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Sample records for latent myofascial trigger

  1. Latent myofascial trigger points.

    Science.gov (United States)

    Ge, Hong-You; Arendt-Nielsen, Lars

    2011-10-01

    A latent myofascial trigger point (MTP) is defined as a focus of hyperirritability in a muscle taut band that is clinically associated with local twitch response and tenderness and/or referred pain upon manual examination. Current evidence suggests that the temporal profile of the spontaneous electrical activity at an MTP is similar to focal muscle fiber contraction and/or muscle cramp potentials, which contribute significantly to the induction of local tenderness and pain and motor dysfunctions. This review highlights the potential mechanisms underlying the sensory-motor dysfunctions associated with latent MTPs and discusses the contribution of central sensitization associated with latent MTPs and the MTP network to the spatial propagation of pain and motor dysfunctions. Treating latent MTPs in patients with musculoskeletal pain may not only decrease pain sensitivity and improve motor functions, but also prevent latent MTPs from transforming into active MTPs, and hence, prevent the development of myofascial pain syndrome.

  2. Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points.

    Science.gov (United States)

    Ge, Hong-You; Zhang, Yang; Boudreau, Shellie; Yue, Shou-Wei; Arendt-Nielsen, Lars

    2008-06-01

    The aim of this present study is to test the hypothesis that nociceptive stimulation of latent myofascial trigger points (MTrPs) increases the occurrence of local muscle cramps. Nociceptive muscle stimulation was obtained by a bolus injection of glutamate (0.1 ml, 0.5 M) into a latent MTrP and a control point (a non-MTrP) located in the right or left gastrocnemius medialis muscles in 14 healthy subjects. A bolus of isotonic saline (0.9%, 0.1 ml) injection served as a control. The injections were guided by intramuscular electromyography (EMG) showing resting spontaneous electrical activity at a latent MTrP and no such activity at a non-MTrP. Intramuscular and surface EMG activities in the gastrocnemius medialis muscle were recorded pre-, during-, and post-injection for a period of 8 min to monitor the occurrence of muscle cramps, which are characterized by a brief episodic burst of high levels of EMG activity. The results showed that glutamate and isotonic saline injections into the latent MTrPs induced higher peak pain intensity than into the non-MTrPs (both P < 0.05). Glutamate injection induced higher peak pain intensity than isotonic saline injection into either latent MTrPs or non-MTrPs (both P < 0.05). Muscle camps were observed in 92.86% of the subjects following glutamate injection into the latent MTrPs, but not into the non-MTrPs (P < 0.001). No muscle cramps were recorded following isotonic saline injection into either the latent MTrPs or the non-MTrPs. These results suggest that latent MTrPs could be involved in the genesis of muscle cramps. Focal increase in nociceptive sensitivity at MTrPs constitutes one of the mechanisms underlying muscle cramps.

  3. Tensiomyography, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points

    Science.gov (United States)

    Calvo-Lobo, César; Diez-Vega, Ignacio; Martínez-Pascual, Beatriz; Fernández-Martínez, Silvia; de la Cueva-Reguera, Mónica; Garrosa-Martín, Gerson; Rodríguez-Sanz, David

    2017-01-01

    Abstract The myofascial pain syndrome (MPS) is considered the most common musculoskeletal condition. The lumbopelvic pain (LPP) is established as one of the most prevalent musculoskeletal disorders. Nevertheless, previous research has not yet studied the contractibility changes by tensiomyography between myofascial trigger point (MTrP) types and normal tissue. Therefore, the aim of this study was to determine the tensiomyography, sonoelastography, and pressure pain threshold (PPT) differences between the palpation area of active and latent MTrPs with regards to control points in the lumbar erector spinae muscles of subjects with LPP. A cross-sectional descriptive study was performed. A convenience sample of 60 points (20 active MTrPs, 20 latent MTrPs, and 20 control points) was registered bilaterally in the lumbar erector spinae muscles from subjects with nonspecific LPP. The palpation order of active MTrPs, latent MTrPs, or control points was randomized for each side. The outcome assessors were blinded to the order or point type. The outcome measurements order for each point was sonoelastography manual strain index, tensiomyography, and PPT, separated by 15 minutes. Five contractile objective parameters were: maximal radial displacement (Dm), contraction time (Tc), sustain time (Ts), delay time (Td), and half-relaxation time (Tr). Tensiomyography parameters did not show any statistically significant difference (P > 0.05) between active MTrPs, latent MTrPs, and control points. Nevertheless, PPT and sonoelastography showed statistically significant differences (P < 0.05) between all point types, except for active and latent MTrPs PPT comparison (P = 0.091). Regarding the active MTrPs, a moderate positive correlation was observed between PPT and Dm (P = 0.047; τB = 0.450). Considering the control points, a moderate positive correlation was shown between sonoelastography and Td (P = 0.044; τB = 0.328). The tensiomyography contractile

  4. Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kai-Hua Chen

    2013-01-01

    Full Text Available Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40 and Yanglingquan (GB34 points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side versus sham needling on the contralateral lower limb (control side in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P=0.03 in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P=0.036. Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle.

  5. Effect of Latent Myofascial Trigger Points on Strength Measurements of the Upper Trapezius: A Case-Controlled Trial

    Science.gov (United States)

    Anshul

    2011-01-01

    ABSTRACT Purpose: The purpose of this article was to determine whether strength is altered in the upper trapezius in the presence of latent myofascial trigger points (MTrP). Methods: This study was case controlled and used convenience sampling. The sample recruited was homogeneous with respect to age, sex, height, and body mass. Participants were assessed for the presence of latent MTrP in the upper trapezius and placed into two groups: an experimental group that had latent MTrP in the upper trapezius and a control group that did not. Eighteen women (mean age 21.4 y, SD 1.89; mean height 156.9 cm, SD 4.03; and mean body mass 51.7 kg, SD 5.84) made up the experimental group, and 19 women (mean age 20.3 y, SD 1.86; mean height 158.6 cm, SD 3.14; and mean body mass 53.2 kg, SD 5.17) made up the control group. We obtained strength measurements of the non-dominant arm using a handheld dynamometer and compared them between the two groups. Results: The difference in the strength measurements between the two groups was not statistically significant (p=0.59). Conclusions: The presence of latent MTrPs may not affect the strength of the upper trapezius. PMID:22942517

  6. Electrophysiological characteristics according to activity level of myofascial trigger points

    OpenAIRE

    Yu, Seong Hun; Kim, Hyun Jin

    2015-01-01

    [Purpose] This study compared the differences in electrophysiological characteristics of normal muscles versus muscles with latent or active myofascial trigger points, and identified the neuromuscular physiological characteristics of muscles with active myofascial trigger points, thereby providing a quantitative evaluation of myofascial pain syndrome and clinical foundational data for its diagnosis. [Subjects] Ninety adults in their 20s participated in this study. Subjects were equally divide...

  7. Etiology of myofascial trigger points

    NARCIS (Netherlands)

    Bron, C.; Dommerholt, J.D.

    2012-01-01

    Myofascial pain syndrome (MPS) is described as the sensory, motor, and autonomic symptoms caused by myofascial trigger points (TrPs). Knowing the potential causes of TrPs is important to prevent their development and recurrence, but also to inactivate and eliminate existing TrPs. There is general

  8. Etiology of myofascial trigger points

    NARCIS (Netherlands)

    Bron, C.; Dommerholt, J.D.

