scholarly journals Rhomboid major muscle ultrasound-guided trigger point injection: a case report and technique description

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Luz Miriam Leiva Pemberthy ◽  
Daniel F. Gallego ◽  
Maria Eugenia Zuluaga Ruiz
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Ultra Sound ◽  
Myofascial Trigger Point ◽  
Abnormal Finding ◽  
Iatrogenic Complications ◽  
Patient Reported ◽  
Point Injection

Introduction: Myofascial pain syndrome is an acute and chronic painful musculoskeletal condition that involves muscle and surrounding connective tissue. Trigger point injection is a common treatment for this condition providing long-term relief. The procedure is generally safe; however some side effects have been reported including pain, nerve injury, bleeding, infection, and pneumothorax. Objective: To report a case of a patient with myofascial pain syndrome successfully treated by Ultra Sound-guided infiltration of a myofascial trigger point in the rhomboid major muscle. Case description: A 39-year-old presented with cervical and dorsal pain of 4 months of evolution. She had physical and occupational therapy, with partial improvement of cervical pain but persistence of dorsal pain. No abnormal finding was noted on the neurological examination. On palpation, the patient had a myofascial trigger point in the left rhomboid major muscle. Given the persistence of the myofascial trigger point after physical therapy, it was considered the patient might benefit from Ultra Sound-guided infiltration. No adverse events were reported. At the end of the procedure, the patient reported a 70% reduction in pain. The patient returned for a follow-up visit one month after the procedure, reporting pain relief of 80%. Conclusions: The use of an Ultra Sound-guided technique for trigger point injection decreases the risk of iatrogenic complications. The blind method may result in poor localization of the point. Further studies are required to develop Ultra Sound based criteria to determine its clinical use.

scholarly journals Trigger Point Injection Therapy in the Management of Myofascial Pain Syndrome in the Maxillofacial Area

2020 ◽  
Vol 28 (6) ◽  
pp. 694-701
Author(s):  
I.A. Arsenova ◽  
◽  
I.O. Pohodenko-Chudakova ◽  
M.A. Lar’kina ◽  
◽  
...  
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Injection Therapy ◽  
Point Injection

Цель. Оценить эффективность инъекций в триггерные точки при лечении миофасциального болевого синдрома челюстно-лицевой области. Материал и методы. С 2014-2017 гг. было пролечено 124 человека с миофасциальным болевым синдромом лица, из них 76 женщин и 48 мужчин в возрасте от 19 до 62 лет. Кроме клинических и рентгенологических методов диагностики всем пациентам выполняли электромиографию и тестирование болей по визуальной аналоговой шкале боли (VAS). С целью купирования миофасциального болевого синдрома применялись методы традиционной терапии: шиновая терапия, коррекция окклюзии, медикаментозная и физиотерапия. При неэффективности традиционных методов выполнялись инъекции «Лимфомиозот» и «Траумель С» в триггерные точки по методике J. Kersschot (2010). Контрольные осмотры проводились через 1, 3, 6, 12 и 18 и 24 месяца после выполнения манипуляции. При контрольных осмотрах обращали внимание на жалобы пациентов, определяли интенсивность боли по VAS. Критерием положительных результатов лечения являлось отсутствие болей в покое и при функциях. Результаты. При стандартном лечении положительные результаты были получены у 86 из 124 человек (69,4%). Инъекции в триггерные точки, выполняемые при недостаточной эффективности лечения у 38 человек, привели к прекращению боли у 32 (84,2%) пациентов. Как показали наши наблюдения, длительный период без боли (в течение двух лет) наблюдали у 12 (37,6%) человек. Продолжительный эффект в течение периода времени до полутора лет был констатирован у 8 пациентов (25%), до 1 года – у 7 человек (21,8%), до 6 месяцев – у 5 (15,6%). Заключение. Инъекции в триггерные точки повышают эффективность терапии и обеспечивают длительный период ремиссии заболевания, что проявляется в отсутствии болевых приступов и ощущения дискомфорта. Научная новизна статьи Впервые для лечения миофасциального болевого синдрома (МБС) лица была использована методика с применением инъекций «Лимфомиозот» и «Траумель С» в триггерные точки. Установлено, что данная методика инъекций в триггерные точки является эффективным методом лечения МБС лица в независимости от причины, его вызвавшей. Показано, что применение инъекций в триггерные точки при миофасциальном болевом синдроме лица способствовало быстрому купированию болей и длительному безболевому периоду сроком наблюдения до двух лет.

Dry Needling Versus Sham Needling for Myofascial Pain Syndrome: A Critically Appraised Topic

2020 ◽  
Vol 25 (6) ◽  
pp. 289-293
Author(s):  
Melissa Jack ◽  
Ryan Tierney ◽  
Jamie Mansell ◽  
Anne Russ
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Clinical Question ◽  
Myofascial Trigger Point ◽  
Dry Needling ◽  
Bottom Line

Focused Clinical Question: In patients with myofascial trigger point pain, does dry needling result in greater decreases in pain compared to sham needling? Clinical Bottom Line: The evidence supporting dry needling as more effective than sham needling in reducing patients’ pain is mixed.

