern

Abstract Aims To evaluate the anatomic variability of the gastrocnemius venous system using ultrasound and the overlap of the same with myofascial trigger points (MTrPs 1 and 2) clinically located in this muscle. Material and Methods In total, 82 legs of 41 healthy adults were studied, belonging to 26 men and 15 women aged between 22 and 50 years. The blood vessels located below MTrP1 and MTrP2, described by Travell and Simons were observed, and each image was analyzed by sectors (medial, central and lateral) to quantify the number of blood vessels, their distribution and overlap with the MTrPs described at this level. Results Examination of the 164 heads of 82 gastrocnemius muscles revealed that at least one vessel exists for each section analyzed. The number of veins per head varied between 1 and 8. The most common pattern in the medial gastrocnemius was three vessels (41.5%) and two vessels (49%) in the lateral gastrocnemius. In 100% of the cases the localization of the veins coincided with the clinical localization of the MTrPs. Conclusions The venous pattern of the proximal gastrocnemius is highly variable among subjects regarding the number of blood vessels and their distribution. There is a complete overlap between the clinical localization of the gastrocnemius MTrPs and the presence of blood vessels.

Trigger Point Dry Needling versus Strain–counterstrain Technique for Upper Trapezius Myofascial Trigger Points: A Randomised Controlled Trial

2016 ◽  
Vol 34 (3) ◽  
pp. 171-177 ◽  
Author(s):  
E Segura-Ortí ◽  
S Prades-Vergara ◽  
L Manzaneda-Piña ◽  
R Valero-Martínez ◽  
JA Polo-Traverso
Keyword(s):  
Randomised Controlled Trial ◽  
Trigger Point ◽  
Controlled Trial ◽  
Trigger Points ◽  
Dry Needling ◽  
Significant Group ◽  
Myofascial Trigger Points ◽  
Upper Trapezius ◽  
Pain Pressure Threshold ◽  
Randomised Controlled

Background Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. Objectives To compare the effects of upper trapezius trigger point dry needling (DN) and strain–counterstrain (SCS) techniques versus sham SCS. Study Design Randomised controlled trial. Method 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects’ own ratings of perceived disability were measured. Results The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI −4.9 to 2.1) or sham SCS (1.8, 95% CI −6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. Conclusions There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. Trial Registration Number NCT01290653.

scholarly journals Efficacy of Myofascial Trigger Point Dry Needling in the Prevention of Pain after Total Knee Arthroplasty: A Randomized, Double-Blinded, Placebo-Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Orlando Mayoral ◽  
Isabel Salvat ◽  
María Teresa Martín ◽  
Stella Martín ◽  
Jesús Santiago ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Physical Therapist ◽  
Trigger Point ◽  
Controlled Trial ◽  
Trigger Points ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Total Knee

The aim of this study was to determine whether the dry needling of myofascial trigger points (MTrPs) is superior to placebo in the prevention of pain after total knee arthroplasty. Forty subjects were randomised to a true dry needling group (T) or to a sham group (S). All were examined for MTrPs by an experienced physical therapist 4–5 hours before surgery. Immediately following anesthesiology and before surgery started, subjects in the T group were dry needled in all previously diagnosed MTrPs, while the S group received no treatment in their MTrPs. Subjects were blinded to group allocation as well as the examiner in presurgical and follow-up examinations performed 1, 3, and 6 months after arthroplasty. Subjects in the T group had less pain after intervention, with statistically significant differences in the variation rate of the visual analogue scale (VAS) measurements 1 month after intervention and in the need for immediate postsurgery analgesics. Differences were not significant at 3- and 6-month follow-up examinations. In conclusion, a single dry needling treatment of MTrP under anaesthesia reduced pain in the first month after knee arthroplasty, when pain was the most severe. Results show a superiority of dry needling versus placebo. An interesting novel placebo methodology for dry needling, with a real blinding procedure, is presented.

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