    2012-01-01

    Myofascial pain syndrome (MPS) is described as the sensory, motor, and autonomic symptoms caused by myofascial trigger points (TrPs). Knowing the potential causes of TrPs is important to prevent their development and recurrence, but also to inactivate and eliminate existing TrPs. There is general ag

  9. Electrophysiological characteristics according to activity level of myofascial trigger points.

    Science.gov (United States)

    Yu, Seong Hun; Kim, Hyun Jin

    2015-09-01

    [Purpose] This study compared the differences in electrophysiological characteristics of normal muscles versus muscles with latent or active myofascial trigger points, and identified the neuromuscular physiological characteristics of muscles with active myofascial trigger points, thereby providing a quantitative evaluation of myofascial pain syndrome and clinical foundational data for its diagnosis. [Subjects] Ninety adults in their 20s participated in this study. Subjects were equally divided into three groups: the active myofascial trigger point group, the latent myofascial trigger point group, and the control group. [Methods] Maximum voluntary isometric contraction (MVIC), endurance, median frequency (MDF), and muscle fatigue index were measured in all subjects. [Results] No significant differences in MVIC or endurance were revealed among the three groups. However, the active trigger point group had significantly different MDF and muscle fatigue index compared with the control group. [Conclusion] Given that muscles with active myofascial trigger points had an increased MDF and suffered muscle fatigue more easily, increased recruitment of motor unit action potential of type II fibers was evident. Therefore, electrophysiological analysis of these myofascial trigger points can be applied to evaluate the effect of physical therapy and provide a quantitative diagnosis of myofascial pain syndrome.

  10. Postneedling soreness after deep dry needling of a latent myofascial trigger point in the upper trapezius muscle: Characteristics, sex differences and associated factors.

    Science.gov (United States)

    Martín-Pintado-Zugasti, Aitor; Rodríguez-Fernández, Ángel Luis; Fernandez-Carnero, Josue

    2016-04-27

    Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent myofascial trigger point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.

  11. Understanding of myofascial trigger points

    Institute of Scientific and Technical Information of China (English)

    Zhuang Xiaoqiang; Tan Shusheng; Huang Qiangmin

    2014-01-01

    Objective To investigate the current practice of myofascial pain syndrome (MPS) including current epidemiology,pathology,diagnosis and treatment.Data sources The data analyzed in this review were mainly from relevant articles without restriction on the publication date reported in PubMed,MedSci,Google scholar.The terms "myofasial trigger points" and "myofacial pain syndrome" were used for the literature search.Study selection Original articles with no limitation of research design and critical reviews containing data relevant to myofascial trigger points (MTrPs) and MPS were retrieved,reviewed,analyzed and summarized.Results Myofascial pain syndrome (MPS) is characterized by painful taut band,referred pain,and local response twitch with a prevalence of 85% to 95% of incidence.Several factors link to the etiology of MTrPs,such as the chronic injury and overload of muscles.Other factors,such as certain nutrient and hormone insufficiency,comorbidities,and muscle imbalance may also maintain the MTrP in an active status and induce recurrent pain.The current pathology is that an extra leakage acetylcholine at the neuromuscular junction induces persistent contracture knots,relative to some hypotheses of integration,muscle spindle discharges,spinal segment sensitization,ect.MTrPs can be diagnosed and localized based on a few subjective criteria.Several approaches,including both direct and supplementary treatments,can inactivate MTrPs.Direct treatments are categorized into invasive and conservative.Conclusion This review provides a clear understanding of MTrP pain and introduces the most useful treatment approaches in China.

  12. Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial.

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    Calvo-Lobo, César; Pacheco-da-Costa, Soraya; Martínez-Martínez, Jorge; Rodríguez-Sanz, David; Cuesta-Álvaro, Pedro; López-López, Daniel

    2016-01-15

    Shoulder pain is a prevalent condition in older adults. Some authors associate nonspecific shoulder pain with myofascial trigger points (MTrPs) in the infraspinatus muscle. Dry needling is recommended to relieve the MTrP pain of shoulders in the short term (dry needling improves shoulder pain and the irritability of the satellite MTrPs in the referred pain area. Nociceptive activity at a latent MTrP may influence motor activity and the sensitivity of MTrPs in distant muscles at a similar segmental level. Therefore, this study aimed to evaluate dry needling on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle of older adults with nonspecific shoulder pain. A single-center, randomized, single-blinded, controlled study (NCT02032602) was carried out. Sixty-six patients aged 65 years and older with trigger points in the ipsilateral infraspinatus of the painful shoulder were randomly assigned to (1) of (2) treatment groups. A session of dry needling on the infraspinatus was performed in (1) the most hyperalgesic active and latent MTrP or (2) only the most hyperalgesic active MTrP. The Numeric Rating Scale, the pressure pain threshold (primary outcome) on the anterior deltoid and extensor carpi radialis brevis latent MTrPs, and grip strength were assessed before, after, and 1 week after the intervention. Statistically significant differences in the reduction of pain intensity (P ≤ .001; η = 0.159-0.269; d = 1.017-1.219) and the increase of pressure pain threshold (P . 05; η = 0.006-0.033; d = 0.158-0.368). One dry needling intervention of the latent MTrP associated with the key active MTrP of the infraspinatus reduces pain intensity and the irritability of the satellite MTrPs located in the referred pain area in the short term in older adults with nonspecific shoulder pain.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is

  13. Introduction to myofascial trigger points in dogs.

    Science.gov (United States)

    Wall, Rick

    2014-06-01

    In dogs, muscles make up 44%-57% of total body weight and can serve as source of both pain and dysfunction when myofascial trigger points are present. However, rarely is muscle mentioned as a generator of pain in dogs, and even less mentioned is muscle dysfunction. The veterinary practitioner with interest in pain management, rehabilitation, orthopedics, and sports medicine must be familiar with the characteristics, etiology, and precipitating factors of myofascial trigger points. Additionally, the development of examination and treatment skill is needed to effectively manage myofascial trigger points in dogs.

  14. Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration.

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    Martín-Pintado-Zugasti, Aitor; Pecos-Martin, Daniel; Rodríguez-Fernández, Ángel Luis; Alguacil-Diego, Isabel María; Portillo-Aceituno, Alicia; Gallego-Izquierdo, Tomás; Fernandez-Carnero, Josue

    2015-10-01

    To investigate the effect of ischemic compression (IC) versus placebo and control on reducing postneedling soreness of 1 latent myofascial trigger point and on improving cervical range of motion (CROM) in asymptomatic subjects. A randomized, double-blind, placebo-controlled trial with 72-hour follow-up. A university community. Asymptomatic volunteers (N = 90: 40 men and 50 women) aged 18 to 39 years (mean ± standard deviation [SD]: 22 ± 3 years). All subjects received a dry needling application over the upper trapezius muscle. Participants were then randomly divided into 3 groups: a treatment group who received IC over the needled trapezius muscle, a placebo group who received sham IC, and a control group who did not receive any treatment after needling. Visual analog scale (VAS; during needling, at posttreatment and 6, 12, 24, 48, and 72 hours) and CROM (at preneedling, postneedling, and 24 and 72 hours). Subjects in the IC group showed significantly lower postneedling soreness than the placebo and the control group subjects immediately after treatment (mean ± standard deviation [SD]: IC, 20.1 ± 4.8; placebo, 36.7 ± 4.8; control, 34.8 ± 3.6) and at 48 hours (mean ± SD: IC, 0.6 ± 1; placebo, 4.8 ± 1; control, 3.8 ± 0.7). In addition, subjects in the dry needling+IC group showed significantly lower postneedling soreness duration (P = .026). All subjects significantly improved CROM in contralateral lateroflexion and both homolateral and contralateral rotations, but only the improvements found in the IC group reached the minimal detectable change. IC can potentially be added immediately after dry needling of myofascial trigger point in the upper trapezius muscle because it has the effect of reducing postneedling soreness intensity and duration. The combination of dry needling and IC seems to improve CROM in homolateral and contralateral cervical rotation movements. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by