Management of Myofascial Pain Syndrome in Armed Force Personnel: Two Novel Therapeutic Approach

2016 ◽  
Vol 27 (4) ◽  
pp. 113-120
Author(s):  
Lt Col Sonu Singh ◽  
Brig. L C Pandey ◽  
Lt Col A S Kalra
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Extracorporeal Shock Wave Therapy ◽  
Myofascial Pain Syndrome ◽  
Treatment Groups ◽  
Pain Syndromes ◽  
Extracorporeal Shock Wave ◽  
Point Injection ◽  
Stretching Exercises

Abstract Background Myofascial pain syndrome is one of the commonest pain syndromes now a days. Its pathophysiology is not fully documented or understood. Goal of treatment is to release the pain and discomfort of myofascial pain syndrome. Methods This was a multicentric prospective study comprising 70 patients who had been diagnosed clinically with myofascial pain syndrome in the neck, shoulder or back. Cases were randomly divided into two treatment groups. First group (36 cases) were treated with physiotherapy modalities (extracorporeal shock wave therapy and ultrasound therapy as combination therapy) and patients in second group (34 cases) were treated with trigger point injection. In both the groups patients were advised stretching exercises as soon as pain decreases. Results Pain was substantially decreased in both the treatment groups but results were early and comparatively better in patients treated by trigger point injection group. Stretching exercises were helpful in regaining strength and also helpful in decreasing recurrence of pain.

CLINICAL-NEURO-PHYSIOLOGICAL CHARACTERISTICS OF MYOFASCIAL PAIN SYNDROME IN A PATIENT WITH LEFT HEMYPLEGIA AFTER INTRACEREBRAL HEMORRHAGIC STROKE

2021 ◽  
pp. 147-151
Author(s):  
S. L. Popel ◽  
T. P. Vasylyk ◽  
I. M. Boiko ◽  
S. L. Anokhina ◽  
M. V. Koval
Keyword(s):  
Myofascial Pain ◽  
Trigger Point ◽  
Pain Syndrome ◽  
Motor Units ◽  
Myofascial Pain Syndrome ◽  
Healthy People ◽  
Physiological Characteristics ◽  
Myofascial Trigger Point ◽  
Characteristic Symptom ◽  
Symptom Complex

Myofascial pain syndrome (MFPS) is one of the most common comorbid pathological processes that develops in skeletal muscle in patients with stroke, which is manifested by local seals and pain in various parts of the muscle. Despite the fact that the interest in MFPS arose in the last century, the intimate mechanisms of its development and course remain to be fully explored. It was found that the main manifestations of MFPS were the presence of miofascial trigger point in the area of palpation of the corresponding muscle with local pain and hypersensitivity within the palpated cord-segmentes, the characteristic pattern of reflected pain and reflected autonomic phenomenon, local convulsive response during transverse palpation. It is accompanied by muscle fatigue and significant muscle weakness without severe atrophy. Attention is drawn to the clear recurrence-reproducibility of pain, ie the so-called "recognizable" pain. All of the above symptoms constitute a general pattern of the disease, which has diagnostic value and is proposed for use as prognostic parameters with the obligatory use of the results of electromyographic examination. Diagnosis of active and latent MTP was performed on the basis of generally accepted l signs. The greatest discomfort for the patient is the presence of active MTP with characteristic spontaneously reproducing pain. Latent MTP is detected in up to 90% of cases among healthy people, and adverse factors only contribute to their transition to an active state with a characteristic symptom complex. The presence of an active myofascial trigger point with a characteristic spontaneously reproducing pain is the most painful manifestation. Latent MTP is also detected in most cases among healthy people, and unfavorable factors only contribute to their transition to an active state with a characteristic symptom complex. The study of the number of turns of the adhesive part of the potential in the zone of active ICC showed that there is a concentration of fibers in the zone of one motor units (MU). The average value of this indicator increases in the early stages of the process by 2 times. Even a small degree of desynchronization of the potentials of individual MU causes an increase in the number of rounds, which reflects the number of fibers involved in the generation of MC PMU. Absence of spontaneous muscle fibers (MF) activity, registration of end plate (EP) activity, PMU parameters such as amplitude decrease, shift of neurohistogram of potential distribution by duration towards smaller values or high percentage of polyphasicity, due to increase in number of turns, and also change  their adhesive part, increase of MF density in zone MTP - they all determine changes in structural and functional parameters by muscle type. The work is devoted to the clinical, neuro-physiological characteristics of a patient with MFPS on the background of intracerebral hemorrhage and left hemyplegia based on the analysis of the neuro-functional organization of the motor units of the back muscles. Substantiated genesis and possible mechanism of development and formation of myofascial trigger point in such patients.

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