scholarly journals Ultrasound-guided dextrose injection treatment for chronic myofascial pain syndrome: A retrospective case series

2020 ◽  
Vol 83 (9) ◽  
pp. 876-879
Author(s):  
Yen Chou ◽  
Hong-Jen Chiou ◽  
Hsin-Kai Wang ◽  
Yi-Chen Lai
Keyword(s):  
Myofascial Pain ◽  
Case Series ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Ultrasound Guided ◽  
Retrospective Case ◽  
Injection Treatment ◽  
Retrospective Case Series

scholarly journals Ultrasound-guided Transmuscular Quadratus Lumborum Block with Depot Steroids in the Management of Abdominal Myofascial Pain Syndrome

2018 ◽  
pp. 103-110
Author(s):  
Gopinarth Niraj
Keyword(s):  
Abdominal Wall ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Case Series ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Ultrasound Guided ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Prospective Longitudinal

Background: Trigger point injection is the current standard in the management of abdominal myofascial pain syndrome (AMPS). However, multiple trigger point injections can cause significant discomfort and there is a possibility of missing trigger points resulting in a reduced efficacy of trigger point treatment. Recently, abdominal wall blocks have been reported in the management of chronic abdominal wall pain. Transmuscular quadratus lumborum block (TQLB) is a novel abdominal wall block. Objective: The report describes the role of the ultrasound-guided TQLB with depot steroids in the management of AMPS. Study Design: Prospective case series. Setting: Tertiary pain medicine clinic in a University Hospital. Methods: Adult patients with AMPS under the care of a single physician were offered TQLBs with a mixture of local anaesthetic and depot methylprednisolone instead of multiple trigger point injections as a part of an on-going prospective longitudinal audit into the management of AMPS. Patients completed brief pain inventory questionnaire at baseline and at 12 weeks postprocedure. Results: Thirty patients underwent TQLB. All patients reported complete absence of pain within 15 minutes of the block and sensory testing revealed extensive hypoaesthesia extending from thoracic T6 to T12 anteriorly. Clinically significant benefit at 12 weeks was reported by 36% of patients, with 60% (18/30) of the patients preferring to receive the novel intervention instead of multiple trigger point injections. None of the patients reported post-procedural flare up. Limitations: Open label case series in a small cohort. Conclusion: The prospective series in a limited cohort suggests that TQLB with depot steroids could play a role in the management of AMPS. Key words: Abdominal myofascial pain syndrome, transmuscular quadratus lumborum block, trigger point treatment, nonspecific abdominal pain, viscerosomatic convergence

Effect of Visual Feedback During Ultrasound-Guided Interfascial Injection for Myofascial Pain Syndrome: A Prospective, Multicenter, Observational Clinical Trial

2021 ◽  
Author(s):  
Hideaki Hasuo ◽  
Hideya Oomori ◽  
Kohei Yoshida ◽  
Mikihiko Fukunaga
Keyword(s):  
Visual Feedback ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Numerical Rating Scale ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Ultrasound Guided ◽  
Feedback Group ◽  
Treatment Expectations ◽  
Numerical Rating

Abstract Background: Expectations for treatment have a favorable effect on the subsequent course of pain and behavior in patients. It is not known whether receiving interfascial injection while patients view their ultrasound image with doctors (visual feedback) is associated with positive treatment expectations. Methods: This was a prospective, multicenter, observational clinical trial. We evaluated whether visual feedback during ultrasound-guided interfascial injection affects treatment expectations and the subsequent course of pain in patients with myofascial pain syndrome. Treatment expectations were set as mediators of pain using path analysis. The primary endpoint was the proportion of patients who showed improvement in pain numerical rating scale score by 50% or more 14 days after initiation of treatment. Results: During 2019 and 2020, 136 outpatients received ultrasound-guided interfascial injection for myofascial pain syndrome. Of these, 65 (47.8%) patients received visual feedback during ultrasound-guided interfascial injection. Compared with the non-visual feedback group, the visual feedback group had higher expectations for treatment, immediately after interfascial injection, and their expectations were maintained at day 14 of treatment (p < .001). In the visual feedback group, 67.7% of patients showed improvement in pain numerical rating scale score by 50% or more at day 14 (95% confidence interval: 56.5–78.9), whereas such improvement was observed in only 36.6% of the non-visual feedback group (95% confidence interval: 25.3–47.9; p < .001). Path analysis revealed that visual feedback had the largest influence on pain numerical rating scale reduction at 14 days, which was indirectly via higher expectations for treatment (β = 0.434).Conclusions: Visual feedback during ultrasound-guided interfascial injection had a positive effect on the subsequent course of pain in patients with myofascial pain syndrome by increasing patients’ treatment expectations.Trial registration: UMIN000043160. Registered 28 January 2021 (registered retrospectively).

