• 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.24 no.1
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• pp.57-60
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• 2011

Pulsed radiofrequency (PRF) treatment of nervous tissue has been proposed as a less neurodestructive technique alternative to continuous RF heat lesioning. Recently, clinical reports using PRF have shown favorable effects in the treatment of a variety of focal pain areas, even in non-nervous tissues; however, the mechanism of effect underlying this treatment to non-nervous tissue remains unclear. We report the case of a 67-year-old male who presented with pain reliving point in the posterior neck. The patient had pain in the posterior neck for 3 years. The pain subsided with pressure applied to a point in the posterior neck. There were no specific abnormal findings on laboratory testing and radiologic examinations. After PRF treatment to the pain-relieving point, he had pain relief which lasted more than 5 months.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.2
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• pp.131-140
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• 2014

Objectives This study was aimed at comparing clinical effectiveness among trigger point treatment, Self-exercise treatment, trigger point - self-exercise cooperative treatment for neck pain caused by traffic accidents. Methods 63 patients with neck pain by traffic accidents were divided into 3 groups. Different types of treatments were carried out for each groups ; group A with trigger point, group B with self-exercise, group C with trigger point and self-exercise cooperative treatment. 3 groups were also treated with general acupuncture and herb-medicine treatment. Pain threshold, visual analogue scale (VAS), and neck disability index (NDI) were checked on a daily basis. SPSS ver. 18.0 for Windows was used for analysis of data. The effectiveness of treatment of each groups were verified by using paired test and one-way repeated-measures ANOVA test, and the comparison of VAS, NDI and pain threshold were demonstrated by independent samples t-test. Results 3 groups all showed significant difference in pain threshold, VAS and NDI after 8 days later. Group C showed more improvement in pain threshold, VAS and NDI than shown in group A and B. In the first period (from pre-treatment to 4th day treatment) group C showed significant difference in NDI and pain threshold but not in VAS as compared to group A and B. In the second period (from 4th treatment to 8th day treatment), Group C showed significant difference in pain threshold, VAS and NDI as compared to group A and B. Conclusions Trigger point - self-exercise cooperative treatment is proved to be more helpful to improve the unstability and reduce neck pain than trigger point treatment or self-exercise treatment only, therefore eventually leading to better satisfaction for patients with neck pain.

• Journal of Acupuncture Research
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• v.23 no.4
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• pp.61-68
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• 2006

Objectives : The Purpose of this report is to examine the effect of Remote Acupuncture Point Needling in the Low Back Pain patient of Acute Stage. Methods : From October 1st 2005 to May 31th 2006, 30 cases of low back pain patients at acute stage were divided into 2 groups; one group(control group) took near acupuncture point needling, and the other group(test group) took near acupuncture point needling with remote acupuncture point needling. For evaluating change of pain, Visual Analog Scale(VAS) was checked before and after Treatment. Results : Both acupuncture therapy showed good effect on low back pain of acute stage. And test group showed better effect on decreasing pain than control group. It was proved by the difference between VAS checked before treatment and what checked after treatment. But it was not significant statistically. Conclusion : Near acupuncture point needling and remote acupuncture point needling can be recommended as a useful therapy to treat low back pain of acute stage.

• Physical Therapy Korea
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• v.28 no.1
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• pp.53-58
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• 2021

Background: To evaluate whether extracorporeal shock wave therapy (ESWT) in the pain point is a more effective treatment than the trigger point for myofascial pain syndrome (MPS) of the upper trapezius. Objects: The purpose of this study was to compare the most effective areas when applying extracorporeal shock wave therapy. Methods: A total of 30 patients with MPS were randomly assigned to the trigger point in the ESWT (n = 15) and pain point ESWT (n = 15) groups. Interventions in both groups were performed in one session, i.e., 2,000 shocks with 1.5 bar intensity. Pain and function were assessed using the visual analog scale (VAS) and cervical range of motion (ROM) and based on mechanical muscle properties. Statistical analysis was performed using the repeated measures two-way analysis of variance to determine the significance probability between pre- and post-test. Results: Changes in mechanical muscle properties were not statistically significant between the two groups. However, VAS and cervical ROM showed statistically significant differences at pre- and post-intervention, regardless of the group (p < 0.05). Conclusion: Although no significant difference was observed in the intervention effect, applying an extracorporeal shock wave to the pain point rather than the pain trigger point should be considered in order to save time in effectively and accurately identifying the pain trigger point and site.

• The Korean Journal of Pain
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• v.23 no.4
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• pp.242-246
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• 2010

Background: The first sacral nerve root block (S1NRB) is a common procedure in pain clinic for patients complaining of low back pain with radiating pain. It can be performed in the office based setting without C-arm. The previously suggested method of locating the needle entry point begins with identifying the posterior superior iliac spine (PSIS). Then a line is drawn between two points, one of which is 1.5 cm medical to the PSIS, and the other of which is 1.5 cm lateral and cephalad to the ipsilateral cornu. After that, one point on the line, which is 1.5 cm cephalad to the level of the PSIS, is considered as the needle entry point. The purpose of this study was to analyze the location of needle entry point and palpated PSIS in S1NRB. Methods: Fifty patients undergoing C-arm guided S1NRB in the prone position were examined. The surface anatomical relationships between the palpated PSIS and the needle entry point were assessed. Results: The analysis revealed that the transverse and vertical distance between the needle entry point and PSIS were $28.7{\pm}8.8mm$ medially and $3.5{\pm}14.0mm$ caudally, respectively. The transverse distance was $27.8{\pm}8.3mm$ medially for male and $29.5{\pm}9.3mm$ medially for female. The vertical distance was $1.0{\pm}14.1mm$ cranially for male and $8.1{\pm}12.7mm$ caudally for female. Conclusions: The needle entry point in S1NRB is located on the same line or in the caudal direction from the PSIS in a considerable number of cases. Therefore previous recommended methods cannot be applied to many cases.

