Dry needling is one of the most common treatments for this condition. In this study the immediate and delayed effects of superficial dry needling (SDN) and deep dry needling (DDN) on upper trapezius ...muscle function and patients' pain and disability was evaluated.
In this quasi-experimental study, 47 women with active MTrPs were randomly divided into SDN and DDN groups and received one session treatment. Pain and disability were assessed before and one week after intervention with visual analogue scale (VAS) and neck disability index (NDI) questionnaire. Muscle activity was assessed by surface electromyography (sEMG) before, immediately and one week after intervention.
Both groups showed significant decrease in VAS (p < 0.001) and NDI (p < 0.001) after one week, however no significant difference were found between the groups (p > 0.05). A significant increase in sEMG activity was observed only in DDN group after one week (p < 0.007), but there were no significant differences in sEMG activity in SDN group after intervention and between the two groups (p > 0.05).
Both SDN and DDN could be effective in reducing pain and disability in patients with active MTrPs of upper trapezius muscle. Regarding muscle function DDN seems to be more effective. So that based on evaluation of the therapist in some cases with not significant muscle dysfunction SDN as a gentle and less invasive method could be used but for long term effectiveness and in those with significant muscle dysfunction DDN could be used.
Introduction To investigate the influence of Myofascial Trigger Points (MTrPs) release combined with shockwave therapy on pain and functions of the upper extremity with shoulder hand syndrome (SHS) ...in stroke patients with diabetic neuropathy. Methods Two groups of thirty stroke patients, divided equally into, the study group: which received MTrPs release with shockwave therapy and conventional physical therapy program, while the control group: received the conventional physical therapy program. All the patients were evaluated pre-and post-intervention by the severity score of the Complex Regional Pain Syndrome (CRPS), Motor Evaluation Scale Upper Extremity Stroke Patients (MESUPES), the figure of eight test for hand swelling, and the Visual Analogue Scale for pain (VAS-P). Results highly significant improvement of affected upper extremity functions, with a significant reduction of SHS symptoms, swelling, and pain of the study group compared to the control group (p < 0.05), also there was a negative significant correlation between MESUPES- all-out score and VAS-P. Conclusions The combination of both MTrPs release with shockwave therapy had a significant improvement effect on upper extremity function and a significant reduction of both SHS symptoms and pain in stroke patients with diabetic neuropathy, which leads to improvement in stroke patients’ functional rehabilitation.
Objective
To compare the effects of electrical dry needling with a non-invasive multi-component intervention in patients with chronic low back pain.
Design
A randomised single-blind clinical trial.
...Setting
Outpatient Physiotherapy Clinic; home.
Participants
Sixty-four patients with chronic low back pain aged 30–65 years.
Interventions
Six-week electrical dry needling on myofascial trigger points, and a non-invasive multicomponent intervention (home exercise programme, stretching and ischemic compression).
Main measures
Pain (Visual Analogue Scale), disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), kinesiophobia (Tampa Scale of Kinesiophobia), quality of life and sleep (Short Form 36-item Health Survey and Pittsburgh Sleep Quality Index), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion (finger-to-floor distance), and pressure pain threshold (algometer) were assessed at baseline, after 6 weeks, and after 2 months.
Results
ANOVA showed statistically significant differences in group-by-time interaction for most pain pressure thresholds of myofascial trigger points (P < 0.05), for disability (Roland-Morris Disability Questionnaire: F = 6.14, P = 0.016; and Oswestry Disability Index: F = 7.36, P = 0.009), for trunk anteflexion (F = 10.03, P = 0.002) and for habitual sleep efficacy (F = 6.65, P = 0.012), use of hypnotics (F = 4.77, P = 0.033) and total score of quality of sleep (F = 8.23, P = 0.006).
Conclusions
In comparison to a non-invasive multicomponent intervention, electrical dry needling has more positive effects on disability, pain intensity, kinesiophobia, and reducing patients’ sensitivity to myofascial trigger points pressure, at post-treatment and at 2 months.
