scholarly journals Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
José M. Climent ◽  
Ta-Shen Kuan ◽  
Pedro Fenollosa ◽  
Francisco Martin-del-Rosario
Keyword(s):  
Clinical Trials ◽  
Botulinum Toxin ◽  
Myofascial Pain ◽  
Botulinum Toxin A ◽  
Pain Syndrome ◽  
Trigger Points ◽  
Control Group ◽  
Injection Technique ◽  
Myofascial Pain Syndromes ◽  
Myofascial Trigger Points

Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results.Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS.Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

Myofascial Pain

2018 ◽  
Vol 38 (06) ◽  
pp. 640-643 ◽  
Author(s):  
Douglas Comeau ◽  
James Otis ◽  
Jason Weller
Keyword(s):  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Cellular Level ◽  
Myofascial Pain Syndromes ◽  
Myofascial Trigger Points ◽  
Pain Syndromes ◽  
Outer Covering ◽  
Motor End Plate

AbstractMyofascial pain syndromes arise from acute and chronic musculoskeletal pain and often have a referred neuropathic component. It affects more than three quarters of the world's population and is one of the most important and overlooked causes of disability. The origins of pain are thought to reside anywhere between the motor end plate and the fibrous outer covering of the muscle, with involvement of microvasculature and neurotransmitters at the cellular level. Diagnosis is made by clinical examination for the presence of myofascial trigger points, though some ancillary tests may provide supportive evidence. The mainstay of treatment is regular physical therapy with the goal of restoration of normal muscle laxity and range of motion. Adjunct therapies including pharmacologic and nonpharmacologic interventions provide varying degrees of benefit in refractory cases, and onabotulinum toxin A injection has the most evidence of efficacy for these patients. Here, we discuss the epidemiology, pathophysiology, and diagnostic and therapeutic options for the evaluation and treatment of myofascial pain syndrome.

scholarly journals Effectiveness between Dry Needling and Ischemic Compression in the Triceps Surae Latent Myofascial Trigger Points of Triathletes on Pressure Pain Threshold and Thermography: A Single Blinded Randomized Clinical Trial

2019 ◽  
Vol 8 (10) ◽  
pp. 1632 ◽  
Author(s):  
Benito-de-Pedro ◽  
Becerro-de-Bengoa-Vallejo ◽  
Losa-Iglesias ◽  
Rodríguez-Sanz ◽  
López-López ◽  
...  
Keyword(s):  
Skin Temperature ◽  
Pain Threshold ◽  
Myofascial Pain ◽  
Pressure Pain Threshold ◽  
Pain Syndrome ◽  
Trigger Points ◽  
Triceps Surae ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Pressure Pain

Background: Deep dry needling (DDN) and ischemic compression technic (ICT) may be considered as interventions used for the treatment of Myofascial Pain Syndrome (MPS) in latent myofascial trigger points (MTrPs). The immediate effectiveness of both DDN and ICT on pressure pain threshold (PPT) and skin temperature of the latent MTrPs of the triceps surae has not yet been determined, especially in athletes due to their treatment requirements during training and competition. Objective: To compare the immediate efficacy between DDN and ICT in the latent MTrPs of triathletes considering PPT and thermography measurements. Method: A total sample of 34 triathletes was divided into two groups: DDN and ICT. The triathletes only received a treatment session of DDN (n = 17) or ICT (n = 17). PPT and skin temperature of the selected latent MTrPs were assessed before and after treatment. Results: Statistically significant differences between both groups were shown after treatment, showing a PPT reduction (p < 0.05) in the DDN group, while PPT values were maintained in the ICT group. There were not statistically significant differences (p > 0.05) for thermographic values before and treatment for both interventions. Conclusions: Findings of this study suggested that ICT could be more advisable than DDN regarding latent MTrPs local mechanosensitivity immediately after treatment due to the requirements of training and competition in athletes’ population. Nevertheless, further studies comparing both interventions in the long term should be carried out in this specific population due to the possible influence of delayed onset muscle soreness and muscle damage on PPT and thermography values secondary to the high level of training and competition.

