• Title/Summary/Keyword: Trigger Points

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

  • Wei-Ting Wu;Ke-Vin Chang;Vincenzo Ricci;Levent Ozcakar
    • Journal of Yeungnam Medical Science
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    • v.41 no.3
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    • pp.179-187
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    • 2024
  • 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.

The Comparison of Effective of Stretching Exercise and Stabilizing Exercise for The Patients with Myofascial Pain Syndrome at The Shoulder Girdle (견관절부 근막동통증후군의 근육내 전기자극치료시 신장운동과 안정화운동의 효과 비교)

  • Kim, Sang-Eun;Lee, Hyun-Ok;Kim, Jong-Soon;Kim, Suhn-Yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.49-61
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    • 2005
  • Summary of Background Data: Myofascial pain syndrome (MPS) is a common painful muscle disorder caused by trigger points occurring in myofascial. MPS is a major cause of chronical pain and is the subject of further clinical examination. Purpose: To uncover effective intramuscular stimulation therapy (IMS), the patients' actively participation stretching exercise and stabilizing around shoulder girdle where trigger point provoking myofascial pain syndrome in usually occurred. Methods: 45 myofascial pain syndrome patients were randomly chosen and divided into 3 groups. The first group (G1) received only IMS therapy, The second group (G2) had both IMS and active stretching exercises administered and the final group (G3) was given IMS therapy and stabilizing exercises. Therapy intervention was given for 3 weeks, 3 times a week and then only stretching exercise for the second group and stabilizing exercise for the third group was given for another 3 weeks. The visual analogue scale was dine before the experiment, 3 weeks after the experiment and 6weeks after the experiment to measure subjective degrees of pain and pressure pain threshold to measure sensitivity improvement of trigger point and functional ability questionnaire to measure daily life performance. Results: There were no significant changes after 3 weeks but after 6 weeks, between GI and G2 and between G1 and G3 showed significant change of pain, pressure pain threshold and daily life performance. There were significant improvement of the measurement of degrees of pain, pressure pain threshold and improvement of daily life performance at different times for G1 showed change 3 weeks after the experiment, but there were no changes 6 weeks after the experiment. There were significant improvement of the measurement at different times for G2 and G3 showed change 3 weeks after the experiment and 6 weeks after the experiment. Conclusions: IMS therapy proved to be effective in inactivation of trigger points of the myofascial pain syndrome patients and stretching and stabilizing exercises beside it keep remedial value longer by improvement of pain and dysfunction that occurred by the trigger point.

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Development of Multi-Array Electrode and Programmable Multi-channel Electrical Stimulator for Firing Trigger Point of Myofascial Pain Syndrome (근막통증증후군의 통증유발점 치료를 위한 멀티어레이 전극과 프로그램 가능한 다채널 전기자극기 개발)

  • Kim, SooHong;Kim, SooSung;Jeon, GyeRok
    • Journal of Biomedical Engineering Research
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    • v.36 no.5
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    • pp.221-227
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    • 2015
  • In this study, Multi-Array Electrodes (MAE) and Programmable Multi-channel Electrical Stimulator (PMES) were implemented for firing Trigger Points (TPs) of the patient with Myofascial Pain Syndrome (MPS). MAE has 25 Ag/AgCl electrodes arranged in the form of array ($5{\times}5$) fabricated with flexible pad, which are applicable to be easy-attached to curved specific region of the human body. PMES consisted of 25 channels. Each channel was to generate various electric stimulus patterns (ESPs) by changing the mono-phasic or bi-phasic of ESP, On/Off duration of ESP, the interval between ESP, and amplitude of ESP. PMES hardware was composed of Host PC, Stimulation Pattern Editing Program (SPEP), and Multi-channel Electrical Stimulator (MES). Experiments were performed using MAE and PMES as the following. First experiment was performed to evaluate the function for each channel of Sub- Micro Controller Unit (SMCU) in MES. Second experiment was conducted on whether ESP applied from each channel of SMCU in PMES was focused to the electrode set to the ground, after applying ESP being output from each channel of SMCU in PMES to MAE.

The immediate effects of 830-nm low-level laser therapy on the myofascial trigger point of the upper trapezius muscle in visual display terminal workers: A randomized, double-blind, clinical trial

  • Lee, Jung-Hoon;Lee, Sun-Min
    • International Journal of Contents
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    • v.7 no.2
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    • pp.59-63
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    • 2011
  • The aim of our study was to evaluate the immediate effects of an 830-nm Aluminium gallium arsenide (GaAlAs) laser, by examining the changes, in pressure-pain threshold (PPT) and tenderness at 3 kg of the myofascial trigger point (MTrP) of the upper trapezius muscle in visual display terminal (VDT) workers in comparison with placebo treatment. Thirty VDT workers (13 males, 17 females) with complaints of upper trapezius muscle were recruited. All participants were given either active GaAlAs laser (830 nm wavelength, 450 mW, 9 J at point) or placebo GaAlAs laser, according to the double-blinded and placebo-controlled trial. Both active and placebo low-level laser therapy (LLLT) treatments showed no significant effect on PPT and tenderness at 3 kg. These results suggest that a higher dosage may be necessary to produce immediate effects when applying LLLT to the MTrP of relatively large muscles such as the upper trapezius muscle.