  15. Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study

    Science.gov (United States)

    Pacheco-da-Costa, Soraya; Hita-Herranz, Edgar

    2017-01-01

    Background: Nonspecific shoulder pain has a high prevalence in older adults and causes functional alterations. Furthermore, there are difficulties in establishing a clinical diagnosis, effective treatments are lacking, and little evidence has been found regarding the use of invasive physical therapy techniques in this age group. Purpose: To determine the efficacy of a single physical therapy intervention with deep dry needling (DDN) on latent and active myofascial trigger points (MTrPs) in older adults with nonspecific shoulder pain. Methods: This pilot study is a single-blind, randomized, controlled clinical trial that included 20 participants, aged 65 years and older, who were diagnosed with nonspecific shoulder pain. The study was approved by the Clinical Research Ethics Committee of the area. Participants were recruited at their homes or at a care center and were randomly assigned into either an experimental group (n = 10), which received a session of DDN on 1 active and 1 latent MTrP of the infraspinatus muscle, or a control group (n = 10), which received a session of DDN on only 1 active MTrP. A blind examiner assessed the pain intensity, pain pressure threshold on the anterior deltoid, and extensor carpi radialis brevis muscles and grip strength before, immediately after, and 1 week after the intervention. Results: Statistically significant differences (P < .05) in the pressure pain thresholds (PPTs) of the extensor carpi radialis brevis were found in the experimental group in both posttreatment assessments. Moreover, the effect size values (d Cohen) varied from small for grip strength (0.017-0.36) to moderate for the pain intensity (0.46-0.78) and PPT in the anterior deltoid (0.49-0.66) and to large for the PPT in the extensor carpi radialis brevis (1.06-1.58). Conclusions: A single physical therapy intervention with DDN on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle may increase the PPT of the extensor carpi radialis

  16. Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study.

    Science.gov (United States)

    Calvo-Lobo, César; Pacheco-da-Costa, Soraya; Hita-Herranz, Edgar

    Nonspecific shoulder pain has a high prevalence in older adults and causes functional alterations. Furthermore, there are difficulties in establishing a clinical diagnosis, effective treatments are lacking, and little evidence has been found regarding the use of invasive physical therapy techniques in this age group. To determine the efficacy of a single physical therapy intervention with deep dry needling (DDN) on latent and active myofascial trigger points (MTrPs) in older adults with nonspecific shoulder pain. This pilot study is a single-blind, randomized, controlled clinical trial that included 20 participants, aged 65 years and older, who were diagnosed with nonspecific shoulder pain. The study was approved by the Clinical Research Ethics Committee of the area. Participants were recruited at their homes or at a care center and were randomly assigned into either an experimental group (n = 10), which received a session of DDN on 1 active and 1 latent MTrP of the infraspinatus muscle, or a control group (n = 10), which received a session of DDN on only 1 active MTrP. A blind examiner assessed the pain intensity, pain pressure threshold on the anterior deltoid, and extensor carpi radialis brevis muscles and grip strength before, immediately after, and 1 week after the intervention. Statistically significant differences (P < .05) in the pressure pain thresholds (PPTs) of the extensor carpi radialis brevis were found in the experimental group in both posttreatment assessments. Moreover, the effect size values (d Cohen) varied from small for grip strength (0.017-0.36) to moderate for the pain intensity (0.46-0.78) and PPT in the anterior deltoid (0.49-0.66) and to large for the PPT in the extensor carpi radialis brevis (1.06-1.58). A single physical therapy intervention with DDN on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle may increase the PPT of the extensor carpi radialis brevis muscle area immediately following and 1 week after

  17. Assessment of Myofascial Trigger Points Using Ultrasound.

    Science.gov (United States)

    Kumbhare, Dinesh A; Elzibak, Alyaa H; Noseworthy, Michael D

    2016-01-01

    Myofascial pain syndrome is a common musculoskeletal pain disorder characterized by the presence of myofascial trigger points (MTrPs). The diagnosis of myofascial pain syndrome is currently made on clinical grounds. Numerous diagnostic criteria are used to identify myofascial pain syndrome, including the localization of MTrPs. Identifying the presence of MTrPs currently requires the physician to palpate the symptomatic region. Because the interrater reliability of the palpation technique has been found to be poor, numerous groups have been interested in finding objective imaging measures to localize the MTrP. This comprehensive review focuses on summarizing ultrasound imaging techniques that have shown promise in visually localizing the trigger point. The authors' literature search identified three sonographic approaches that have been used in MTrP localization: conventional gray-scale imaging, Doppler imaging, and elastographic ultrasound imaging. This review article explains the basic physics behind the imaging methods and summarizes the characteristics of the MTrP as identified by the ultrasonic techniques.

  18. Pathophysiology of Trigger Points in Myofascial Pain Syndrome.

    Science.gov (United States)

    Money, Sarah

    2017-06-01

    Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. Trigger point pathophysiology in myofascial pain syndrome, which involves muscle stiffness, tenderness, and pain that radiates to other areas of the body, is considered. The causes of trigger points and several theories about how they develop are reviewed, and treatment approaches, including stretching, physical therapy, dry needling, and injections, are offered.

  19. DRY NEEDLING FOR MYOFASCIAL TRIGGER POINT PAIN: A CLINICAL COMMENTARY.

    Science.gov (United States)

    Unverzagt, Casey; Berglund, Kathy; Thomas, J J

    2015-06-01

    Sports and orthopaedic physical therapists have long used a multitude of techniques in order to address pain and dysfunction associated with myofascial trigger points. One technique in particular has recently received overwhelming attention: trigger point dry needling (DN). Despite its efficacy and low risk, questions remain as to its effectiveness, safety, and whether the technique is within the scope of practice of physical therapists. Therefore, the purpose of this clinical commentary is to summarize the current literature related to the associated mechanisms of action of DN, the safety of DN, as well as to discuss relevant scope of practice concerns. 5.

  20. Myofascial trigger point therapy: laser therapy and dry needling.

    Science.gov (United States)

    Uemoto, Luciana; Nascimento de Azevedo, Rosany; Almeida Alfaya, Thays; Nunes Jardim Reis, Renata; Depes de Gouvêa, Cresus Vinicius; Cavalcanti Garcia, Marco Antonio

    2013-09-01

    The aim of the present review is to discuss two forms of treatment for myofascial pain: laser therapy and dry needling. Although studies have reported the deactivation of myofascial trigger points with these two methods, clinical trials demonstrating their efficacy are scarce. The literature reports greater efficacy with the use of laser over dry needling. It has been suggested that improvements in microcirculation through the administration of laser therapy may favor the supply of oxygen to the cells under conditions of hypoxia and help remove the waste products of cell metabolism, thereby breaking the vicious cycle of pain, muscle spasm and further pain. While laser therapy is the method of choice for patients with a fear of needles and healthcare professionals inexperienced with the dry needling technique, further controlled studies are still needed to prove the greater efficacy of this method.

  1. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation.

    Science.gov (United States)

    Ge, Hong-You; Fernández-de-Las-Peñas, César; Yue, Shou-Wei

    2011-03-25

    Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy.

  2. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation

    Directory of Open Access Journals (Sweden)

    Fernández-de-las-Peñas César

    2011-03-01

    Full Text Available Abstract Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy.

