The relative effectiveness of a home programme of ischaemic compression, sustained stretch and a combination of both for the treatment of myofascial trigger points in the upper trapezius musculature

Trigger Points ◽

Clinical Findings ◽

Upper Trapezius

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.

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 ◽

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.

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 ◽

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

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 ◽

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.

Evaluation of the Analgesic Effect of Combination Therapy on Chronic Plantar Pain Through the Myofascial Trigger Points Approach

Journal of the American Podiatric Medical Association ◽

10.7547/16-038 ◽

2018 ◽

Vol 108 (1) ◽

pp. 27-32 ◽

Cited By ~ 2

Author(s):

Rocío Melero-Suárez ◽

José Antonio Sánchez-Santos ◽

Gabriel Domínguez-Maldonado

Keyword(s):

Combination Therapy ◽

Analgesic Effect ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Pain Syndrome ◽

Trigger Points ◽

Adductor Muscle ◽

Rank Test ◽

Myofascial Trigger Points

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.

Results of the post-registration clinical study “PARUS” on efficiency and safety assessment of Mydocalm-Richter for local injection therapy of a myofascial trigger zone

Terapevticheskii arkhiv ◽

10.26442/terarkh201890681-88 ◽

2018 ◽

Vol 90 (6) ◽

pp. 81-88

Author(s):

F I Devlikamova

Keyword(s):

Muscle Relaxant ◽

Blood Circulation ◽

Myofascial Pain ◽

Ultrasound Examination ◽

Pain Syndrome ◽

Trigger Points ◽

Orthostatic Test ◽

Sedative Effects

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.

Effect of bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points on upper back myofascial pain syndrome: a randomized controlled trial

Journal of Traditional Chinese Medicine ◽

10.1016/s0254-6272(16)30004-8 ◽

2016 ◽

Vol 36 (1) ◽

pp. 26-31 ◽

Cited By ~ 4

Author(s):

Jiang Guimei ◽

Jia Chao ◽

Lin Mode

Keyword(s):

Randomized Controlled Trial ◽

Myofascial Pain ◽

Controlled Trial ◽

Pain Syndrome ◽

Trigger Points ◽

Randomized Controlled ◽

Bloodletting Therapy

Myofascial Trigger Points and Myofascial Pain Syndrome: A Critical Review of Recent Literature

Journal of Manual & Manipulative Therapy ◽

10.1179/jmt.2006.14.4.125e ◽

2006 ◽

Vol 14 (4) ◽

pp. 125E-171E ◽

Cited By ~ 1

Author(s):

David G. Simons ◽

Jan Dommerholt

Keyword(s):

Critical Review ◽

Recent Literature ◽

Myofascial Pain ◽

Pain Syndrome ◽

Trigger Points ◽

Myofascial Trigger Points

Probable Mechanisms of Needling Therapies for Myofascial Pain Control

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/705327 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 36

Author(s):

Li-Wei Chou ◽

Mu-Jung Kao ◽

Jaung-Geng Lin

Keyword(s):

Animal Studies ◽

Myofascial Pain ◽

Pain Syndrome ◽

Trigger Points ◽

Dry Needling ◽

Appropriate Treatment ◽

Clinical Pain ◽

Hormonal System

Myofascial pain syndrome (MPS) has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP) can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM) theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed.

Acupuncture Needling versus Lidocaine Injection of Trigger Points in Myofascial Pain Syndrome in Elderly Patients – a Randomised Trial

Acupuncture in Medicine ◽

10.1136/aim.25.4.130 ◽

2007 ◽

Vol 25 (4) ◽

pp. 130-136 ◽

Cited By ~ 67

Author(s):

Hyuk Ga ◽

Ji-Ho Choi ◽

Chang-Hae Park ◽

Hyun-Jung Yoon

Keyword(s):

Elderly Patients ◽

Myofascial Pain ◽

Randomised Trial ◽

Pain Syndrome ◽

Trigger Points ◽

Upper Trapezius ◽

Significant Difference ◽

Lidocaine Injection ◽

Reduction Of Pain

Aim To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients. Methods Thirty nine participants with myofascial pain syndrome of one or both upper trapezius muscles were randomised to treatment with either acupuncture needling (n=18) or 0.5% lidocaine injection (n=21) at all the trigger points on days 0, 7 and 14, in a single-blinded study. Pain scores, range of neck movement, pressure pain intensity and depression were measured up to four weeks from the first treatment. Results Local twitch responses were elicited at least once in 94.9% of all subjects. Both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point up to one month. Overall, the range of cervical movement improved in both groups, apart from extension in the acupuncture needling group. Changes in depression showed only trends. Conclusion There was no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating myofascial pain syndrome in elderly patients.