• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.19-27
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• 2022

Background: Myofascial pain dysfunction syndrome (MPDS) is the most common type of temporomandibular disorder. This study compared the efficacies of low-level diode laser therapy (LLLT) and laser acupuncture therapy (LAT) in the treatment of MPDS. Methods: This double-blind randomized controlled clinical trial included 24 patients with MPDS who were randomly divided into two equally sized groups. Patients in the LLLT group received 12 sessions of low-level diode laser irradiation applied to the trigger points of the masticatory muscles during 1 month. The same protocol was also used in the LAT group according to the specific trigger points. We measured pain intensity and maximum mouth opening in both groups at baseline, during treatment, and 2 months after treatment completion. Results: The pain intensities decreased from 6.58±1.31 to 0.33±0.65 and from 7.08 ± 1.37 to 0 in the LLLT and LAT groups, respectively. The maximum mouth openings increased from 32.25 ± 8.78 mm to 42.58 ± 4.75 mm and from 33 ± 6.57 mm to 45.67 ± 3.86 mm in the LLLT and LAT groups, respectively. Pain intensity (P = 0.839) and level of maximum mouth opening (P = 0.790) did not differ significantly between the groups. Conclusion: Our results showed similar efficacy between LLLT and LAT in the treatment of MPDS signs and symptoms.

• Journal of Pharmacopuncture
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• v.18 no.4
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• pp.26-31
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• 2015

Objectives: This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Methods: Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

• Journal of Acupuncture Research
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• v.18 no.5
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• pp.1-10
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• 2001

Objective : This study was performed to confirm the effects of acupuncture on myofascial pain syndrome(MPS) through the change of visual analogue scale(VAS) and pain pressure threshold(PPT) and the usefulness of pressure algometer on the evaluation of pain. Methods : We perfomed this study with 20 outpatients complaining of upper back pain. Before acupuncture therapy(AT), immediately after AT and 2-3 days after AT, we respectively checked visual analogue scale(VAS) and pain pressure threshold(PPT) through pressure algometer, with patients seated and relaxed. The PPT was checked at major trigger point of upper trapezius, levator scapulae, supraspinatus, infraspinatus, rhomboideus minor. and the patients were needled at the same points and maintained for 15 minutes. Results : VAS of immediately after AT was mild higher than that of before AT, but not significantly different. and VAS of 2-3 days after AT was significantly lower than before AT and immediately after AT. PPT of immediately after AT was lower than before PT, but not significantly different. PPT of 2-3 days after AT was significantly higher than that of before AT and immediately after AT. Also PPT was significantly correlated with VAS. Conclusion : PPT of omen was signicantly lower than that of men. and there was no significant difference by age. PPT was increased according to pain duration. Effectiveness of acupuncture on myofascial pain syndrome through PPT and VAS is showed at 2-3 days after AT rather than immediatly after AT. and pressure algometer is useful for the evaluation of Acupuncture therapy on myofascial pain syndrome.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.1
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• pp.58-64
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• 2010

The purpose of this study was to investigate the distribution of trigger points(TrPs) on athletes with various sporting background. To achieve the purpose, a study was carried out through a survey from 180 athletes involved in 6 selected sports at Yong-In University. Selected sports included Judo, Taekwondo, Kendo, Ssi-reum(Korean traditional wrestling), Boxing, and Golf. An interview type survey and physical examination were conducted with each thirty athletes from each of the selected sports groups. Technical statistic(SPSS 15.0) was used to analyze the distribution of TrPs on these athletes. The most common TrPs observed in muscles of Trapezius, Quadratus Lumborum, Quadriceps in Judo. In Taekwondo, it was on the trapezius and triceps surae. Kendo athletes had TrPs at sites of trapezius, brachioradialis and triceps surae. Ssirem athletes were found to have TrPs on trapezius, deltoid and quadrates lumborum. In boxers, TrPs appearing at trapezius and brachioradialis were observed. Finally, Golf players were seen to have TrPs at trapezius, quadrates lumborum and brachioradialis. Hence, the analysis shows that there are significant differences of the distribution of TrPs according to the different sport items of the athlete.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.15-21
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• 2019

Objective: The purpose of this study was to identify whether cutaneous sensory (CS) changes induced by mechanical intervention (MI) increases the trigger point threshold of the same spinal segment as well as to investigate the relationship between the amounts of change in CS pressure pain thresholds (PPT). Design: Randomized controlled trial. Methods: Thirty-nine persons with myofacial pain (MFP) were recruited in this experiment. The subjects consisted of 20 men and 19 women (age 20-39). MI was applied on the subjects using the Graston technique for 5 minutes to induce CS changes. The CS changes were measured with sensory tests by using the Von Frey Filament, and PPT changes were estimated by using the pressure threshold meter. For the observation of sensory and PPT changes with time, the test was conducted for 15 minutes including a pre, post, and after intervention session. Results: CS threshold increased significantly when MI was applied (p<0.001). On the same spinal segment, changes in the right infraspinatus PPT was observed (p<0.001) but the PPT changes in other muscles were not significantly different. Furthermore, the control group CS and PPT were not significantly different. In addition, regression analysis showed that the CS changes have a larger impact on PPT in the same spinal segment (p<0.001). Conclusions: CS changes induced by MI make to change PPT on the same spinal segment. In other words, it is possible to identify PPT changes following CS changes except for the muscle which belongs to a different spinal segment. Therefore, application of MI is necessary for the CS changes in the same spinal segment. Furthermore, it can be useful in the clinical fields as a method of providing pain control and increasing the PPT.

