Background
Electrotherapeutic modalities have proven to be one of the best therapeutic options for myofascial pain syndrome, targeting the myofascial trigger points (MTrPs). Combined therapy (CT) is ...described with paucity in literature as the application of ultrasound (US) and electrical stimulating current concurrently and at the same site.
Aim
The aim was to compare between low‐frequency, high‐intensity burst transcutaneous electrical nerve stimulation CT (burst‐TENS‐CT) and medium‐frequency, low‐intensity amplitude modulated frequency CT (AMF‐CT) on upper trapezius active MTrPs (A‐MTrPs).
Participants and intervention
In this single‐blinded randomized controlled trial design, 70 participants with acute mechanical neck pain and at least two A‐MTrPs in the upper trapezius were simply and randomly allocated into three groups—the burst‐TENS‐CT, the AMF‐CT, or the sham‐CT control groups. All groups received three sessions per week for four consecutive weeks.
Outcome measures
Outcome measures included pressure pain threshold (PPT) using a digital electronic algometer and active cervical lateral flexion range of motion (ROM) using an iPhone Clinometer application. Data were collected prior to the first treatment and at the end of the 4‐week trial.
Results
There were statistically significant improvements in postintervention PPT and ROM values in both treatment groups (p < 0.0001). As for the sham‐US, no significant difference was found between the preintervention and postintervention values (p > 0.05). Bonferroni correction test revealed that there was a significant difference between all the three groups (p < 0.0001). Additionally, burst‐TENS‐CT yields a greater increase in PPT and ROM values (547% and 49.32%, respectively) than that of medium‐frequency AMF‐CT.
Conclusion
Within the scope of this study, both CT modalities were effective in increasing PPT and cervical lateral flexion ROM. Nonetheless, low‐frequency, high‐intensity burst‐TENS‐CT was shown to be superior over the medium‐frequency, low‐intensity AMF‐CT in terms of reducing pain sensitivity and increasing ROM.
Dry needling (DN) is commonly used to inactivate myofascial trigger points (MTrPs). However, a daily report of pain reduction has not been determined.
The aim was to evaluate the time of the greatest ...pain relief after performing a single session of DN in MTrPs of the upper trapezius muscle.
A patient who had MTrPs in the upper trapezius muscle was enrolled into a prospective descriptive study. Each patient received a single session of DN, using a fast-in-fast-out technique, with needle retention for 30 min. Numerical rating scale (NRS) scores were collected daily for 14 days. The mean difference of pain and an effect size were calculated. The 1–5 satisfaction score was a secondary outcome.
Sixty-seven subjects completed the intervention. The mean duration of the symptom was 27.32 months. The mean baseline NRS score was 5.30. The pain decreased significantly between immediate post-procedure and 1 day after the DN treatment from 5.16 to 3.40 (mean difference 1.76, p < 0.01, effect size = 0.87). The pain continuously reduced until day 10 and then it gradually rose. The pain on day 10 was compared with the baseline that revealed the largest effect size of 3.08 (mean difference 4.67, p < 0.01). Eighty-eight percent of the subjects were very satisfied with their treatment.
A single session of DN treatment in the upper trapezius MTrPs combined with self-stretching exercises could greatly reduce pain between immediate post-procedure and 1 day after DN treatment. The peak effect on pain reduction occurred on day 10.
Latent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to ...investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA.
This randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-month follow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up.
A total of 42 patients in the dry needling group (DNG) and 35 patients in the diclofenac group (DG), respectively, completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed a significantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG.
Dry needling on latent and active MTrPs combined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretching for at least 6 months.
Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) in 17/11/2017 with the following code: ChiCTR-INR-17013432.
Myofascial pain syndrome (MPS) is characterized by myofascial trigger points and fascial constrictions. At present, domestic and foreign scholars have not reached a consensus on the etiology and ...pathogenesis of MPS. Due to the lack of specific laboratory indicators and imaging evidence, there is no unified diagnostic criteria for MPS, making it easy to confuse with other diseases. The Chinese Association for the Study of Pain organized domestic experts to formulate this Chinese Pain Specialist Consensus on the diagnosis and treatment of MPS. This article reviews relevant domestic and foreign literature on the definition, epidemiology, pathogenesis, clinical manifestation, diagnostic criteria and treatments of MPS. The consensus is intended to normalize the diagnosis and treatment of MPS and be used by first-line doctors, including pain physicians to manage patients with MPS.