  3. Comparison between four treatment modalities for active myofascial triggers points

    Directory of Open Access Journals (Sweden)

    Atef Fouda

    2014-06-01

    Full Text Available Aim: The study aimed at the painful trigger points (TrPs for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction. Methods: We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction. Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain. We used mean and standard deviation values. The Mann-Whitney U-test was used to compare the two groups. The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores. The Student's t-test was used to compare maximum mouth opening (MMO groups. Then paired t-test was also used to study the changes of time in an MMO. Results: The results showed that pulsed electromagnetic field (PEMF therapy is the most effective treatment modality regarding for pain relief. Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods, and a statistically significant increase in mean MMO. Conclusion: The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.

  4. [Differences between myofascial trigger points and tender points].

    Science.gov (United States)

    Mense, S

    2011-02-01

    The article describes and compares the characteristics of myofascial trigger points (MTrPs) of the myofascial pain syndrome and the tender points (TePs) of the fibromyalgia syndrome. Many statements are hypothetical, because not all aspects of the disorders have been clarified in solid studies. Signs and symptoms of MTrPs: (1) palpable nodule, often located close to the muscle belly, (2) often single, (3) allodynia and hyperalgesia at the MTrP, (4) referral of the MTrP pain, (5) normal pain sensitivity outside the MTrPs, (6) local twitch response, (7) local contracture in biopsy material, (8) peripheral mechanism probable. Signs and symptoms of TePs: (1) no palpable nodule, (2) location often close to the muscle attachments, (3) multiple by definition, (4) allodynia and hyperalgesia also outside the TePs, (5) enhanced pain under psychic stress, (6) unspecific histological changes in biopsy material, (7) central nervous mechanism probable. The multitude of differences speak against a common aetiology and pathophysiology.

  5. Mechanical pain sensitivity of deep tissues in children - possible development of myofascial trigger points in children

    Directory of Open Access Journals (Sweden)

    Han Ting-I

    2012-02-01

    Full Text Available Abstract Background It is still unclear when latent myofascial trigger points (MTrPs develop during early life. This study is designed to investigate the mechanical pain sensitivity of deep tissues in children in order to see the possible timing of the development of latent MTrPs and attachment trigger points (A-TrPs in school children. Methods Five hundreds and five healthy school children (age 4- 11 years were investigated. A pressure algometer was used to measure the pressure pain threshold (PPT at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site, the mid-point of the muscle belly (site B, assumed to be the MTrP site, and the muscle-tendon junction as a control site (site C. Results The results showed that, for all children in this study, the mean PPT values was significantly lower (p p Conclusions It is concluded that a child had increased sensitivity at the tendon attachment site and the muscle belly (endplate zone after age of 4 years. Therefore, it is likely that a child may develop an A-Trp and a latent MTrP at the brachioradialis muscle after the age of 4 years. The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years. Further investigation is still required to indentify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

  6. Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome.

    Science.gov (United States)

    Shah, Jay P; Gilliams, Elizabeth A

    2008-10-01

    This article discusses muscle pain concepts in the context of myofascial pain syndrome (MPS) and summarizes microdialysis studies that have surveyed the biochemical basis of this musculoskeletal pain condition. Though MPS is a common type of non-articular pain, its pathophysiology is only beginning to be understood due to its enormous complexity. MPS is characterized by the presence of myofascial trigger points (MTrPs), which are defined as hyperirritable nodules located within a taut band of skeletal muscle. MTrPs may be active (spontaneously painful and symptomatic) or latent (non-spontaneously painful). Painful MTrPs activate muscle nociceptors that, upon sustained noxious stimulation, initiate motor and sensory changes in the peripheral and central nervous systems. This process is called sensitization. In order to investigate the peripheral factors that influence the sensitization process, a microdialysis technique was developed to quantitatively measure the biochemical milieu of skeletal muscle. Biochemical differences were found between active and latent MTrPs, as well as in comparison with healthy muscle tissue. In this paper we relate the findings of elevated levels of sensitizing substances within painful muscle to the current theoretical framework of muscle pain and MTrP development.

  7. Traditional Chinese Medicine acupuncture and myofascial trigger needling: The same stimulation points?

    Science.gov (United States)

    Liu, Lizhou; Skinner, Margot A; McDonough, Suzanne M; Baxter, George David

    2016-06-01

    Acupuncture originates in China, and its effectiveness has been well documented in musculoskeletal pain disorders and other conditions. A widely accepted contemporary medical treatment option for myofascial pain is trigger point needling. Although there are many differences between Traditional Chinese Medicine acupuncture theory and the myofascial trigger point needling framework, it is argued that the stimulation sites for these two needling modalities are similar. In this paper we examined the correspondence between Traditional Chinese Medicine acupoints and myofascial trigger points. Based on this correspondence, we considered exploration of Ah-shi points from four aspects: pain recognition, distal Ah-shi points, Anti-Ah-shi points, and management approaches. The extent of correspondence is influenced by definitions of acupoints. Myofascial trigger points are significantly correlated to Traditional Chinese Medicine acupoints, including primary channel acupoints, extra acupoints, and Ah-shi points. Considering the correlation between MTrPs and acupoints and the rarely-studied research area of Ah-shi points, it may be reasonable to incorporate research findings of myofascial trigger points into further investigations into Ah-shi points. Correspondence between myofascial trigger points and acupoints enhances contemporary understanding of the mechanism of action of acupuncture, and may serve to facilitate increased integration of acupuncture into clinical management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.

    Science.gov (United States)

    Moraska, Albert F; Schmiege, Sarah J; Mann, John D; Butryn, Nathan; Krutsch, Jason P

    2017-09-01

    This study aimed to assess the effects of single and multiple massage treatments on pressure-pain threshold (PPT) at myofascial trigger points (MTrPs) in people with myofascial pain syndrome expressed as tension-type headache. Individuals (n = 62) with episodic or chronic tension-type headache were randomized to receive 12 twice-weekly 45-min massage or sham ultrasound sessions or wait-list control. Massage focused on trigger point release (ischemic compression) of MTrPs in the bilateral upper trapezius and suboccipital muscles. PPT was measured at MTrPs with a pressure algometer pre and post the first and final (12th) treatments. PPT increased across the study timeframe in all four muscle sites tested for massage, but not sham ultrasound or wait-list groups (P myofascial trigger points to myofascial pain; (2) Describe an effective treatment for decreasing tenderness of a myofascial trigger point; and (3) Discuss the relative values of single vs. multiple massage sessions on increasing pressure-pain thresholds at myofascial trigger points. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

  9. Myofascial trigger points in cluster headache patients: a case series

    Directory of Open Access Journals (Sweden)

    Rico-Villademoros Fernando

    2008-12-01

    Full Text Available Abstract Active myofascial trigger points (MTrPs have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3% and in 6 (85.7% of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

  10. [Progress of research on acupuncture at trigger point for myofascial pain syndrome].

    Science.gov (United States)

    Ma, Yao; Bu, He; Jia, Ji-rong; Zhang, Xue

    2012-06-01

    To review the literature of acupuncture at trigger point for myofascial pain syndrome from the main selected points (trigger point), the mechanism of Chinese medicine and modern research and its clinical application. The results show that acupuncture at trigger point has significant effect on the myofascial pain syndrome, which could be influenced by the type of needle, manipulation, insertion angle and depth of the needles. However, the involved studies at present are still far from enough and lack of systematic study with multivariate analysis, it is needed to be improved that some problems about the clinical diagnosis and basic research.

  11. Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.