Acupuncture Treatment for T.M.D. (악관절증의 침치료에 대한 고찰 (근육장애을 중심으로))

  • Kim, Suk;Kim, Chang-Hwan
    • The Journal of Korean Medicine
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    • v.16 no.1 s.29
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    • pp.36-50
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    • 1995
  • Acupuncture is so effective and simple to use in the pain and dysfunction syndrome of TMD. Acupuncture treatment is a point-specific. So, the selection of acupuncture point is very important. According to the traditional meridian theory, we select the points; local points around TMJ and mastication muscles(ST6, ST7, GB20, GB21) and remote point(LI4). And if there is another pain, one or two other points are added. Both neural and humoral mechanism play an important role in acupuncture analgesia. The discovery of spinal gate mechanisms shows somatic stimulation can induce pain inhibition. Humoral mechanism has been established from the discovery of opioid receptors and endogenous opioids. Acupuncture induces a relaxation in the patient, which further decreases the muscle tension.

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The Effect of Low Level Laser Therapy at the Trigger Points in Masseter and Trapezius Muscles (저출력레이저를 이용한 교근 및 승모근 발통점의 치료에 관한 연구)

  • Sun-Young Kim;June-Sang Park
    • Journal of Oral Medicine and Pain
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    • v.21 no.1
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    • pp.25-36
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    • 1996
  • To investigate the effect of low level laser therapy, the author selected 37 dental students with tender points in both masseters and trapeziuses, also measured maximum comportable opening(MCO), Numerical analog scale(NAS) and pressure pain threshold (PPT). 20 subjects were assigned randomly and were treated with GaAlAs diode laser after ultrasound. The other 17 subjects were treated with ultrasound and laser without irradiation. All the subjects were treated after 2 and 4 day respectively and were examined again after 6 days. And the obtained results were as follows : 1. The MCO of irradiated group increased more significantly after treatment than non-irradiated group. 2. The NAS of irradiated group decreased more significantly after treatment than non-irradiated group. 3. The PPT or irradiated group increased more significantly after treatment than non-irradiated group.

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Electric Stimulation for Pain Relief Using Acupuncture Needles (침을 이용한 전기자극 통증치료)

  • Shin, Keun-Man;Hong, Soon-Yong;Cho, Young-Ryong
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.52-56
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    • 1992
  • For pain relief my collegue and I used thin acupuncture needles as electrodes in electric stimulation. The needles were inserted into a trigger point and into another point located in the same muscle instead of meridian points of electro-acupuncture. Low frequency electric stimulation was given through the needles to 130 patients for 15 min. The results were as follows In 25 acute sprain patients electric stimulation was given $3.14{\pm}1.12$ times and the pain was reduced on the average by $83.00{\pm}6.77%$ (VAS). In 45 chronic sprain patients electric stimulation was given $5.51{\pm}1.38$ times and the pain was reduced on the average by $70.22{\pm}8.98%$ (VAS). In 28 myofascial pain syndrome patients electric stimulation was given $6.22{\pm}1.25$ times and the pain was reduced on the average by $66.48{\pm}8.75$(%). In 7 muscle contraction headache patients electric stimulation was given $4.14{\pm}1.57$ times and the pain was reduced on the average by $75.00{\pm}9.57%$ (VAS). In 25 radiculopathy patients electric stimulation was given $4.73{\pm}1.131$ times and the pain was reduced on the average by $21.37{\pm}9.31%$ (VAS). We he conclude that electric stimulation therapy using acupuncture needles is very effective in acute sprain, chronic sprain, myofascial pain syndrome and muscle contraction headache. Any doctor with knows anatomy and trigger points can practice this method without studying oriental medicine or difficult acupuncture techniques.

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The efficacy of low-level diode laser versus laser acupuncture for the treatment of myofascial pain dysfunction syndrome (MPDS)

  • Khalighi, Hamid Reza;Mortazavi, Hamed;Mojahedi, Seyed Masoud;Azari-Marhabi, Saranaz;Parvaie, Parvin;Anbari, Fahimeh
    • 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.

Analysis on Current Limiting and Recovery Characteristics of a SFCL using a Trigger of Superconducting Element (초전도소자의 트리거를 이용한 초전도 전류제한기의 전류제한 및 회복특성 분석)

  • Lim, Sung-Hun
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.24 no.1
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    • pp.112-116
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    • 2010
  • As one of the countermeasures to improve the recovery characteristics of the SFCL (superconducting fault current limiter), the method using the trigger of high-TC superconducting element (HTSC) when the quench in the HTSC element occurred was proposed. To confirm the suggested method, the control circuit to detect the quench occurrence of HTSC element in case of the fault occurrence was designed and the current limiting and recovery experiments of the SFCL using the designed control circuit were performed. Through the analysis for the experimental results, the points of both the open time and the closing time of a power switch comprising the control circuit could be adjusted by the resistance amplitude of a normal conducting current limiting resistor (CLR) and the recovery characteristics of the SFCL together with the current limiting operation could be confirmed to be improved by using the control circuit.