Journal of Yeungnam Medical Science

영남대 의대 학술지 편집위원회 (Yeungnam University College of Medicine, Yeungnam University Institute Medical Science)
권호 표지
DOI QR코드

DOI QR Code

Ultrasound imaging and guidance in the management of myofascial pain syndrome: a narrative review

  • Wei-Ting Wu (Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch) ;
  • Ke-Vin Chang (Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch) ;
  • Vincenzo Ricci (Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco) ;
  • Levent Ozcakar (Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School)
  • 투고 : 2024.05.01
  • 심사 : 2024.05.22
  • 발행 : 2024.07.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.

키워드

과제정보

This study was funded by the National Taiwan University Hospital, Bei-Hu Branch; Ministry of Science and Technology, Taiwan (MOST 106-2314-B-002-180-MY3 and MOST 109-2314-B-002-114-MY3) and National Science and Technology, Taiwan (NSTC 112-2314-B-002-134).

참고문헌

  1. Tantanatip A, Chang KV. Myofascial pain syndrome. Updated 2023 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 May 1]. https://www.ncbi.nlm.nih.gov/books/NBK499882/.
  2. Fleckenstein J, Zaps D, Ruger LJ, Lehmeyer L, Freiberg F, Lang PM, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey. BMC Musculoskelet Disord 2010;11:32.
  3. Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 2008;89:16-23. https://doi.org/10.1016/j.apmr.2007.10.018
  4. Rubin D. Myofascial trigger point syndromes: an approach to management. Arch Phys Med Rehabil 1981;62:107-10.
  5. Hao CJ, Kang XY, Kang CS, Li TT, Huo JZ, Xu Q, et al. Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography. Quant Imaging Med Surg 2023;13:5168-81.
  6. Hung CY, Wang B, Chang HC, Wu WT, Liu PT, Chang KV, et al. Pictorial essay on ultrasound and magnetic resonance imaging of paraspinal muscles for myofascial pain syndrome. Life (Basel) 2024;14:499.
  7. Ricci V, Mezian K, Chang KV, Tarantino D, Guvener O, Gervasoni F, et al. Ultrasound imaging and guidance for cervical myofascial pain: a narrative review. Int J Environ Res Public Health 2023;20:3838.
  8. Suarez-Ramos C, Gonzalez-Suarez C, Gomez IN, Gonzalez MK, Co PH, Llamas JA. Effectiveness of ultrasound guided interfascial hydrodissection with the use of saline anesthetic solution for myofascial pain syndrome of the upper trapezius: a single blind randomized controlled trial. Front Rehabil Sci 2023;4:1281813.
  9. Hasuo H, Oomori H, Yoshida K, Fukunaga M. Effect of visual feedback during ultrasound-guided hydrodissection for myofascial pain syndrome: an exploratory, prospective, observational clinical trial on the expectations for treatment. FrontPsychiatry 2022;13:794425.
  10. Ozyemisci Taskiran O, Albayrak H, Topaloglu M, Manici M, Ketenci A, Gurkan Y. Effect of ultrasound-guided rhomboid interfascial plane block on pain severity, disability, and quality of life in myofascial pain syndrome: a case series with one-year follow-up. Pain Physician 2023;26:E815-22. https://doi.org/10.36076/ppj.2023.26.E815
  11. Lai YC, Tsai SH, Chiou HJ. Ultrasound-guided dextrose solution perimysium dissection for posterior shoulder myofascial pain. J Chin Med Assoc 2021;84:650-4. https://doi.org/10.1097/JCMA.0000000000000541
  12. Anwar N, Li S, Long L, Zhou L, Fan M, Zhou Y, et al. Combined effectiveness of extracorporeal radial shockwave therapy and ultrasound-guided trigger point injection of lidocaine in upper trapezius myofascial pain syndrome. Am J Transl Res 2022;14:182-96.
  13. Chang KV, Lin CP, Lin CS, Wu WT, Karmakar MK, Ozcakar L. Sonographic tracking of trunk nerves: essential for ultrasound-guided pain management and research. J Pain Res 2017;10:79-88. https://doi.org/10.2147/JPR.S123828
  14. Barreto Silva A, Malheiro N, Oliveira B, Pereira D, Antunes F, Borges J, et al. Efficacy of ultrasound-guided infiltration with levobupivacaine and triamcinolone for myofascial pain syndrome of the quadratus lumborum: a retrospective observationalstudy. Braz J Anesthesiol 2023;73:718-24. https://doi.org/10.1016/j.bjane.2021.06.026