• Journal of Haehwa Medicine
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• v.23 no.1
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• pp.79-92
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• 2014

Objectives : This study aimed to investigate the medical contents of Korean medical textbooks and intervention usage in clinical practice. Method : We conducted an email survey of Doctors of Korean Medicine(DKMs) registered with the Association of Korean Medicine and analyzed the 259 responses that we received. Results : 1, The study showed that most DKMs used western medical knowledge concerning "history taking and diagnosis"(96.5%), "management and prevention"(95.8%), "causes and overview"(91.9%), and "prognosis"(90.3%). DKMs did not usually use western medical knowledge with regard to "diagnosis and treatment evaluation tools"(40.9%) or "western medical treatments"(25.1%) in their clinical practice. 2. Of the DKMs surveyed, 39.0% usually used traditional and western medical terms at similar levels of frequency in explaining their patients' conditions, while 35.9% used western medical terms more often and 20.8% used Korean traditional medical terms more often. 3. Most DKMs usually used acupuncture, herbal medicine, cupping therapy, Moxibustion in their practice and used herbal prescriptions presented in Dongeuibogam(57.1%), Bangyakhappyeon(52.9%), and Sa-Sang Constitutional Medicine(36.7%), although 27.8% used their own herbal prescriptions in creating for patients. In practice, DKMs usually used meridian acupuncture(64.1%), needling myofascial trigger points(54.8%), sa-am acupuncture(42.1%), dong-shi acupuncture therapy(24.7%), and constitutional acupuncture therapy(8.5%). Conclusions : We found that most DKMs use western medical contents as well as Korean medical contents in clinical practice. New Korean medical contents should be establish based on these results.

• Physical Therapy Korea
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• v.21 no.2
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• pp.67-73
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• 2014

The aim of this study was to compare the activity of the upper trapezius (UT) and serratus anterior (SA) and ratio of UT to SA during shoulder elevations. Ten subjects with UT pain (UTP) and 13 subjects without UTP participated in this study. Subjects with a UTP of over five in a pain intensity visual analogue scale (0-10 ㎝) for more than 2 months and latent myofascial trigger points (MTrPs) in the UT muscle were included in the UTP group. Electromyography (EMG) data of UT and SA at 1st and 10th elevations were analyzed. Two-way repeated analyses of variance were used to compare the EMG activity of UT and SA and the ratio of UT to SA during shoulder elevations between groups with and without UTP. There was a significant increase in UT/SA ratio in the group with UTP compared to the group without UTP (p=.01). The activity of UT and SA measured at the 10th elevation was significantly greater than that in the first elevation (p<.05). The activity of SA was significantly greater in the group without UTP than the group with UTP (p=.03). However, there was no significant difference between groups with and without UTP in terms of UT activity (p=.28). These results indicate that UTP may have relevance to the increased muscle activity ratio of UT to SA during shoulder elevations.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.23-37
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• 2004

Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.187-197
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• 2011

Temporomandibular disorders(TMD) is a collective term which is embracing a number of clinical problems that involve the masticatory musculature, the TMJ and associated structures, or both. Myofascial pain, which is a kind of masticatory muscle disorder of TMD, is the sensory, motor, and autonomic symptoms caused by myofascial trigger points. There has been some controversies regarding etiologies of TMD and MFP. Especially the issue of occlusal conditions has been a critical issue for long time. Despite much efforts, the results of studies regarding occlusal conditions were contradictory. These controversies might be mostly due to various factors resulting from the complex nature of TMD, however, inaccurate and inappropriate study design, selection criteria, methodologies also play significant roles. Recently, a computerized occlusal analysis system, T-Scan II which made it possible to reveal quantifiable time data and relative force data for analyzing occlusion, was introduced. Some authorities suggested that the concept of disclusion time and prolonged disclusion time of posterior tooth and MFP are related using T-Scan II. But the previous studies which used T-SCAN II are not reliable for they did not provide accurate diagnostic criteria of MFP. Morever they did not compare with controls, and had many other problems. The purpose of this study was to evaluate the relationship between MFP and prolonged disclusion time of posterior tooth, which is one of the occlusal factors of TMD, by selecting 30 subjects as the study group through strict criteria and comparing them with 38 controls using T-SCAN II, computerized occlusal analysis system. The results, statistically analyzed, are summarized as follows: 1. Cronbach ${\alpha}$ coefficient of repeated measurements of disclusion time was 0.92. 2. There were no statistically significant differences at repeated measured disclusion time of both side between control and study group. 3. There was no statistically significant diffefence in the disclusion time between right and left side. From the results above, we can suggest that there was no relationship between MFP and disclusion time, so irreversible treatments leading to the reduction of disclusion time for treating MFP would not be appropriate. However more controlled, large scaled study, which consider various occlusal factors, and quantification of symptoms using Helkimo index would be necessary in the future.