• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.127-131
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• 2014

Skeletal muscles which are the largest part of human body may develop pain and dysfunction. The myofascial pain syndrome that has trigger points as a unique characteristic is a major cause of morbidity. Trigger points are focal, hyperirritable painful areas located in a taut band of skeletal muscle. They produce local area pain and a referred pattern pain and often accompany chronic joint dysfunction. Various modalities are used to inactivate trigger points in myofascial pain syndrome. Trigger-point injection has been shown to be one of the most effective treatment modality to provide prompt relief of symptoms. This review article presents general concept of myofascial pain syndrome and technique of trigger point injection.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.108-114
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• 2003

The shoulder is a complex area which makes it vulnerable to painful pathologic processes. Chronic shoulder pain has become more common recently due to increased use of computers and a ,generally more sedentary life style among most people . Trigger point injection and neural blockade are useful for the management of chronic shoulder pain which has not improved with conservative treatment. Published articles concerning trigger point injection or neural blockade for chronic shoulder pain were reviewed to evaluate promising methods. If we are careful to remain aware of the details and complications in addition to adhering to effective treatments, these should be good armamentarium for doctors enthusiastic about the management of chronic shoulder pain.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.74-77
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• 2007

The trigger point injection technique is widely used in pain clinics for the treatment of acute and chronic pain. Yet it has a variety of complications such asvasovagal syncope, total spinal anesthesia, paralysis, root block, pneumothorax, needle breakage, skin infection, and hematoma formation. Among them, the simultaneous occurrence of psoas and epidural abscesses is extremely rare. We report here on a patient who was diagnosed with epidural and psoas abscesses after paravertebral trigger point injection.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.272-278
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• 1995

Headache is a common disease of the general population. But the main problem in any study of headache has been that of defining the disease entities. In 1988, the Headache Classification committee of the International Headache Society introduced operational diagnostic criteria for all headache disorders into 13 major group; migraine, tension-type headache, cluster headache and chronic paroxysmal hemicrania etc. Sjaastad was the first to describe "cervicogenic headache", one of various head pain syndromes that probably originate in the cervical spine. Between March 1995 and June 1995, we studied 78 out-patients of the Department of Neuro pain clinic, Sanggye Paik Hospital, Inje university. We divided the patients into three study group: Fifty-three patients with tension-type headache, 13 with cervicogenic headache, and 12 with migraine headache. The reponse of trigger point injection and $C_2$-ganglion block in patients was investigated. We paid particular attention to the response of trigger point injection in patients of the three group. The effect of trigger point injection was more marked in tension-type headache group than in the other categories. The pain reduction after $C_2$-ganglion block was more marked in cervicogenic headache group than in the others.

• Journal of Korean Physical Therapy Science
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• v.2 no.3
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• pp.727-738
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• 1995

Myofascial pain syndrome is one of the major cause of chronic pain and trigger point injection, stretching, spray and electrical therapy are often used in clinical situation for treatment of myofascial pain syndrome. Myofascial pain syndrome is characterzied by the existence of a hypersensitive region, called the trigger point in a muscle or in the connective tissue, together with palpable noble, stiffness, limitation of motion and referred pain when trigger point is stimulated. Physiologically, they represent a self-sustaining vicious cycle of pain-spasm-pain. The purpose of this study is to illustrate mechanisms of pain by stimulation of acupuncture and trigger point, to introduce clinic application of orient and western stimulative point (acupuncture, trigger point)for treatment of MPS(myofascial pain syndrome), to make physiotherapist use both stimulative points for treatment of MPS.

• The Korean Journal of Pain
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• v.25 no.1
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• pp.52-54
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• 2012

Trigger point injection treatment is an effective and widely applied treatment for myofascial pain syndrome. The trapezius muscle frequently causes myofascial pain in neck area. We herein report a case in which direct pulsed radiofrequency (RF) treatment was applied to the trapezius muscle. We observed that the RF treatment produced continuous pain relief when the effective duration of trigger point injection was temporary in myofascial pain.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.263-267
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• 1999

We have observed retroperitoneal hematoma after trigger point injections of quadratus lumborum in a patient with chronic low back pain. Severe flank pain and dyspnea was observed three hours after injection of local anesthetic and steroid to the trigger point of quadratus lumborum muscle. There was fuge hematoma in abdominal CT image around the right kidney, which displaced and compressed the kidney anteriorly. Following infusion of contrast media, extravasation through renal vein and IVC was notified. Patient had a past history of having been treated with platelet aggregation inhibitor and lower dose aspirin treatment after cerebral ischemia for a year, but coagulative function was within normal range. Patient was admitted 12 days for bed rest, pain control and transfusion. We need to take greater care with a frequent aspiration and exact direction of needle, during trigger point injection of quadratus lumborum, particu right side, to avoid vascular injury.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.75-80
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• 1999

Background: Despite tension type headache is popular, the exact mechanism and method of treatment are not certain yet. So, we supposed the basic mechanism of tension type headache is myogenic, and did Tienchu acupoint block, occipital nerve block, and trigger point injection in tension type headache patients. Methods: Fifty-seven tension type headache patients were treated with local anesthetics and small dose of steroid. The intensity of pain and effect of every treatment was evaluated as Verbal Rating Score (VRS; 0~10) before and after every treatment. Evaluation of treatment was based on the time of treatment (1,2 times, 3 times, 4,5 times). Goal of treatment was VRS reaching below two point and it was considered as treated state. Results: Symptom improvement rates of each treatment were 90% (1, 2 times), 91% (3 times), 70% (4, 5 times) respectively. VRS reduction more than 50% rates were 60%, 64%, 60% respectively. Treated state (VRS<2) rates were 33%, 27%, 30% respectively. Conclusion: Tienchu acupoint block, occipital nerve block, trigger point injection were sorts of most effective and simply applicable modalities of treatment in tension type headache.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.193-197
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• 1998

Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)

• Journal of Oral Medicine and Pain
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• v.42 no.3
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• pp.53-61
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• 2017

Myogenous temporomandibular disorder is a collective term for pathologic conditions of the masticatory muscles, mainly characterized by pain and dysfunction associated with various pathophysiological processes. Among the subtypes of myogenous temporomandibular disorder, myofascial pain is one of the most common muscle disorders, characterized by the presence of trigger points (TrPs). Various modalities, such as ultrasound, manipulative therapy, spray-and-stretch technique, transcutaneous electrical nerve stimulation, injection/dry needling, and low-level laser therapy are used to inactivate TrPs. Needling/injection on the TrPs is one of the most common treatments for myofascial pain. Despite the evidence, there is continued controversy over defining the biological and clinical characteristics of TrPs and the efficacy of injection/dry needling. This review discusses the current concept of injection/needling to relieve TrPs.