scholarly journals Effectiveness of Bupivacaine Trigger Points Injections in the Treatment of Myofascial Pain Syndrome

Author(s):  
Rabiu Mohammed Bashir ◽  
Afeez Abdulrahman ◽  
Zakari Suleiman

Background: Myofascial pain syndrome is a regional or widespread muscular pain associated with tenderness localized to linear or nodular hardening, trigger points in one or group of muscles. It is a major cause of time loss from work and low quality of life. Injections of myofascial trigger points either with local anaesthetics, steroid, normal saline or without any agent have been proven to provide pain relief. This study aims to determine the effectiveness of trigger point injection with bupivacaine in treatment of myofascial pain syndrome and improvement in quality of life. Methods: After Institutional Ethical Committee approval, forty one patients aged 16 years and above with myofacial pain syndrome had 0.5mls of 0.25% plain bupivacaine trigger points injections with size 26G 11 /2 inch hypodermic needle. Pain was assessed using Numerical Rating Scale and Pain disability questionnaire was administered to all the patients before the procedures and 1 month post-intervention (follow-up visits) to assessed functional and psychological component of pain disability scale and their response to treatment. Results:

2010 ◽  
Vol 38 (05) ◽  
pp. 849-859 ◽  
Author(s):  
Mei-Yuan Sun ◽  
Ching-Liang Hsieh ◽  
Yung-Yen Cheng ◽  
Hung-Chang Hung ◽  
Tsai-Chung Li ◽  
...  

Chronic neck myofascial pain syndrome (MPS) is a common disorder seen in clinics. There is no gold standard method to treat myofascial pain. We investigated the effects of acupuncture on patients with chronic neck MPS by a single-blind randomized controlled trial. A total of 35 patients were randomly allocated to an acupuncture group (AG) or a sham acupuncture group (SG). Each subject received acupuncture treatment twice per week for three consecutive weeks. The primary outcome measure was quality of life as assessed with Short Form-36, and secondary outcome measures were neck range of motion (ROM), motion-related pain, and Short-Form McGill Pain Questionnaire (SF-MPQ), as determined by a blinded investigator. The clinical assessments were made before treatment (BT) and after six acupuncture treatments (AT), as well as four weeks (F1) and 12 weeks (F2) after the end of the treatment. A total of 34 patients completed the trial. The results indicated that there is no significant difference in the ROM, motion-related pain, and SF-MPQ scores between AG and SG at AT, F1 and F2 (all p > 0.05). However, AG has greater improvement in physical functioning and role emotional of Short Form-36 quality of life at F2. The results indicate that acupuncture may be used to improve the quality of life in patients with chronic neck MPS.


2018 ◽  
Vol 108 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Rocío Melero-Suárez ◽  
José Antonio Sánchez-Santos ◽  
Gabriel Domínguez-Maldonado

Background: Closely related pathologic disorders sometimes manifest with the same symptoms, making for a complex differential diagnosis. This is the situation in plantar fasciitis (PF) and myofascial pain syndrome (MPS) with myofascial trigger points (MTPs) in the sole of the foot. This research assessed the analgesic effect on plantar pain of combination therapy with interferential current stimulation therapy (ICST), treating MTPs in the great toe adductor muscle and the short flexor muscles of the toes in patients whose diagnosis was compatible with PF or MPS. Methods: This study included 22 feet of 17 patients with a diagnosis compatible with PF or MPS with MTP. Participants received combination therapy with ICST for 15 sessions, and the decrease in pain was measured with an algometer and the visual analog scale. Both measurements were taken before and after every fifth session. The pressure pain threshold (PPT) results obtained with the Student t test and the pain intensity perception (PIP) results obtained with the Wilcoxon signed rank test were analyzed by comparing the measurements taken before the treatment and after the fifth, tenth, and 15th sessions. Results: The decrease in PIP was significant after the fifth, tenth, and 15th sessions (P < .001). The increase in PPT was also significant after the fifth (P = .010), tenth (P = .023), and 15th (P = .001) sessions (P < .05). Conclusions: The suggested combination therapy of ultrasound with ICST is clinically significant for reducing plantar pain after 15 treatment sessions, with a 6.5-point reduction in mean PIP and a 4.6-point increase in PPT.


