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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 5/2010

01-10-2010

New Trends in the Treatment and Management of Myofascial Pain Syndrome

Author: John Z. Srbely

Published in: Current Pain and Headache Reports | Issue 5/2010

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Abstract

Myofascial pain syndrome presents a significant physical and financial burden to society. In view of the aging demographics, myofascial pain promises to be an even greater challenge to health care in the future. Myofascial trigger points have been identified as important anatomic and physiologic phenomena in the pathophysiology of myofascial pain. While their pathophysiologic mechanisms are still unclear, emerging research suggests that trigger points may be initiated by neurogenic mechanisms secondary to central sensitization, and not necessarily by local injury. A variety of treatments are employed in the management of trigger points, including manual therapy, electrotherapy, exercise, and needle therapy. Therapeutic ultrasound demonstrates significant potential as a safe, cost-effective, and relatively noninvasive therapeutic alternative in the treatment and management of this modern day medical enigma.
Literature
1.
Gerwin RD: A review of myofascial pain and fibromyalgia—factors that promote their persistence. Acupunct Med 2005, 23:121–134.CrossRefPubMed
2.
3.
Staud R: Future perspectives: pathogenesis of chronic muscle pain. Best Pract Res Clin Rheumatol 2007, 21:581–596.CrossRefPubMed
4.
Health Canada: Economic Burden of Illness in Canada. Ottawa: Health Canada; 1998.
5.
Jonsson E, Nachemson A: Collected knowledge about back pain and neck pain. What we know--and what we don’t know. Lakartidningen 2000, 97:4974–4980.PubMed
6.
Drewes AM, Jennum P: Epidemiology of myofascial pain, low back pain, morning stiffness and sleep-related complaints in the general population. J Musculoskelet Pain 1995, 3(Suppl 1):121.
7.
Podichetty VK, Mazanec DJ, Biscup RS: Chronic non-malignant musculoskeletal pain in older adults: clinical issues and opioid intervention. Postgrad Med J 2003, 79:627–633.CrossRefPubMed
8.
Simons DG: Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol 2004, 14:95–107.CrossRefPubMed
9.
Melzack R, Stillwell D, Fox E: Trigger points and acupuncture points for pain: correlations and implications. Pain 1977, 3:3–23.CrossRefPubMed
10.
Kao MJ, Hsieh YL, Kuo FJ, Hong CZ: Electrophysiological assessment of acupuncture points. Am J Phys Med Rehabil 2006, 85:443–448.CrossRefPubMed
11.
Srbely J, Dickey J, Lee D, Lowerison M: Needle stimulation of a myofascial trigger point causes segmental antinociceptive effects. J Rehabil Med 2010, 42:463–468.CrossRefPubMed
12.
Simons DG: New aspects of myofascial trigger points: etiological and clinical. J Musculoskelet Pain 2004, 12:15–21.CrossRef
13.
Hong CZ: Pathophysiology of myofascial trigger point. J Formos Med Assoc 1996, 95:93–104.PubMed
14.
Couppe C, Midttun A, Hilden J, et al.: Spontaneous needle electromyographic activity in myofascial trigger points in the infraspinatus muscle: a blinded assessment. J Musculoskelet Pain 2001, 9:7–16.CrossRef
15.
Shah JP, Phillips TM, Danoff JV, Gerber LH: An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol 2005, 99:1977–1984.CrossRefPubMed
16.
McNulty WH, Gevirtz RN, Hubbard DR, Berkoff GM: Needle electromyographic evaluation of trigger point response to a psychological stressor. Psychophysiol 1994, 31:313–316.CrossRef
17.
18.
Chen SM, Chen JT, Kuan TS, Hong CZ: Myofascial trigger points in intercostal muscles secondary to herpes zoster infection of the intercostal nerve. Arch Phys Med Rehabil 1998, 79:336–338.CrossRefPubMed
19.
Tsai WC, Wang TG, Hong CZ: Myofascial trigger points in the ipsilateral gluteal muscles associated with pyogenic sacroiliitis: a case report. J Musculoskelet Pain 1999, 7:73–82.CrossRef
20.
Hong CZ: New trends in myofascial pain syndrome. Zhonghua Yi Xue Za Zhi (Taipei) 2002, 65:501–512.
21.
Svensson P, Rendt-Nielsen L, Houe L: Muscle pain modulates mastication: an experimental study in humans. J Orofac Pain 1998, 12:7–16.PubMed
22.
Kuan TS, Hong CZ, Chen JT: The spinal cord connections of the myofascial trigger spots. Eur J Pain 2007, 11:624–634.CrossRefPubMed
23.
Woolf CJ, Salter MW: Neuronal plasticity: increasing the gain in pain. Science 2000, 288:1765–1769.CrossRefPubMed
24.
Coderre TJ, Katz J, Vaccarino AL, Melzack R: Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence. Pain 1993, 52:259–285.CrossRefPubMed
25.
Richardson JD, Vasko MR: Cellular mechanisms of neurogenic inflammation. J Pharmacol Exp Ther 2002, 302:839–845.CrossRefPubMed
26.
Giamberardino MA, Affaitati G, Lerza R: Relationship between pain symptoms and referred sensory and trophic changes in patients with gallbladder pathology. Pain 2005, 114:239–249.CrossRefPubMed
27.
Janig W: Relationship between pain and autonomic phenomena in headache and other pain conditions. Cephalalgia 2003, 23(Suppl 1):43–48.CrossRefPubMed
