Management of a patient with myofascial pain syndrome (piriformis syndrome): clinical follow-up

The article considers a clinical case of treatment of one of the variants of myofascial pain syndrome – piriformis syndrome without signs of sciatic nerve neuropathy. The peculiarity of the case is the comorbidity of the opioid syndrome with diabetic sensorimotor polyneuropathy and osteoporosis, which required the appointment of complex therapy. The diagnosis was confirmed by additional research methods: spondylography, MRI of the lumbosacral spine, ultrasound of the piriformis muscle, electroneuromyography. A patient management tactic was chosen based on federal clinical guidelines for the treatment of patients with nonspecific back pain. Treatment included non-medicinal and medicinal methods. In order to relieve pain, dexketoprofen was prescribed 2 ml intramuscularly per 2 ml of 0.5% lidocaine solution – 1 time а day No. 2 – under navigation by ultrasound. Subsequently, the transfer was made to oral administration of 25 mg 3 times а day for 3 days. A step-by-step scheme of prescribing dexketoprofen: its introduction into the piriformis muscle with subsequent transfer to oral administration allowed to significantly reduce the severity of pain after 5 days of treatment. The complex effect on the spasmodic piriformis muscle with the help of a tableted muscle relaxant in combination with postisometric relaxation made it possible to quickly stop the pain syndrome and prevent its chronization. The administration of the preparation of thioctic acid pursued two goals: to improve the metabolism of the spasmodic muscle and restore the energy metabolism of peripheral nerves. As a result of the use of complex, pathogenetically based therapy, a positive effect was achieved.

Evaluating the Relationship Between Myofascial Pain Syndrome (MPS) and Physical and Mental Health Status in Patients with Stroke

Background: Myofascial pain syndrome (MPS) is a non-inflammatory disorder with muscle stiffness and pain that occurs with the appearance of palpable and irritating nodules in the muscular system. Stroke is one of the most common neurological diseases that in many cases leads to disability and reduction of quality of life (QOL). Objectives: This study aimed to evaluate the relationship between MPS and physical and mental health (MH) status in patients with stroke. Methods: Using available sampling method, this case-control study included 260 patients with stroke. To collect data, demographic characteristics, Visual Analogue Scale (VAS), 36-item Short Form Survey (SF-36), and Depression, Anxiety and Stress Scale (DASS-21) were used. Data analysis was performed using SPSS 16. Mean and standard deviation were used for descriptive statistics and independent t-test, paired t-test, and analysis of variance (ANOVA) were used for inferential tests. Results: While the pain score was 6.35 (1.39), QOL score was 38.86 (11.69), and MH score was 16.26 (2.75) in the intervention group, these scores were 2.15 (0.96), 63.96 (17.52), and 9.02 (4.63), respectively, in the control group. The results showed no statistically significant relationship between MPS and QOL. But there was a statistically significant relationship between MPS and MH, so that the MH status of patients with MPS was lower than the MH status of other patients. Conclusions: Necessary interventions have been done to improve the health status of patients with MPS, which will lead to an increase in the health status of these patients.

A rare cause of insidious shoulder pain in a young female: A soft tissue aneurysmal bone cyst in supraspinatus muscle

Aneurysmal bone cyst (ABC) is an expansile cystic lesion which may affect any bone of the skeleton. Although extremely rare, lesions with histomorphological characteristics of an ABC occur in the soft tissue. Herein, we report the first case of ABC involving the supraspinatus muscle and mimicking common pathologies, such as myofascial pain syndrome or subacromial impingement syndrome.

YouTube as a Source of Patient Information on Myofascial Pain Syndrome

Introduction Myofascial pain syndrome is a local disorder characterised by pathological myofascial constrictions and trigger points. One of the most popular sources of internet-based information for patients is YouTube, which provides a lot of videos related to myofascial pain syndrome, making it one of the top clinical conditions searched for on the site. This study aimed to examine the quality of the YouTube video content on myofascial pain syndrome. Method This study was designed as a cross-sectional study and used the YouTube video sharing website as the main source of data. A search of the relevant videos was performed by entering the words “myofascial pain syndrome” in June 2021. Video characteristics were recorded, and the quality of the videos was assessed according to the Journal of the American Medical Association (JAMA) benchmark criteria, the DISCERN Scale and the Global Quality Scale. Results A total of 322 videos were evaluated, 186 of which were subjected to analysis after applying the inclusion/exclusion criteria. The videos were categorised into groups, with 10 (5.4%) falling into the high-quality group, 16 (8.6%) into the intermediate quality group, and 160 (86%) into the low-quality group. The findings from the study showed that the most popular videos, the highest number of video likes and the highest number of video views were in the intermediate group, while the high-quality group had the lowest popularity level, number of video likes and number of video views (p ˂ 0.05). Conclusions Although there are videos with high-quality content on YouTube offering guidance to patients about the disease, it is important to keep in mind that inaccurate and deficient information about the disease may also be present on this platform.

Effects of Low-Level Laser Irradiation and Dry Needling on the Symptoms of Myofascial Pain Syndrome: A Controlled Pilot Study

Introduction: This study aimed to compare the effects of Low-Level Laser Therapy (LLLT) combined with Dry Needling (DN) with DN alone on pain and neck disability index following myofascial pain syndrome. Materials and Methods: Sixteen women with active Trigger Points (TrPs) in their upper trapezius muscles participated in this study. They were divided into two groups: Experimental and control. The experimental group received one session of the DN plus the LLLT with 6 j/ cm2 energy at their TrPs. The patients in the control group were under a similar procedure, but they did not receive any energy by the LLLT (placebo). The pain score was assessed before, immediately, and 48 hours after the treatment. Neck Disability Index (NDI) was assessed before and 48 hours after the treatment. Results: There was a significant improvement in pain intensity and NDI scores 48 hours after the treatment in both groups compared with the baseline scores (P<0.05). The pain was also significantly reduced at the patients following laser therapy immediately after the treatment (P=0.01). Conclusion: A combination of the LLLT and DN might be more effective compared with using DN alone, and reduce immediate pain at the patients with the active TrPs. There was no difference between the groups 48 hours after the treatment. It seems that LLLT has no considerable effect on NDI and pain intensity 48 hours after the treatment.