• Title/Summary/Keyword: trigger points

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Treatment of Myofascial Trigger Points of the Infraspinatus is Effective in Relieving Shoulder Pain and Improving Shoulder Functions

  • Park, Sungeon;Cho, Juchul;Lee, Seungwon
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.335-343
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    • 2022
  • Objective: This study aimed to investigate the effects of ischemic compression treatment (ICT) or low-level laser therapy (LLLT) applied to the trigger points of the infraspinatus muscle on shoulder pain and function in patients with shoulder pain. Design: A randomized clinical trial Methods: Thirty patients with shoulder pain were randomly allocated into the ICT group (n=15) or LLLT groups (n=15). ICT was performed on three myofascial trigger points (MTrPs) of the infraspinatus muscle twice a week for 4 weeks (eight sessions), with 5 minutes of treatment per trigger point. LLLT was performed similarly. Shoulder pain was assessed using the visual analogue scale (VAS) and pain pressure threshold (PPT), and shoulder function was assessed using the Korean Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, rotator cuff strength, and range of motion (ROM) of shoulder flexion and abduction. Results: Significant changes in VAS score and PPT were found after the intervention in both groups (p<0.05). Significant changes were observed in the Korean DASH score, rotator cuff strength, and ROM of shoulder flexion (p<0.05) but not in the ROM of shoulder abduction (p<0.05). There were no significant differences between the two groups. Conclusions: This study showed that both ICT and LLLT applied on the MTrPs of the infraspinatus muscle were effective for relieving shoulder pain and improving shoulder functions in patients with shoulder pain.

Quantitative Analysis of Myofascial Pain Syndrome in Trapezius Muscle Using Pressure Algometer and Surface Electromyography

  • Kim, Shin-Hye;Ko, Yu-Min;Park, Ji-Won;Youn, Jong-In
    • 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.

Ultrasound Imaging and Electrophysiological Characteristic According to Activity Levels of Myofascial Trigger Point (근근막 발통점의 활성도에 따른 초음파 영상구조 및 전기생리학적 특성)

  • Kim, Hyun-Jin;Kim, Su-Hyun;Park, Young-Hyun;Oh, Seok;Choi, Ji-Ho;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.23-29
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    • 2010
  • Purpose : This study is to offer clinical primary data that examines the change of imaging structure and the quantitative evaluation of muscle activity on myofascial trigger points. This study examines neuromuscular physiological characteristic by comparing the differences in physical findings, pressure pain threshold, imaging, and electrophysiological characteristics in latent and active myofascial trigger points muscle and normal muscle through the following experimental procedures. Methods : The participants for the study were thirty-three adults in their twenties. We divided three groups into normal, latent and active myofascial trigger points groups by physical findings. We analyzed the results of measured pressure pain, threshold for pain, ultrasound imaging perform for structure characteristic of muscle, surface EMG according to type of muscle contraction for function of muscle contraction. Results : Significant differences were indicated in pressure pain threshold (p<0.05). Significant differences were discovered in the ultrasound imaging analysis. There were increases in muscle Echogenicity white area index (p<0.001). There were significant differences that decrease in %MVIC (p<0.05), increase in MDF (p<0.05). Conclusion : From these results, active rnyotascial trigger points muscle showed quality deterioration on ultrasound imaging and decreased function of muscle contraction, increased motor unit action potential of II type fiber, and electrophysiologically. Imaging structure and neuromuscular physiological characteristic can be diagnostic and quantitative analytical techniques for myofascial pain syndrome and a primary factor that reflected in physical therapy intervention.

Myofascial Pain Syndrome : A review of clinical characteristics of 47 patients (근막 동통 증후군 환자에 대한 조사 연구)

  • Kim, Suhn-Yeop;Kang, Heung-Kee;Kwon, Oh-Yun
    • Journal of Korean Physical Therapy Science
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    • v.2 no.1
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    • pp.393-404
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    • 1995
  • The purpose of this review was to examine the clinical characteristics of patients who had a diagnosis of Myofascial Pain Syndrome(MPS). Myofascial pain is a painful condition of skeletal muscle characterized by the presence of one or more trigger points. A trigger point(TrP) is a focus of hyperirritability in a tissues. Of the patients with MPS, 21(44.7 %) were male and 26(55.3 %) were female. The mean duration of MPS was 9.6 months for males and 11.3 months for females. Trigger points with associated referred patterns of pain were found in muscles of the post neck(trapezius, infrasupinatus) and in quadratus lumborum muscle. Patients reported increased fatigue(87.2 %), tingling sensation(66.0 %), numbness(66.0 %), tension(55.3 %), anxiety(44.7 %), headache (59.6 %), pilomotor activation(59.6 %).

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Clinical Consideration of Trigger Point Injection/Dry Needling Therapy: A Narrative Review

  • Jung, Jae-Kwang;Byun, Jin-Seok;Choi, Jae-Kap
    • 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.