    Science.gov (United States)

    Shah, Jay P; Thaker, Nikki; Heimur, Juliana; Aredo, Jacqueline V; Sikdar, Siddhartha; Gerber, Lynn

    2015-07-01

    The intent of this article is to discuss the evolving role of the myofascial trigger point (MTrP) in myofascial pain syndrome (MPS) from both a historical and scientific perspective. MTrPs are hard, discrete, palpable nodules in a taut band of skeletal muscle that may be spontaneously painful (i.e., active) or painful only on compression (i.e., latent). MPS is a term used to describe a pain condition that can be acute or, more commonly, chronic and involves the muscle and its surrounding connective tissue (e.g. fascia). According to Travell and Simons, MTrPs are central to the syndrome-but are they necessary? Although the clinical study of muscle pain and MTrPs has proliferated over the past two centuries, the scientific literature often seems disjointed and confusing. Unfortunately, much of the terminology, theories, concepts, and diagnostic criteria are inconsistent, incomplete, or controversial. To address these deficiencies, investigators have recently applied clinical, imaging (of skeletal muscle and brain), and biochemical analyses to systematically and objectively study the MTrP and its role in MPS. Data suggest that the soft tissue milieu around the MTrP, neurogenic inflammation, sensitization, and limbic system dysfunction may all play a role in the initiation, amplification, and perpetuation of MPS. The authors chronicle the advances that have led to the current understanding of MTrP pathophysiology and its relationship to MPS, and review the contributions of clinicians and researchers who have influenced and expanded our contemporary level of clinical knowledge and practice.

  12. Dry Needling Alters Trigger Points in the Upper Trapezius Muscle and Reduces Pain in Subjects With Chronic Myofascial Pain.

    Science.gov (United States)

    Gerber, Lynn H; Shah, Jay; Rosenberger, William; Armstrong, Kathryn; Turo, Diego; Otto, Paul; Heimur, Juliana; Thaker, Nikki; Sikdar, Siddhartha

    2015-07-01

    To determine whether dry needling of an active myofascial trigger point (MTrP) reduces pain and alters the status of the trigger point to either a non-spontaneously tender nodule or its resolution. A prospective, nonrandomized, controlled, interventional clinical study. University campus. A total of 56 subjects with neck or shoulder girdle pain of more than 3 months duration and active MTrPs were recruited from a campus-wide volunteer sample. Of these, 52 completed the study (23 male and 33 female). Their mean age was 35.8 years. Three weekly dry needling treatments of a single active MTrP. Baseline and posttreatment evaluations of pain using a verbal analogue scale, the Brief Pain Inventory, and the status of the MTrP as determined by digital palpation. Trigger points were rated as active (spontaneously painful), latent (requiring palpation to reproduce the characteristic pain), or resolved (no palpable nodule). Profile of Mood States, Oswestry Disability Index, and Short Form 36 scores, and cervical range of motion. A total of 41 subjects had a change in trigger point status from active to latent or resolved, and 11 subjects had no change (P Dry needling reduces pain and changes MTrP status. Change in trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction of pain is associated with improved mood, function, and level of disability. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  13. Prevalence of myofascial trigger points in fibromyalgia: the overlap of two common problems.

    Science.gov (United States)

    Ge, Hong-You

    2010-10-01

    With the objective evidence of their existence, myofascial trigger points (MTrPs) contribute to an increasing number of chronic regional and widespread pain conditions. The widespread spontaneous pain pattern in fibromyalgia (FM) is a summation of multiple regional pains due to active MTrPs. A regional pain in FM is from local active MTrPs and/or referred from remote active MTrPs. Positive tender points specified in FM are MTrPs, either active or latent. Manual stimulation of active MTrPs located in the muscles in different body regions completely reproduced overall spontaneous FM pain pattern. Active MTrPs as tonic peripheral nociceptive input contribute tremendously to the initiation and maintenance of central sensitization, to the impairment of descending inhibition, to the increased excitability of motor units, and to the induction of sympathetic hyperactivity observed in FM. The considerable overlap of MTrPs and FM in pain characteristics and pathophysiology suggests that FM pain is largely due to MTrPs.

  14. Treatment of myofascial trigger points in patients with chronic shoulder pain : a randomized, controlled trial

    NARCIS (Netherlands)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A. B.

    2011-01-01

    Background: Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the

  15. Incidence of trapezius myofascial trigger points in patients with the possible carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Hamid Azadeh

    2010-01-01

    Full Text Available Background: Patients with carpal tunnel syndrome (CTS often complain of prominent pain in shoulder and arm, also there are patients that have pain in their shoulder and arm which is due to myofascial trigger point (MTP located in their upper trapezius muscle. Despite the frequency of this observation, few studies have previously sought to establish possible relationship between the CTS and MTP in shoulder area. Methods: Samples were 160 patients (221 hands consist of 130 females and 30 males, with suspected diagnosis of CTS, from March 2008 to October 2008. In this study after performing electrodiagnosis searches, another evaluation was performed to find out if there was any sign of myofascial trigger point. The correlation between these two was sought. Results: It was found that all of 36 hands with normal electrodiagnostic findings had myofascial trigger points in their upper trapezius muscle. Out of 185 hands, 130 hands (70% with electrophysiological evidences of CTS showed myofascial trigger points in their trapezius muscles. Statistical analysis revealed significant (p < 0.001 reverse correlation between the severity of CTS and the presence of MTP. Conclusions: The findings of this study imply the significant correlation between occurrence of CTS and MTP. It is suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS.

  16. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome

    DEFF Research Database (Denmark)

    Ge, Hong-You; Nie, Hongling; Madeleine, Pascal

    2009-01-01

    The generalized hypersensitivity associated with fibromyalgia syndrome (FMS) may in part be driven by peripheral nociceptive sources. The aim of the study was to investigate whether local and referred pain from active myofascial trigger points (MTrPs) contributes to fibromyalgia pain. FMS patients...

  17. Incidence of trapezius myofascial trigger points in patients with the possible carpal tunnel syndrome

    Science.gov (United States)

    Azadeh, Hamid; Dehghani, Mohammad; Zarezadeh, Abolghasem

    2010-01-01

    BACKGROUND: Patients with carpal tunnel syndrome (CTS) often complain of prominent pain in shoulder and arm, also there are patients that have pain in their shoulder and arm which is due to myofascial trigger point (MTP) located in their upper trapezius muscle. Despite the frequency of this observation, few studies have previously sought to establish possible relationship between the CTS and MTP in shoulder area. METHODS: Samples were 160 patients (221 hands) consist of 130 females and 30 males, with suspected diagnosis of CTS, from March 2008 to October 2008. In this study after performing electrodiagnosis searches, another evaluation was performed to find out if there was any sign of myofascial trigger point. The correlation between these two was sought. RESULTS: It was found that all of 36 hands with normal electrodiagnostic findings had myofascial trigger points in their upper trapezius muscle. Out of 185 hands, 130 hands (70%) with electrophysiological evidences of CTS showed myofascial trigger points in their trapezius muscles. Statistical analysis revealed significant (p < 0.001) reverse correlation between the severity of CTS and the presence of MTP. CONCLUSIONS: The findings of this study imply the significant correlation between occurrence of CTS and MTP. It is suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS. PMID:21526092

  18. Treatment of myofascial trigger points in patients with chronic shoulder pain : a randomized, controlled trial

    NARCIS (Netherlands)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A. B.

    2011-01-01

    Background: Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effecti

  19. Ovlivnění myofasciálního trigger pointu pomocí aplikace suché jehly

    OpenAIRE

    Halatová, Jana

    2016-01-01

    The historical roots of dry needling go back to the fist half of the 20th century. According to huge spread of issues connected with myofascial trigger points in society, dry needling is together with other therapeutic methods more and more on the front burner all around the world. This bachelor thesis is theoretical and introduces dry needling as possible treatment of myofascial pain and myofascial pain syndrome. The first part is focused on characteristic of myofascial trigger points, in th...