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

2018 ◽  
Vol 108 (1) ◽  
pp. 27-32 ◽  
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 ◽  
Myofascial 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 &lt; .001). The increase in PPT was also significant after the fifth (P = .010), tenth (P = .023), and 15th (P = .001) sessions (P &lt; .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.

scholarly journals 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

2018 ◽  
Vol 90 (6) ◽  
pp. 81-88
Author(s):  
F I Devlikamova
Keyword(s):  
Muscle Relaxant ◽  
Blood Circulation ◽  
Myofascial Pain ◽  
Ultrasound Examination ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Orthostatic Test ◽  
Myofascial Trigger Points ◽  
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.

scholarly journals Acute Effects of Tecar Therapy on Skin Temperature, Ankle Mobility and Hyperalgesia in Myofascial Pain Syndrome in Professional Basketball Players: A Pilot Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8756
Author(s):  
Mireia Yeste-Fabregat ◽  
Luis Baraja-Vegas ◽  
Juan Vicente-Mampel ◽  
Marcelino Pérez-Bermejo ◽  
Iker J. Bautista González ◽  
...  
Keyword(s):  
Myofascial Pain ◽  
Intervention Group ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Absolute Temperature ◽  
Medial Gastrocnemius ◽  
Control Group ◽  
Basketball Players ◽  
Myofascial Trigger Points ◽  
Professional Basketball

(1) Background: Myofascial pain syndrome (MPS) is a clinical condition characterized by localized non-inflammatory musculoskeletal pain caused by myofascial trigger points. Diathermy or Tecar therapy (TT) is a form of noninvasive electro-thermal therapy classified as deep thermotherapy based on the application of electric currents. This technique is characterized by immediate effects, and its being used by high performance athletes. (2) Methods: A total of thirty-two participants were included in the study who were professional basketball players. There was a 15-person Control Group and a 17-person Intervention Group. TT was applied in the Intervention Group, while TT with the device switched off (SHAM) was applied in the Control Group. The effects were evaluated through the Lunge test, infrared thermography, and pressure threshold algometry at baseline, 15, and 30 min after the intervention. (3) Results: the Intervention Group exhibited a greater increase in absolute temperature (F[1,62] = 4.60, p = 0.040, η2p = 0.13) compared to the Control Group. There were no differences between the groups in the Lunge Test (F[1.68,53.64] = 2.91, p = 0.072, η2p = 0.08) or in pressure algometry (visual analog scale, VAS) (F[3.90] = 0.73, p = 0.539, η2p = 0.02). No significant short-term significant differences were found in the rest of the variables. (4) Conclusions: Diathermy can induce changes in the absolute temperature of the medial gastrocnemius muscle.

scholarly journals Pathophysiological substantiation of the complex approach to rehabilitation of patients with myofascial pain syndrome of the neck region

2020 ◽  
Vol 2 (1) ◽  
pp. 66-70
Author(s):  
O. V. Shimarova ◽  
V. V. Malakhovskiy ◽  
V. G. Zilov
Keyword(s):  
Myofascial Pain ◽  
Neck Region ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Muscle Stiffness ◽  
Myofascial Pain Syndromes ◽  
Pain Syndromes ◽  
Complex Approach

Myofascial pain syndromes are a widespread pathology, which is a condition that is characterized by local muscle stiffness and the formation of trigger points in them. The pathophysiology of myofascial pain syndromes is not fully understood. Studies indicate the role of dysfunction of the end plate of the muscle, impaired proprioreception and sensomotor control, central sensitization. The review presents a modern view of approaches to the treatment of myofasial pain syndrome of the neck region, based on an understanding of its pathophysiology.

scholarly journals 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

2003 ◽  
Author(s):  
◽  
Marlon Thoresson
Keyword(s):  
Myofascial Pain ◽  
Relative Effectiveness ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Clinical Findings ◽  
Myofascial Trigger Points ◽  
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.

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