Abstract Background Latent Myofascial Trigger Points are pain-free neuromuscular lesions that have been found to affect muscle activation patterns in the unloaded state. The aim was to extend these ...observations to loaded motion by investigating muscle activation patterns in upward scapular rotator muscles (upper and lower trapezius and serratus anterior) hosting Latent Myofascial Trigger Points simultaneously with lesion-free synergists for shoulder abduction (infraspinatus and middle deltoid). This approach allowed examination of the effects of these lesions on both their hosts and their lesion-free synergists in order to understand their effects on the performance of shoulder abduction. Methods Surface electromyography was employed to measure the timing of onset of muscle activation of the upper and lower trapezius and serratus anterior (upward scapular rotators), infraspinatus (rotator cuff) and middle deltoid (abductor of the arm) initially without load and then with light (1–4 kg) dumbbells. Comparisons were made between control (no Latent Trigger Points; n = 14) and Latent Trigger Point ( n = 28) groups. Findings The control group displayed a relatively stable sequence of muscle activation that was significantly different in timing and variability to that of the Latent Trigger Point group in all muscles except middle deltoid (all P < 0.05). The Latent Trigger Point group muscle activation pattern under load was inconsistent, with the only common feature being the early activation of the infraspinatus. Interpretation The presence of Latent Trigger Points in upward scapular rotators alters the muscle activation pattern during scapular plane elevation, potentially predisposing to overuse conditions including impingement syndrome, rotator cuff pathology and myofascial pain.
Myofascial pain is a common syndrome seen by family practitioners worldwide. It can affect up to 10% of the adult population and can account for acute and chronic pain complaints. In this clinical ...narrative review we have attempted to introduce dry needling, a relatively new method for the management of musculoskeletal pain, to the general medical community. Different methods of dry needling, its effectiveness, and physiologic and adverse effects are discussed. Dry needling is a treatment modality that is minimally invasive, cheap, easy to learn with appropriate training, and carries a low risk. Its effectiveness has been confirmed in numerous studies and 2 comprehensive systematic reviews. The deep method of dry needling has been shown to be more effective than the superficial one for the treatment of pain associated with myofascial trigger points. However, over areas with potential risk of significant adverse events, such as lungs and large blood vessels, we suggest using the superficial technique, which has also been shown to be effective, albeit to a lesser extent. Additional studies are needed to evaluate the effectiveness of dry needling. There also is a great need for further investigation into the development of pain at myofascial trigger points.
Dry needling is one of the methods used to treat myofascial pain syndrome. The treatment involves the use of disposable acupuncture needles but dry needling and acupuncture are not the same. In most ...cases, the treatment includes myofascial trigger point puncturing. The desired effect to be achieved during the procedure is eliciting a local muscle contraction. The most common response after treatment is pain in the needled area.
Dry needling is one of the methods used to treat myofascial pain syndrome. The treatment involves the use of disposable acupuncture needles but dry needling and acupuncture are not the same. In most ...cases, the treatment includes myofascial trigger point puncturing. The desired effect to be achieved during the procedure is eliciting a local muscle contraction. The most common response after treatment is pain in the needled area.
Myofascial pain syndrome (MPS) is thought to stem from masticatory muscle hypersensitivity. Masticatory myofascial pain syndrome (MMPS) is characterized by multiple trigger points (MTrPs), also known ...as hyperirritable points, in taut bands of affected muscles, regional muscle pain, or referred pain to nearby maxillofacial areas like teeth, masticatory muscles or the temporomandibular joint (TMJ). Muscle stiffness, reduced range of motion, muscle weakening without atrophy, and autonomic symptoms may accompany regional discomfort. Multiple treatments have been utilized to reduce trigger points and mandibular function restrictions. As a result of these incapacitating symptoms, MMPS can significantly impair many elements of quality of life. The application of Kinesio tape (KT) is a non-invasive method of treating dormant myofascial trigger points. Utilizing the body's innate capacity for self-repair, this technique entails taping specific regions of the skin. KT alleviates discomfort, decreases swelling and inflammation, enhances or suppresses motor function in the muscles, stimulates proprioception, promotes lymphatic drainage, stimulates blood flow, and expedites tissue recovery. However, studies conducted to assess its effects have frequently yielded contradictory results. To the best of our knowledge, just a few research has looked into the therapeutic effects of KT on MMPS. The purpose of this review is to determine the efficacy of KT as a therapeutic tool for regular treatment or as an adjunct to existing therapy for MMPS based on the evidence presented in this review. To establish KT as a reliable independent treatment option, additional research is necessary to confirm the efficacy of KT techniques and applications, specifically randomized clinical trials.
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