28.
Wesselmann U, Lai J: Mechanisms of referred visceral pain: uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain 1997, 73:309–317.CrossRefPubMed
29.
30.
Alagiri M, Chottiner S, Ratner V, et al.: Interstitial cystitis: unexplained associations with other chronic disease and pain syndromes. Urology 1997, 49(Suppl 5A):52–57.CrossRefPubMed
31.
Noronha R, Akbarali H, Malykhina A, et al.: Changes in urinary bladder smooth muscle function in response to colonic inflammation. Am J Physiol Renal Physiol 2007, 293:F1461–F1467.CrossRefPubMed
32.
Dmitrieva N, Johnson OL, Berkley KJ: Bladder inflammation and hypogastric neurectomy influence uterine motility in the rat. Neurosci Lett 2001, 313:49–52.CrossRefPubMed
33.
Hsueh TC, Yu S, Kuan TS, Hong CZ: Association of active myofascial trigger points and cervical, disc lesions. J Formos Med Assoc 1998, 97:174–180.PubMed
34.
• Srbely J, Dickey J, Bent L, Lee D: Capsaicin induced central sensitization evokes segmental increases in trigger point sensitivity in humans. J Pain 2009 Dec 14 (Epub ahead of print). This article describes the segmental relationship between central sensitization and trigger point sensitivity. It provides important insight into potential neurogenic origins of trigger points and myofascial pain.
35.
36.
Majlesi J, Unalan H: High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: a randomized, double-blind, case-control study. Arch Phys Med Rehabil 2004, 85:833–836.CrossRefPubMed
37.
Streitberger K, Ezzo J, Schneider A: Acupuncture for nausea and vomiting: an update of clinical and experimental studies. Auton Neurosci 2006, 129:107–117.CrossRefPubMed
38.
Tougas G, Yuan LY, Radamaker JW, et al.: Effect of acupuncture on gastric acid secretion in healthy male volunteers. Dig Dis Sci 1992, 37:1576–1582.CrossRefPubMed
39.
Lundeberg T, Eriksson SV, Theodorsson E: Neuroimmunomodulatory effects of acupuncture in mice. Neurosci Lett 1991, 128:161–164.CrossRefPubMed
40.
• Chou LW, Hsieh YL, Kao MJ, Hong CZ: Remote influences of acupuncture on the pain intensity and the amplitude changes of endplate noise in the myofascial trigger point of the upper trapezius muscle Arch Phys Med Rehabil 2009, 90:905–912. This article describes the segmental effects of stimulating remote acupoints and provides important evidence supporting the paradigm of segmental acupuncture. CrossRefPubMed
41.
Lin JG, Lo MW, Wen YR, et al.: The effect of high and low frequency electroacupuncture in pain after lower abdominal surgery. Pain 2002, 99:509–514.CrossRefPubMed
42.
Lee J, Dodd M, Dibble S, Abrams D: Review of acupressure studies for chemotherapy-induced nausea and vomiting control. J Pain Symptom Manage 2008, 36:529–544.CrossRefPubMed
43.
Smania N, Corato E, Fiaschi A, et al.: Repetitive magnetic stimulation: a novel therapeutic approach for myofascial pain syndrome. J Neurol 2005, 252:307–314.CrossRefPubMed
44.
• Srbely JZ, Dickey JP, Lowerison M, et al.: Stimulation of myofascial trigger points with ultrasound induces segmental antinociceptive effects: a randomized controlled study. Pain 2008, 139:260–266. This article describes the segmental therapeutic antinociceptive effects of ultrasound stimulation of trigger points. It provides important evidence to support the use of therapeutic ultrasound in the treatment of trigger points and myofascial pain. CrossRefPubMed
45.
Rickards LD: The effectiveness of non-invasive treatments for active myofascial trigger point pain: a systematic review of the literature. Int J Osteopath Med 2006, 9:120–136.CrossRef
46.
Kamanli A, Kaya A, Ardicoglu O, et al.: Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome. Rheumatol Int 2005, 25:604–611.CrossRefPubMed
47.
Dorsher PT: Myofascial referred-pain data provide physiologic evidence of acupuncture meridians. J Pain 2009, 10:723–731.CrossRefPubMed
48.
• Srbely JZ, Dickey JP, Lee D, Lowerison M: Dry needle stimulation of Myofascial trigger points evokes segmental anti-nociceptive effects. J Rehabil Med 2010, 42:463–468. This article highlights the segmental antinociceptive effects of dry needling trigger points. It provides important evidence to support the paradigm of segmental trigger point therapy. CrossRefPubMed
49.
Tsui PH, Wang SH, Huang CC: In vitro effects of ultrasound with different energies on the conduction properties of neural tissue. Ultrasonics 2005, 43:560–565.CrossRefPubMed
50.
Srbely JZ, Dickey JP: Randomized control study of the antinociceptive effect of ultrasound on trigger point sensitivity: novel applications in myofascial therapy? Clin Rehabil 2007, 21:411–417.CrossRefPubMed
Metadata
Title
New Trends in the Treatment and Management of Myofascial Pain Syndrome
Author
John Z. Srbely
Publication date
01-10-2010
Publisher
Current Science Inc.
Published in
Current Pain and Headache Reports / Issue 5/2010
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-010-0128-4

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