scholarly journals Ultrasound-Guided Inactivation of Trigger Points Combined with Muscle Fascia Stripping by Liquid Knife in Treatment of Postherpetic Neuralgia Complicated with Abdominal Myofascial Pain Syndrome: A Prospective and Controlled Clinical Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Xiang-Hong Lu ◽  
Xiao-Lan Chang ◽  
Si-Lan Liu ◽  
Jing-Ya Xu ◽  
Xiao-Jun Gou
Keyword(s):  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Effective Rate ◽  
Primary Treatment ◽  
Control Group ◽  
Ultrasound Guided ◽  
Vas Score ◽  
Significant Difference ◽  
Muscle Fascia

Objective. To evaluate ultrasound-guided inactivation of myofascial trigger points (MTrPs) combined with abdominal muscle fascia stripping by liquid knife in the treatment of postherpetic neuralgia (PHN) complicated with abdominal myofascial pain syndrome (AMPS). Methods. From January 2015 to July 2018, non-head-and-neck PHN patients in the Pain Department, The First Affiliated Hospital of Soochow University, were treated with routine oral drugs and weekly paraspinal nerve block for two weeks. Patients with 2 < VAS (visual analogue scale) score < 6 were subjects of the study. They were assigned into control group 1 (C1, n = 33) including those with PHN and without myofascial pain syndrome (MPS) and control group 2 (C2, n = 33) including those with PHN complicated with MPS and observation group 1 (PL, n = 33) including those with PHN complicated with limb myofascial pain syndrome (LMPS) and observation group 2 (PA, n = 33) including those with PHN complicated with AMPS. All groups received zero-grade treatment: routine oral drugs and weekly paraspinal nerve block. PL and PA groups were also treated step by step once a week: primary ultrasound-guided inactivation of MTrPs with dry needling, secondary ultrasound-guided inactivation of MTrPs with dry and wet needling, and tertiary ultrasound-guided dry and wet needling combined with muscle fascia stripping by liquid knife. At one week after primary treatment, patients with a VAS score > 2 proceeded to secondary treatment. If the VAS score was <2, the treatment was maintained, and so on, until the end of the four treatment cycles. Pain assessment was performed by specialized nurses at one week after each treatment, including VAS score, McGill pain questionnaire (MPQ) score, pressure pain sensory threshold (PPST), and pressure pain tolerance threshold (PPTT). VAS score was used as the main index and VAS <2 indicated effective treatment. At 3 months after treatment, outpatient and/or telephone follow-up was performed. The recurrence rate was observed and VAS > 2 was regarded as recurrence. Results. At one week after primary treatment, the effective rate was 66.7% in PL group, significantly higher than that in PA group (15.2%, P<0.05). At one week after secondary treatment, the effective rate was 100% and 37.5% in PL and PA groups, respectively, with significant difference between the groups (P<0.05). The effective rate increased to 90.6% in PA group at one week after tertiary treatment. At one week after the end of treatment cycles, the scores of VAS and MPQ were significantly lower in C1, PL, and PA groups than in C2 group (P<0.05), while PPST and PPTT were significantly higher than in C2 group (P<0.05). There was no significant difference between C1 group and PL group (P>0.05). At follow-up at 3 months after treatment, the recurrence rate was low in each group, with no significant difference between the groups (P>0.05). Conclusion. About 57% of PHN patients with mild to moderate pain are complicated with MPS, and ultrasound-guided inactivation of MTrPs with dry and wet needling can effectively treat PHN patients complicated with LMPS. However, patients with PHN complicated with AMPS need to be treated with ultrasound-guided MTrPs inactivation combined with muscle fascia stripping by liquid knife as soon as possible.

Sign in / Sign up

Export Citation Format

Share Document