Pressure Pain Threshold Measurement Using a Pressure Algometer in Myofascial Pain Syndromes (근근막 통증 증후군에서 Pressure Algometer를 이용한 골격근 압통 역치에 관한 연구)

  • Kwon, Young-Eun;Lee, Su-Jong;Yoon, Chae-Sik;Lee, Jun-Hak
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.32-36
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    • 2001
  • Background: There is no reliable objective test for the diagnosis of myofascial pain syndromes. The aim of this study was to evaluate the usefulness of a pressure algometer for the diagnosis of the trigger points and for the evaluation of the treatment in myofascial pain syndromes (MPS). Methods: Twenty female patients with clinical MPS of shoulder were included in this study. Pressure pain thresholds were measured by a pressure algometer at three different sites including the trapezius, supraspinatus and infraspinatus before, and then the 1st, 3rd and 7th days after TPI. Results: Mean pressure pain thresholds were lower in patients with MPS in than normal volunteers in all the examined skeletal muscles. Mean pressure pain thresholds in patients with MPS were increased significantly after TPI in all the examined skeletal muscles. Conclusions: Pressure algometer can be used as relatively objective diagnostic tool for locating trigger points and to quantify the effect of TPI in MPS. However, more investigation is necessary.

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Potential Benefits of a Selective Region High-frequency Diathermy with Therapeutic Exercises on Older Persons with Degenerative Knee Osteoarthritis: A Case Report

  • Ha, Sin Ho;Lee, Dong Geon;Hong, Soung Kyun;Lee, Gyu Chang
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.387-397
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    • 2021
  • Objective: The purpose of this case study was to investigate selective region high-frequency diathermy at trigger points with therapeutic exercises on pain, function, balance and gait in older patients with degenerative knee osteoarthritis (DKO). Design: A case report. Methods: The patient who participated in this study was a 71-year-old woman, who had been diagnosed with moderate osteoarthritis with grade II Kellgren & Lawrence grading scale. The intervention consisted of selective region high-frequency diathermy at trigger points, with hip and knee stretching and strengthening exercises. The participant was given assessments before and after every intervention session using the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Timed Up and Go test (TUG) and the 10 Meter Walk Test (10MWT). The participant performed the intervention 18 times for a total of 30 minutes each. Results: As a result of this study, the patient VAS decreased to 3 points, and the WOMAC decreased to 53 points. In addition, the TUG decreased to 3.25 s and the 10MWT decreased to 1.14 s. Conclusions: The results of this study suggest that selective region high-frequency diathermy at trigger points with therapeutic exercises may be an effective intervention to decrease pain, improve knee function, balance and gait in patients with DKO. The selective region high-frequency diathermy with therapeutic exercises may be feasible and provide potential benefits for rehabilitation of DKO.

Surface Electromyographic Characteristics of a Myofascial Trigger Point of the Temporalis Muscle: A Case Report (측두근의 근막동통 발통점의 표면 근전도 특성: 증례 보고)

  • Im, Yeong-Gwan;Baek, Hey-Sung;Lee, Guem-Sug;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.261-266
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    • 2013
  • Myofascial pain is a condition associated with regional pain and muscle tenderness characterized by the presence of myofascial trigger points. In this case report, a subject complaining of nighttime bruxism was clinically assessed, and a latent trigger point of the anterior temporalis muscle was identified with manual palpation. A surface electromyographic (SEMG) exam of the anterior temporalis muscle harboring the latent trigger point demonstrated several SEMG features, including post-contraction irritability, delayed relaxation following contraction and accelerated muscle fatigue. It was concluded that a SEMG exam may detect abnormal masticatory muscle function and, therefore, assist in the evaluation of myogenous temporomandibular disorders.

-On Acupoints & Trigger Points- Muscle fatigue evaluation using the Micro-electromagnetic stimulation (-경혈 및 트리거 포인트에서- 미약 자기장을 이용한 근피로 회복 평가)

  • Kim, Soo-Byung;Lee, Na-Ra;Shim, Tae-Kyu;Lee, Seung-Wook;Lee, Yong-Heum
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.14 no.5
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    • pp.1231-1239
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    • 2010
  • The aim of this study was developing the non-invasive focused magnetic stimulation system(NI_FMSS) that can stimulates acupoints which are small parts and knotted muscular tissues. To evaluate pain treatment effect of the NI_FMSS, we caused muscle fatigue to 25 subjects in biceps of the arm. Then, we stimulated acupoints(trigger points) HT2 using low frequency stimulator(10 subjects) and NI_FMSS(10 subjects). The other 5 subjects had not been stimulated. We analyzed muscle fatigue recovery with median frequency, RMS and median power in frequency domain for 5 days. We checked the magnetic stimulation effect on acupoint by evaluation of muscle fatigue recovery. Therefore, we identified that the NI_FMSS was more efficient system to relieve muscle pain than electric-stimulation system.

Needle Type of Hybrid Temperature Probe for Both Diagnosis and Treatment of Musculoskeletal Pain Syndrome (근골격계 통증질환의 진단과 치료를 위한 주사바늘형 복합온도 프로브의 개발)

  • Nam, Sung-Ki;Kim, Hyung-Il;Byun, Chang-Ho;Lee, Sun-Kyu
    • Journal of the Korean Society for Precision Engineering
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    • v.31 no.4
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    • pp.359-364
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    • 2014
  • This paper describes the development of needle type probe that measures temperature and injects medicine for both diagnosis and treatment of musculoskeletal pain syndrome (MPS). The size of trigger points is from several micrometers to millimeter. Therefore, it is required to develop a medical device that is capable of not only finding the trigger points by temperature measurement, but also injecting medicine at the exact location for treatment. To challenge these difficulties, thermocouple was fabricated on the surface of a needle using metal deposition process. Special type of stainless-constantan thermocouple was achieved from the stainless body of a needle itself and deposited constantan metal film. In particular, parylene coating enables to limit the temperature sensitive area to the end of the needle tip. Fabricated needle type probe produces $3.25mV/^{\circ}C$ of thermoelectric sensitivity and compared its performance with commercial T-type thermocouple in animal muscle sample.