• The Journal of Korean Physical Therapy
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• v.33 no.5
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• pp.258-263
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• 2021

Purpose: Myofascial syndrome is a chronic muscle pain caused by repetitive motions with stress-related muscle tension. This study aimed to investigate the validity and reliability of the evidence for diagnosing myofascial pain syndrome in trapezius muscle using a pressure algometer and surface electromyography. Methods: The experiments were performed using a total of 10 subjects, and the target locations were determined by means of a pressure algometer in the right upper trapezius muscle. The part with the lowest pain value as the trigger point and the part with the highest pain value as the non-pain trigger point were selected for measuring the locations. The median frequency and average frequency were measured in those locations with electromyography. To check the muscle fatigue, the upper trapezius muscle was moved up and down for 2 seconds at 5-second intervals in 30 seconds. The measured values were evaluated using the independent paired t-test and MannWhitney U-test. Results: The median frequency at the non-trigger point (13.7) was significantly higher than that at the trigger point (7.3). Furthermore, the mean frequency (14.7) at the non-trigger point was significantly higher than that at the trigger point (6.3). Conclusion: The results showed the correlations between the trigger points of the muscle pain and frequency analysis of surface electromyography. Thus, this study may be possible to use as a diagnostic tool for myofascial pain syndrome.

• 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 Journal of Korean Medicine
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• v.28 no.4
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• pp.86-94
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• 2007

Objective : Kuesu point is a newly discovered point, it is located in 3-cun from the centre of sacrum laterally, paralleled to the 4th foramen on the sacrum. This controlled trial was to evaluate the superior effect of Kuesu point on back pain which radiated to lower extremities. Methods : Randomized Controlled Trial (RCT) and Single Blind in patient was designed. Patients (n=31) were randomized to two groups, Kuesu-point acupuncture group (Group A, n=16) and non Kuesu point acupuncture group (Group B, n=15). Group A was acupunctured on B25 (大腸兪), B26 (關元兪) and B60 (崑崙) with Kuesu point. Group B was acupunctured on the same points without Kuesu point. The clinical subjects were female patients. Beside acupuncture, the other therapies were excluded. Clinical period was three weeks total. Each group was treated 4-5 times per week for 3 weeks. The outcome measurements were The Estimation Index of Backache (quality of life), Pain Rating Scale (pain intensity) and other physical examinations (ROM, SLR, etc.). Results : 31 patients (Group A: n=16, Group B: n=15) were Randomized, 6 of them dropped out. Eventually 25 patients (Group A: n=15, Group B: n=10) were included in the analysis. Group A acupunctured on Kuesu point scored more significant Estimation Index of Backache and lower PRS (Pain Rating Scale) than Group B acupunctured without Kuesu point (p=0.003/2). It turned out that the group acupunctured on Kuesu point show meaningful high improvement index. And other examination's results showed that the treatment effects of Group A are twice as better as Group B. Conclusion : These results suggest that Kuesu point acupuncture was more effective on lower back pain and improved the life quality of patients, being compared with non Kuesu point acupuncture.

• Korean Journal of Acupuncture
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• v.21 no.2
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• pp.47-67
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• 2004

Objectives : In the present study, the effect of Scolopendrid Water-Alcohol Extract (SWAE) applied to acupuncture point BL23 (Shinsu) on the neuropathic pain was examined. A common source of persistent pain in humans is the neuropathic pain. Anti-convulsant drugs are used to treat the neuropathic pain. In the oriental medicine, Scolopendrid was used for long time to treat convulsant syndrome and back pain, etc. Methods : On the bases of the Scolopendrid clinical application, the effect of SWAE applied to the acupuncture point was tested in the rat model of neuropathic pain. Neuropathic pain was induced by tight ligation of L5 spinal nerve. When rats developed pain behaviors, One hundred microliter of SWAE was applied into the ipsilateral BL23 point at a dose of 10 mg/ml under enflurane anesthesia. The foot withdraw latency of the hind limb was measured for an indicator of pain level after each manipulation. Results : SWAE injection increased the mechanical threshold of the foot in the rat model of neuropathic pain significantly for the duration of 4h, suggesting a partial alleviation of pain. SWAE applied to BL23 point produced a significant improvement of mechanical sensitivity of the foot lasting for at least 4h. However, neither contralateral BL23 point, ST25 (Chonchu) point, nor LR3 (Taechung) point produce as much increase of mechanical sensitivity as ipsilateral BL23 point. And, this increase of mechanical sensitivity was dose-dependent. The improvement of mechanical threshold was interpreted as an analgesic effect. In addition, the analgesic effect of Scolopendrid 4 mg/kg injection is equivalent to that of gabapentin 50 mg/kg injection. The relations between SWAE-induced analgesia and endogenous nitric oxide(NO), inducible NO synthase (iNOS)/neuronal NO synthase (nNOS) were also examined. Results were turned out that both NO production and nNOS/iNOS protein expression which are increased by nerve injury were suppressed by SWAE injection applied to BL23 point. Conclusions : The data suggest 1) that SWAE produces a potent analgesic effect on the neuropathic pain model in the rat and 2) that SWAE-induced analgesia modulate endogenous NO through the suppression of nNOS/iNOS protein expression.