2018 ◽  
Vol 90 (6) ◽  
pp. 81-88
Author(s):  
F I Devlikamova

Aim. The “PARUS” program included investigation of the analgesic, muscle relaxant and sedative effects of Mydocalm-Richter which acts as central muscle relaxant in patients with myofascial pain syndrome, taking into account its registered indication for use - the hypertonus and cross-striated muscle spasm. Materials and methods. Fifty patients with myofascial trigger points, the mean age of 41.67±11.86 years, have been enrolled in the study. All patients had undergone clinical examination that allowed the diagnosis of myofascial pain syndrome. The intensity of pain syndrome was evaluated using the pain visual analogue scales and McGill pain questionnaire. Visualization of area in spasm and evaluation of blood circulation was carried out using the ultrasound scan of target muscle. In order to objectively evaluate any conceivable hypotensive and sedative effects of Mydocalm-Richter we used the orthostatic test, Schulte’s test for attention span and perfor-mance distribution and Munsterberg’s test for attention discrimination and concentration. Results. The analgesic and muscle relaxant effects of Mydocalm-Richter become apparent by day 3 post-injection, and the muscle relaxation effect is reaching its maximum on day 10 post-injection. Cardiovascular function following administration of Mydocalm-Richter was evaluated using the orthostatic test which revealed good orthostatic tolerance. Single injection of tolperisone hydrochloride possessing a central muscle relaxant activity has no sedative effect and does not influence patient response time. The ultrasound examination data demonstrated the improvement and in some cases restoration of blood circulation in the myofascial trigger points. Conclusion. Clinical study “PARUS” conducted in patients with myofascial pain has demonstrated a positive muscle relaxant and analgesic effect of Mydocalm-Richter that resulted in restoration of peripheral circulation in the myofascial trigger pointsconfirmed by ultrasound examination. An important benefit of this drug product is the absence of sedative effect and arterial hypotension.


2003 ◽  
Author(s):  
◽  
Marlon Thoresson

The purpose of this study was to determine the relative effectiveness of a home programme of ischaemie compression, sustained stretch and a combination of the two, in terms of subjective and objective clinical findings for the treatment of Myofascial Pain Syndrome.


Toxins ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 355 ◽  
Author(s):  
Da-ye Kim ◽  
Jae Kim

Myofascial pain syndrome is a common painful condition encountered in the general population. Previous studies evaluating the efficacy of botulinum toxin for the treatment of myofascial pain syndrome are limited, with variable results. This prospective study investigated the efficacy and safety of direct injection of Prabotulinumtoxin A (Nabota®) into painful muscle groups for cervical and shoulder girdle myofascial pain. Twelve patients with chronic myofascial pain syndrome of the neck and shoulder underwent an injection of Prabotulinumtoxin A. Painful muscles containing trigger points were injected in the mid-belly. Pain scores and quality of life measurements were assessed at baseline, as well as 6 weeks and 12 weeks post-injection. Safety and tolerability were also assessed. This trial is registered under clinical research information service (CRIS) number KCT0001634. Patients injected with Prabotulinumtoxin A showed a significant improvement in pain at 12 weeks (p < 0.001). At 6 weeks, the pain had not significantly improved compared with baseline (p = 0.063). However, at that time, 41.7% of patients were characterized as Prabotulinumtoxin A responders, with a 30% reduction in pain rating score compared to baseline. In the Neck Disability Index scores, the patients demonstrated significant improvement at both 6 weeks and 12 weeks. No serious adverse effects occurred during the study. Prabotulinumtoxin A injection into chronically painful muscles associated with cervical and shoulder girdle myofascial pain syndrome resulted in an improvement in pain scores and quality of life lasting at least 12 weeks. Additionally, the injections were well tolerated. As these are preliminary findings in a pilot study, future studies should carefully consider using randomized, controlled, prospective trials.


Head & Neck ◽  
2014 ◽  
Vol 37 (12) ◽  
pp. 1733-1737 ◽  
Author(s):  
Leticia Rodrigues Cardoso ◽  
Cláudia Carvalho Rizzo ◽  
Cleyton Zanardo de Oliveira ◽  
Carlos Roberto dos Santos ◽  
André Lopes Carvalho

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Seyed Kazem Shakouri ◽  
Neda Dolatkhah ◽  
Sepideh Omidbakhsh ◽  
Alireza Pishgahi ◽  
Maryam Hashemian

Abstract Objectives We aimed to determine the serum concentrations of some inflammatory and oxidative stress biomarkers in relation with pain intensity and quality of life in patients with myofascial pain syndrome (MPS) compared to healthy controls. This study is a case–control study. The participants were selected from MPS patients who referred to rehabilitation outpatient clinics of the Tabriz University of Medical Sciences, Iran. Results Serum hs-CRP (4.68 ± 4.36 vs. 2.92 ± 4.55 g/mlµ respectively, p = 0.011), phospholipase A2 (PLA2) (6.81 ± 2.22 vs. 4.73 ± 2.97 pg/ml respectively, p < 0.001) and malondialdehyde (MDA) (2.63 ± 0.71 vs. 1.98 ± 0.90 nmol/ml respectively, p < 0.001) levels were significantly higher and serum total antioxidant capacity (TAC) (2.46 ± 0.49 vs. 2.83 ± 0.82 mmol/L respectively, p = 0.011) and superoxide dismutase (SOD) (78.89 ± 37.93 vs. 154.25 ± 115.93 U/ml respectively, p < 0.001) levels were significantly lower in the MPS patients compared to healthy controls. Serum high-sensitivity C-reactive protein (hs-CRP) level was significantly and positively associated with resting (r = 0.349, p = 0.019), activity (r = 0.295, p = 0.049) and night pain (r = 0.304, p = 0.043) intensities, pressure pain threshold (PPT) (r = 0.210, p = 0.047) and pain duration (r = 0.283, p = 0.007). Serum TAC level was significantly and negatively associated with resting pain intensity (r = −0.312, p = 0.037). Some scales and subscales of quality of life were positively correlated with serum TAC level and negatively associated with serum hs-CRP and PLA2 levels.


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