Clinical Trial Registration number
NCT04804228. Registered on May 28th, 2021. Available at https://clinicaltrials.gov/ct2/show/NCT04804228
Myofascial pain associated with myofascial trigger points (MTrPs) is a common cause of nonarticular musculoskeletal pain. Although the presence of MTrPs can be determined by soft tissue palpation, ...little is known about the mechanisms and biochemical milieu associated with persistent muscle pain. A microanalytical system was developed to measure the in vivo biochemical milieu of muscle in near real time at the subnanogram level of concentration. The system includes a microdialysis needle capable of continuously collecting extremely small samples (approximately 0.5 microl) of physiological saline after exposure to the internal tissue milieu across a 105-microm-thick semi-permeable membrane. This membrane is positioned 200 microm from the tip of the needle and permits solutes of <75 kDa to diffuse across it. Three subjects were selected from each of three groups (total 9 subjects): normal (no neck pain, no MTrP); latent (no neck pain, MTrP present); active (neck pain, MTrP present). The microdialysis needle was inserted in a standardized location in the upper trapezius muscle. Due to the extremely small sample size collected by the microdialysis system, an established microanalytical laboratory, employing immunoaffinity capillary electrophoresis and capillary electrochromatography, performed analysis of selected analytes. Concentrations of protons, bradykinin, calcitonin gene-related peptide, substance P, tumor necrosis factor-alpha, interleukin-1beta, serotonin, and norepinephrine were found to be significantly higher in the active group than either of the other two groups (P < 0.01). pH was significantly lower in the active group than the other two groups (P < 0.03). In conclusion, the described microanalytical technique enables continuous sampling of extremely small quantities of substances directly from soft tissue, with minimal system perturbation and without harmful effects on subjects. The measured levels of analytes can be used to distinguish clinically distinct groups.
Chronic nonspecific low back pain is a frequent clinical condition affecting the general population and influencing disability level and quality of life. We performed a single-blinded, randomized, ...and controlled study to compare the effectiveness of manual pressure release (MPR) and electrical neuromodulation (ENM) treatments in the management of chronic low back pain. There were 20 patients with chronic low back pain randomly assigned to 6 treatment sessions with either technique. Both groups were treated for 2 days a week for 3 weeks. Myofascial trigger points (MTrPs) were identified and skin conductance, pressure-pain threshold, postural changes, and the Oswestry Disability Index were assessed before and after each treatment session, along with the protocol-end data compared against the baseline data in each group. We found an outstanding and about equal deactivation of MTrPs from pre- to post-treatment in both groups, reducing disability in patients with chronic low back pain. The study highlights the ENM as a reliable tool for the evaluation of MTrPs, given a high agreement with the MPR. The effect on the neuromuscular condition of treating the "key trigger points" found in this study advances the knowledge of medical rehabilitation.
Ma YT, Li LH, Han Q, et al. J Pain Res.2020;13:1677-1686. The authors have advised Figure 3 on page 1682 is incorrect.Due to an error at the time of figure assembly Figure2 and Figure 3 were ...duplicated. The correct Figure 3 isshown below. The authors apologize for this error and advise it does notaffect the results of the paper. Read the original article
Myofascial pain syndrome is a common musculoskeletal pain disorder characterized by the presence of myofascial trigger points (MTrPs). The diagnosis of myofascial pain syndrome is currently made on ...clinical grounds. Numerous diagnostic criteria are used to identify myofascial pain syndrome, including the localization of MTrPs. Identifying the presence of MTrPs currently requires the physician to palpate the symptomatic region. Because the interrater reliability of the palpation technique has been found to be poor, numerous groups have been interested in finding objective imaging measures to localize the MTrP. This comprehensive review focuses on summarizing ultrasound imaging techniques that have shown promise in visually localizing the trigger point. The authors' literature search identified three sonographic approaches that have been used in MTrP localization: conventional gray-scale imaging, Doppler imaging, and elastographic ultrasound imaging. This review article explains the basic physics behind the imaging methods and summarizes the characteristics of the MTrP as identified by the ultrasonic techniques.
The most important clinical problem in myofascial pain syndrome (MPS) is trigger points (TrPs). The aim of the present study was to investigate the comparison of immediate effect of deep transverse ...friction massage (DTFM), high-power pain threshold ultrasound (HPPTUS), and whole body vibration (WBV) on treatment of active myofascial trigger points (MTrPs).
Materials and Methods: sixty six men with active TrPs of upper trapezius muscle were randomly divided into three equal groups: DTFM, HPPT US, and WBV. Pain intensity based on the Visual Analogue Scale (VAS), pressure pain threshold (PPT) and active contralateral lateral flexion range of motion (CLF ROM) of the neck were evaluated before and immediately after the interventions.
The VAS, PPT and the active CLF ROM were substantially improved after intervention in all groups (P < 0.01). When the three groups were compared regarding VAS, participants in the WBV group reported significantly more reduction in pain (P < 0.01). On comparing the interventions, there were no significant differences in PPT values (P > 0.05). The CLF ROM value in HPPTUS and WBV groups have significant increase in comparison to the DTFM group.
All three interventions can improve neck pain, PPT and ROM in participants with active TrPs in upper trapezius muscle, but due to the fact that the DTFM has more pressure on therapist fingers, and the HPPTUS technique requires proper interaction with the participants, WBV can be used as one of the effective intervention on active MTrPs of upper trapezius.
IRCT20200518047498N1.
PDF