  20. Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain.

    Science.gov (United States)

    Turo, Diego; Otto, Paul; Hossain, Murad; Gebreab, Tadesse; Armstrong, Katherine; Rosenberger, William F; Shao, Hui; Shah, Jay P; Gerber, Lynn H; Sikdar, Siddhartha

    2015-12-01

    To compare a mechanical heterogeneity index derived from ultrasound vibration elastography with physical findings before and after dry-needling treatment of spontaneously painful active myofascial trigger points in the upper trapezius muscle. Forty-eight patients with chronic myofascial pain enrolled in a prospective interventional trial of 3 weekly dry-needling treatments for active myofascial trigger points. Trigger points were evaluated at baseline and at treatment completion using palpation, the pressure-pain threshold, and the mechanical heterogeneity index. Thirty patients were reevaluated at 8 weeks. Trigger points that "responded" changed to tissue that was no longer spontaneously painful, with or without the presence of a palpable nodule. Trigger points that "resolved" changed to tissue without a palpable nodule. The mechanical heterogeneity index was defined as the proportion of the upper trapezius muscle that appeared mechanically stiffer on elastography. Statistical significance for comparisons was determined at P dry needle treatments, the mechanical heterogeneity index decreased significantly for the 38 myofascial trigger points (79% of 48) that responded to treatment. Among these, the baseline mechanical heterogeneity index was significantly lower for the 13 trigger points (27% of 38) that resolved, but the decrease after 3 dry needle treatments did not reach significance. The pressure-pain threshold improved significantly for both groups. At 8 weeks, the mechanical heterogeneity index decreased significantly for the 22 trigger points (73% of 30) that responded and for the 10 (45% of 22) that resolved. The pressure-pain threshold improvement was significant for trigger points that responded but did not reach significance for resolved trigger points. The mechanical heterogeneity index identifies changes in muscle tissue properties that correlate with changes in the myofascial trigger point status after dry needling. © 2015 by the American Institute

  1. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points

    DEFF Research Database (Denmark)

    Ge, Hongyou; Wang, Ying; Danneskiold-Samsøe, Bente;

    2010-01-01

    The aim of this present study is to test the hypotheses that the 18 predetermined sites of examination for tender points (TP sites) in fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs), and that the induced pain from active MTrPs at TP sites may mimic fibromyalgia pain. Each TP site......), but not latent MTrPs (r = -.001, P = .99), was positively correlated with spontaneous pain intensity in FMS. The current study provides first evidence that pain from active MTrPs at TP sites mimics fibromyalgia pain. MTrPs may relate to generalized increased sensitivity in FMS due to central sensitization....... PERSPECTIVE: This article underlies the importance of active MTrPs in FMS patients. Most of the TP sites in FMS are MTrPs. Active MTrPs may serve as a peripheral generator of fibromyalgia pain and inactivation of active MTrPs may thus be an alternative for the treatment of FMS....

  2. An update on botulinum toxin A injections of trigger points for myofascial pain.

    Science.gov (United States)

    Zhou, Jon Y; Wang, Dajie

    2014-01-01

    Myofascial pain syndrome (MPS) is a common chronic pain condition that is characterized by distinct "trigger points." Despite current treatments with physical therapy, analgesics, anti-depressants and trigger-point injections, myofascial pain remains a challenging chronic pain condition in clinical practice. Botulinum toxin A (BTX-A) can cause prolonged muscle relaxation through inhibition of acetylcholine release. It may offer some advantages over the current treatments for MPS by providing a longer sustained period of pain relief. Despite numerous clinical trials, the efficacy of BTX-A in alleviating MPS is not well-established due to mixed results from recent clinical trials. Active trigger points are associated with referred pain and greatly impact many aspects of activities of daily living, mood, and health status. This review is designed to analyze the clinical trials regarding the efficacy of BTX-A injection of active trigger points as a treatment for MPS. The literature referenced was obtained via a computer search with Google Scholar, Pubmed, Medline and EMbase. Our search terms included "Botulinum toxin," "myofascial pain," "trigger points," "myofascial trigger points," "chronic pain." Additional references were retrieved from the reference list of the reports found via this search. Studies were considered eligible for inclusion if they were double-blinded, randomized, controlled trials evaluating the efficacy of BTX-A injections into trigger points for pain reduction, and if the trigger point selection in the trial included referred pain and/or local twitch response. Open-label studies, case reports, and other non-randomized studies were excluded. Eight trials were found according to the above criteria and are summarized in Table 1. There are well-designed clinical trials to support the efficacy of trigger-point injections with BTX-A for MPS. However, further clinical trials with considerations of minimizing placebo effect, repeated dosing, adequate

  3. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    Science.gov (United States)

    2011-01-01

    Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs) are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72) for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ) was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active MTrPs) and 4 (latent MTr

  4. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    Directory of Open Access Journals (Sweden)

    Wensing Michel

    2011-06-01

    Full Text Available Abstract Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72 for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active

  5. Skeletal muscle pain:the possible development of latent myofascial trigger points in the junction of brachioradialis muscle and tendon of obese people%骨骼肌疼痛:肥胖人群中右手臂肱桡肌肌腱结合处隐性触发点的可能性发展

    Institute of Scientific and Technical Information of China (English)

    汤莉; 黄强民

    2014-01-01

    BACKGROUND:Studies have shown that obesity is associated with skeletal muscle pain, but the specific factors have not yet been discovered. OBJECTIVE: To analyze the possible development of latent myofascial trigger points in obese people. METHODS:Fifty-seven obese persons (aged 9-20 years) who participated in the summer camp of weight loss were investigated (for participants younger than 18 years old, written consent was obtained from their parents). Their body fat rate was more than 30%. A pressure algometer was used to measure the pressure pain thresholds at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site), the mid-point of the muscle bely (site B, assumed to be the MTrP site), and the muscle-tendon junction as a control site (site C). In addition, 19 obese persons were selected randomly. They did the based exercise in badminton and table tennis in the next 2 weeks. RESULTS AND CONCLUSION:The results showed that, for al the obese participants in this study, the mean pressure pain threshold was lowest at the site B and highest at thesite C. For different genders, the pressure pain thresholds at the site A were significantly lower in the female than the male. With the increase of body mass index, the pressure pain thresholds at the site B was increased. However, no significant difference in the pressure pain thresholds at these three sites was found before and after exercise. It is concluded that the latent trigger point may appear in the brachioradialis after 9 years old. Women may be more likely to form the attachment trigger point in the tendon. Movement has no effect on the activation and elimination of latent trigger points.%背景:有研究显示肥胖与骨骼肌疼痛存在一定的相关性,但具体因素尚未发现。目的:分析肥胖人群中隐性触发点的可能性发展。  方法:选择暑期减肥夏令营中体脂率均大于30%,年龄在9-20

  6. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome.

