scholarly journals Pathophysiological substantiation of the complex approach to rehabilitation of patients with myofascial pain syndrome of the neck region

2020 ◽  
Vol 2 (1) ◽  
pp. 66-70
Author(s):  
O. V. Shimarova ◽  
V. V. Malakhovskiy ◽  
V. G. Zilov
Keyword(s):  
Myofascial Pain ◽  
Neck Region ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Muscle Stiffness ◽  
Myofascial Pain Syndromes ◽  
Pain Syndromes ◽  
Complex Approach

Myofascial pain syndromes are a widespread pathology, which is a condition that is characterized by local muscle stiffness and the formation of trigger points in them. The pathophysiology of myofascial pain syndromes is not fully understood. Studies indicate the role of dysfunction of the end plate of the muscle, impaired proprioreception and sensomotor control, central sensitization. The review presents a modern view of approaches to the treatment of myofasial pain syndrome of the neck region, based on an understanding of its pathophysiology.

Myofascial Pain

2018 ◽  
Vol 38 (06) ◽  
pp. 640-643 ◽  
Author(s):  
Douglas Comeau ◽  
James Otis ◽  
Jason Weller
Keyword(s):  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Cellular Level ◽  
Myofascial Pain Syndromes ◽  
Myofascial Trigger Points ◽  
Pain Syndromes ◽  
Outer Covering ◽  
Motor End Plate

AbstractMyofascial pain syndromes arise from acute and chronic musculoskeletal pain and often have a referred neuropathic component. It affects more than three quarters of the world's population and is one of the most important and overlooked causes of disability. The origins of pain are thought to reside anywhere between the motor end plate and the fibrous outer covering of the muscle, with involvement of microvasculature and neurotransmitters at the cellular level. Diagnosis is made by clinical examination for the presence of myofascial trigger points, though some ancillary tests may provide supportive evidence. The mainstay of treatment is regular physical therapy with the goal of restoration of normal muscle laxity and range of motion. Adjunct therapies including pharmacologic and nonpharmacologic interventions provide varying degrees of benefit in refractory cases, and onabotulinum toxin A injection has the most evidence of efficacy for these patients. Here, we discuss the epidemiology, pathophysiology, and diagnostic and therapeutic options for the evaluation and treatment of myofascial pain syndrome.

scholarly journals Myofascial Pain Syndrome: A Concise Update on Clinical, Diagnostic and Integrative and Alternative Therapeutic Perspectives

2019 ◽  
pp. 1-14 ◽  
Author(s):  
Naseem A. Qureshi ◽  
Hamoud A. Alsubaie ◽  
Gazzaffi I. M. Ali
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Muscle Twitch ◽  
Myofascial Trigger Points ◽  
Pain Syndromes ◽  
Clinical Diagnostic ◽  
Regional Pain Syndromes

Background: Myofascial pain syndrome is a common multifactorial condition that presents with key manifestations and comorbid with many systemic diseases and regional pain syndromes. Objective: This study aims to concisely review clinical, diagnostic and integrative therapeutic aspects of myofascial pain syndrome. Methods: E-searches (2000-2019) using keywords and Boolean operators were made and using exclusion and inclusion criteria, 50 full articles that focused on myofascial pain syndrome were retained for this review. Results: Myofascial pain syndrome is a multidimensional musculoskeletal disorder with ill-understood etiopathogenesis and pathophysiology and characterized by tender taut muscle with myofascial trigger points, muscle twitch response, specific pattern of referred pain and autonomic symptoms. A variety of pharmacological and nonpharmacological therapies with variable efficacy are used in myofascial pain syndrome, the latter modalities such as education, stretching and exercises, moist hot and cold packs, dry needling and myofascial massage or myofascial trigger point massage are used as first line options. Conclusion: Myofascial pain syndrome and trigger points initiated by repeated strains and injuries co-occur with diverse physical diseases and regional pain syndromes, which need comprehensive diagnostic evaluation using multiple methods. Several interventions are used in patients with myofascial pain syndrome who effectively respond to myofascial massage. This study calls for exploring etiopathogenesis and basic pathophysiological mechanisms underlying myofascial pain syndrome in future.

Association of myofascial trigger points in neck and shoulder region with depression, anxiety and stress among university students

2021 ◽  
pp. 1-11
Author(s):  
Muhammad Kashif ◽  
Shahira Tahir ◽  
Faiqa Ashfaq ◽  
Sania Farooq ◽  
Wizra Saeed ◽  
...  
Keyword(s):  
University Students ◽  
Myofascial Pain ◽  
Neck Region ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Cross Sectional Study ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Myofascial Trigger Points

Abstract Objective: To determine the prevalence of myofascial trigger points in the shoulder and neck region, and to assess association with depression, anxiety and stress. Method: The cross-sectional study was conducted from January to September 2019 at Riphah International University, Faisalabad, Pakistan, and comprised students from different universities in Faisalabad. Myofascial trigger points were identified among the subjects using palpation method by a therapist. Depression anxiety stress scale was used to determine the level of depression, anxiety and stress. Data was analysed using SPSS 20. Results: Of the 2000 subjects, 970(49%) were male and 1030(52%) were female. The overall age range was 18-25 years. Myofascial trigger points were present in 1727(86.4%) subjects and absent in 273(13.7%). The trigger points had significant association with depression, anxiety and stress (p<0.001). Conclusion: Myofascial trigger points were quite common among university students and were associated with depression, anxiety and stress. Key Words: Anxiety, Depression, Myofascial trigger points, Myofascial pain syndrome, Stress, Students. Continuous...

Granisetron vs. lidocaine injection to trigger points in the management of myofascial pain syndrome: a double-blind randomized clinical trial

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.

Myofascial pain syndrome and trigger points

2019 ◽  
Vol 13 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Marco Barbero ◽  
Alessandro Schneebeli ◽  
Eva Koetsier ◽  
Paolo Maino
Keyword(s):  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points

scholarly journals Dinamics of somatosensory generated potentials in myofascial pain syndromes

2001 ◽  
Vol 82 (5) ◽  
pp. 336-340
Author(s):  
G. A. Ivanichev ◽  
A. V. Ovchinnikov
Keyword(s):  
Nervous System ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndromes ◽  
Pain Syndromes ◽  
Antinociceptive System

In pronounced pain syndrome the most important functional shifts (the generators of pathologically increased excitement) by recording somatosensory generated potentials arc revealed at higher levels than in slight tenderness. At the same time in slight painfulness tenderness a great number of the generators of mild activity arc found, showing insufficient activity of antinociceptive system. After treatment a number of the generators of pathologically increased excitement decrease, at the same time the migration to the caudal parts of nervous system occurs. The neurophysiologic basis for possible worsening myofascial pain syndromes is created.

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

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.

scholarly journals 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

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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