    Science.gov (United States)

    Ge, Hong-You; Nie, Hongling; Madeleine, Pascal; Danneskiold-Samsøe, Bente; Graven-Nielsen, Thomas; Arendt-Nielsen, Lars

    2009-12-15

    The generalized hypersensitivity associated with fibromyalgia syndrome (FMS) may in part be driven by peripheral nociceptive sources. The aim of the study was to investigate whether local and referred pain from active myofascial trigger points (MTrPs) contributes to fibromyalgia pain. FMS patients and healthy controls (n=22 each, age- and gender-matched) were recruited. The surface area over the upper trapezius muscle on each side was divided into 13 sub-areas (points) of 1cm in diameter for each point. Pressure pain threshold (PPT) and the local and referred pain pattern induced by manual palpation at 13 points bilaterally in the upper trapezius were recorded. Results showed that PPT levels at all measured points were significantly lower in FMS than controls. Multiple active MTrPs (7.4+/-2.2) were identified bilaterally in the muscle in FMS patients, but no active MTrPs were found in controls. The mid-fiber region of the muscle had the lowest PPT level with the largest number of active MTrPs in FMS and with the largest number of latent MTrPs in controls. The local and referred pain pattern induced from active MTrPs bilaterally in the upper trapezius muscle were similar to the ongoing pain pattern in the neck and shoulder region in FMS. In conclusion, active MTrPs bilaterally in the upper trapezius muscle contribute to the neck and shoulder pain in FMS. Active MTrPs may serve as one of the sources of noxious input leading to the sensitization of spinal and supraspinal pain pathways in FMS.

  7. Dry needling versus cervical spine manipulation combined with dry needling of infraspinatus muscle myofascial trigger points

    OpenAIRE

    2013-01-01

    M.Tech. (Chiropractic) Objective: The purpose of this study was to compare dry needling with cervical spine manipulation combined with dry needling, in the treatment of infraspinatus muscle myofascial trigger points. Study Design: This was a randomized experimental study Setting: The participants were treated at the University of Johannesburg chiropractic day clinic Subjects: 30 participants volunteered for the study. The participants were divided into groups by randomly drawing thirty num...

  8. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    OpenAIRE

    Wensing Michel; Stegenga Boudewijn; Dommerholt Jan; Bron Carel; Oostendorp Rob AB

    2011-01-01

    Abstract Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs) are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment target...

  9. Dry needle stimulation of myofascial trigger points evokes segmental anti-nociceptive effects.

    Science.gov (United States)

    Srbely, John Z; Dickey, James P; Lee, David; Lowerison, Mark

    2010-05-01

    To test the hypothesis that dry needle stimulation of a myofascial trigger point (sensitive locus) evokes segmental anti-nociceptive effects. Double-blind randomized controlled trial. Forty subjects (21 males, 19 females). Test subjects received intramuscular dry needle puncture to a right supraspinatus trigger point (C4,5); controls received sham intramuscular dry needle puncture. Pain pressure threshold (PPT) readings were recorded from right infraspinatus (C5,6) and right gluteus medius (L4,5S1) trigger points at 0 (pre-needling baseline), 1, 3, 5, 10 and 15 min post-needling and normalized to baseline values. The supraspinatus and infraspinatus trigger points are neurologically linked at C5; the supraspinatus and gluteus medius are segmentally unrelated. The difference between the infraspinatus and gluteus medius PPT values (PPTseg) represents a direct measure of the segmental anti-nociceptive effects acting at the infraspinatus trigger point. Significant increases in PPTseg were observed in test subjects at 3 (p = 0.002) and 5 (p = 0.015) min post-needling, compared with controls. One intervention of dry needle stimulation to a single trigger point (sensitive locus) evokes short-term segmental anti-nociceptive effects. These results suggest that trigger point (sensitive locus) stimulation may evoke anti-nociceptive effects by modulating segmental mechanisms, which may be an important consideration in the management of myofascial pain.

  10. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    Science.gov (United States)

    2011-01-01

    Introduction It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern. The current study investigated whether the overall spontaneous FM pain pattern can be reproduced by local and referred pain from active MTPs located in different muscles. Methods A spontaneous pain pattern in FM was recorded in 30 FM patients and 30 healthy subjects served as controls. Local and referred pain patterns induced from active (patients) and latent (controls) MTPs were recorded following manual stimulation. The existence of MTPs was confirmed by intramuscular electromyographical registration of spontaneous electrical activity. Results Local and referred pain areas induced from key active MTPs in FM were larger than pain areas from latent MTPs in healthy controls (P 0.05). The induced pain area was positively associated with current spontaneous pain intensity in FM (P fibromyalgia pain is largely composed of pain arising from muscle pain and spasm. Targeting active MTPs and related perpetuating factors may be an important strategy in FM pain control. Trial registration ISRCTN ISRCTN43167547. PMID:21426569

  11. Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle.

    Science.gov (United States)

    Tsai, Chien-Tsung; Hsieh, Lin-Fen; Kuan, Ta-Shen; Kao, Mu-Jung; Chou, Li-Wei; Hong, Chang-Zern

    2010-02-01

    To investigate the remote effect of dry needling on the irritability of a myofascial trigger point in the upper trapezius muscle. Thirty-five patients with active myofascial trigger points in upper trapezius muscles were randomly divided into two groups: 18 patients in the control group received sham needling, and 17 patients in the dry-needling group received dry needling into the myofascial trigger point in the extensor carpi radialis longus muscle. The subjective pain intensity, pressure pain threshold, and range of motion of the neck were assessed before and immediately after the treatment. Immediately after dry needling in the experimental group, the mean pain intensity was significantly reduced, but the mean pressure threshold and the mean range of motion of cervical spine were significantly increased. There were significantly larger changes in all three parameters of measurement in the dry-needling group than that in the control group. This study demonstrated the remote effectiveness of dry needling. Dry needling of a distal myofascial trigger point can provide a remote effect to reduce the irritability of a proximal myofascial trigger point.

  12. EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRAPEZIUS MYOFASCIAL TRIGGER POINTS IN NECK PAIN

    Directory of Open Access Journals (Sweden)

    Pragnya Ravichandran

    2016-04-01

    Full Text Available Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression on functional outcome in neck pain. Methods: A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis. Result: There was no statistical significance between groups (p≥0.05. But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01 in relation to all parameters. Conclusion: Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in pain pressure threshold and functional outcome in neck pain.

  13. The importance of postural habits in perpetuating myofascial trigger point pain.

    Science.gov (United States)

    Edwards, Janet

    2005-06-01

    Various structural abnormalities that contribute to the perpetuation of myofascial trigger point activity and the pain arising from it, have previously been well documented. In addition, however, there are a number of postural habits that are important to recognise as they may also contribute, as shown in the five cases discussed. These postural habits, which are likely to be carried out both frequently and unconsciously, are adopted during the course of sitting, standing or sleeping. They are entirely independent of any structural abnormalities that may be present. Correcting them is a necessary contribution to treatment, as failure to do so is liable to lead to persistence of the pain.

  14. Fibromyalgia, myofascial pain, tender points and trigger points: splitting or lumping?

    Science.gov (United States)

    Bennett, Robert M; Goldenberg, Don L

    2011-06-30

    Myofascial trigger points (MTPs) have long been a contentious issue in relation to fibromyalgia, and poorly defined pain complaints in general. Can MTPs be reproducibly identified? Do MTPs have valid objective findings, such as spontaneous electromyographic activity, muscle microdialysis evidence for an inflammatory milieu or visualization with newer ultrasound techniques? Is fibromyalgia a syndrome of multiple MTPs, or is focal muscle tenderness a manifestation of central sensitization? These issues are discussed with relevance to a recent paper reporting that manual palpation of active MTPs elicits the spontaneous pain experienced by fibromyalgia patients.

  15. Fibromyalgia, myofascial pain, tender points and trigger points: splitting or lumping?

    Science.gov (United States)

    2011-01-01

    Myofascial trigger points (MTPs) have long been a contentious issue in relation to fibromyalgia, and poorly defined pain complaints in general. Can MTPs be reproducibly identified? Do MTPs have valid objective findings, such as spontaneous electromyographic activity, muscle microdialysis evidence for an inflammatory milieu or visualization with newer ultrasound techniques? Is fibromyalgia a syndrome of multiple MTPs, or is focal muscle tenderness a manifestation of central sensitization? These issues are discussed with relevance to a recent paper reporting that manual palpation of active MTPs elicits the spontaneous pain experienced by fibromyalgia patients. PMID:21722339

  16. Effect of bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points on upper back myofascial pain syndrome: a randomized controlled trial.

    Science.gov (United States)

    Jiang, Guimei; Jia, Chao; Lin, Mode

    2016-02-01

    To observe the clinical efficacy of bloodletting therapy and acupuncture at Jiaji points for treating upper back myofascial pain syndrome (MPS), and compare this with lidocaine block therapy. A total of 66 upper back MPS patients were randomly assigned to either the treatment group or the control group in a 1: 1 ratio. The treatment group (n = 33) were treated with bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points; one treatment course consisted of five, single 20-min-treatments with a 2-day break between each treatment. The control group (n = 33) were treated with a lidocaine block at trigger points; one treatment course consisted of five sessions of lidocaine block therapy with a 2-day break between each session. The simplified McGill Scale (SF-MPQ) and tenderness threshold determination were used to assess pain before and after a course of treatment. After the third and fifth treatment, the SF-MPQ values were significantly decreased (P 0.05). There were five cases with minor adverse reactions reported in the control patients, while no adverse reactions were reported in the treatment group. Bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji points was effective in treating upper back MPS. Clinically, bloodletting and acupuncture therapy had the same efficacy as the lidocaine block therapy, with fewer adverse reactions.

  17. Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle.

    Science.gov (United States)

    Ziaeifar, Maryam; Arab, Amir Massoud; Nourbakhsh, Mohammad Reza

    2016-12-01

    The purpose of this study was to investigate the effect of dry needling (DN) on pain intensity and pressure pain threshold (PPT) compared with ischemic compression (IC) immediately and 48 hours after each treatment session in individuals with myofascial trigger points in the upper trapezius muscle. Thirty-one patients with myofascial trigger points in the upper trapezius muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 14). The treatment protocol for the standard group consisted of IC, whereas the patients in the experimental group received DN. The results indicated that the effect size of the DN methods for pain intensity and PPT was considerably greater after 2 days compared with immediately after the treatment session. In contrast, the effect of the IC for PPT was greater immediately after treatment compared with the measures after 2 days. There was also no noticeable difference in the effect size for IC on pain intensity between the scores obtained immediately and 2 days after treatment. However, our data also revealed a greater effect size for DN on PPT after 2 days compared with the IC technique. In this study, DN improved the pain intensity and PPT after 2 days. However, it had no clinical improvement immediately after application because of muscle soreness. Thus, assessment of the effect of DN immediately after application can be criticized, and the results should be interpreted with caution.

  18. Neurophysiological and clinical effects of dry needling in patients with upper trapezius myofascial trigger points.

    Science.gov (United States)

    Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

    2017-01-01

    Dry needling (DN) is a widely used in treatment of myofascial trigger points (MTrPs). The purpose of this pretest-posttest clinical trial was to investigate the neurophysiological and clinical effects of DN in patients with MTrPs. A sample of 20 patients (3 man, 17 women; mean age 31.7 ± 10.8) with upper trapezius MTrPs received one session of deep DN. The outcomes of neuromuscular junction response (NMJR), sympathetic skin response (SSR), pain intensity (PI) and pressure pain threshold (PPT) were measured at baseline and immediately after DN. There were significant improvements in SSR latency and amplitude, pain, and PPT after DN. The NMJR decreased and returned to normal after DN. A single session of DN to the active upper trapezius MTrP was effective in improving pain, PPT, NMJR, and SSR in patients with myofascial trigger points. Further studies are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    DEFF Research Database (Denmark)

    Ge, Hong-You; Wang, Ying; Fernandez-de-las-Penas, Cesar

    2011-01-01

    It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern...

  20. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    DEFF Research Database (Denmark)

    Ge, Hong-You; Wang, Ying; Fernandez-de-las-Penas, Cesar

    2011-01-01

    It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern...

  1. Quantification of dry needling on myofascial trigger points using a novel ultrasound method: A study protocol.

    Science.gov (United States)

    Taheri, Navid; Rezasoltani, Asghar; Okhovatian, Farshad; Karami, Mehdi; Hosseini, Sayed Mohsen; Kouhzad Mohammadi, Hosein

    2016-07-01

    Myofascial pain syndrome (MPS) is a neuromuscular dysfunction consisting of both motor and sensory abnormalities. Considering the high prevalence of MPS and its related disabilities and costs, this study was designed to determine the reliability of new ultrasonographic indexes of the upper trapezius muscle as well as the sensitivity and specificity of 2D ultrasound imaging for diagnostic purposes. Furthermore, we sought to evaluate the effectiveness of dry needling (DN) on studied ultrasonographic indexes. This study will be performed in two steps with two different designs. The first is a pilot study and was designed as a semi-experimental study to determine the sensitivity and specificity of ultrasonography for the diagnosis of MPS and the reliability of ultrasonographic measurements like muscle thickness, area of myofascial trigger points (MTrPs) in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and pennation angle of upper trapezius muscle. The second study is an interventional study which was designed to investigate the effectiveness of DN on ultrasonographic measurements, for which the reliability was determined in the first study. we will quantify the effectiveness of DN on MTrPs and muscle tissue by using novel ultrasonographic indexes. The results of the current study will provide baseline information to design more interventional studies to improve the evaluation of other treatments of MPS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Treatment of myofascial trigger points in female patients with chronic tension-type headache - A randomized controlled trial

    DEFF Research Database (Denmark)

    Berggreen, S.; Wiik, E.; Lund, Hans

    2012-01-01

    The aim of this study was to evaluate the efficacy of myofascial trigger point massage in the muscles of the head, neck and shoulders regarding pain in the treatment of females with chronic tension-type headache. They were randomized into either a treatment group (n = 20) (one session of trigger...... point massage per week for 10 weeks) or a control group receiving no treatment (n = 19). The patients kept a diary to record their pain on a visual analogue scale (VAS), and the daily intake of drugs (mg) during the 4 weeks before and after the treatment period. The McGill Pain Questionnaire......: 8.8 (95% CI 0.1117.4), p = 0.047). Furthermore, a significant decrease in the number of trigger points was observed in the treatment group compared with the control group. Myofascial trigger point massage has a beneficial effect on pain in female patients with chronic tension-type headache....

  3. Effects of treatment of myofascial trigger points on the pain of fibromyalgia.

    Science.gov (United States)

    Giamberardino, Maria Adele; Affaitati, Giannapia; Fabrizio, Alessandra; Costantini, Raffaele

    2011-10-01

    Myofascial pain syndromes (MPSs) from trigger points (TrPs) and fibromyalgia syndrome (FMS) are common musculoskeletal pain conditions that frequently coexist in the same patients. In recent decades, it has become evident that these entities greatly influence each other's clinical expression. FMS is mainly rooted in the central nervous system, while TrPs have a peripheral origin. However, the nociceptive impulses from TrPs may have significant impact on symptoms of FMS, probably by enhancing the level of central sensitization typical of this condition. Several attempts have been made to assess the effects of treatment of co-occurring TrPs in FMS. We report the outcomes of these studies showing that local extinction of TrPs in patients with fibromyalgia produces significant relief of FMS pain. Though further studies are needed, these findings suggest that assessment and treatment of concurrent TrPs in FMS should be systematically performed before any specific fibromyalgia therapy is undertaken.

  4. The Ultrasonographic Findings of Trigger Points of Myofascial Pain Syndrome in a Rabbit Model

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Kyung Mi; Park, Seog Hee [Catholic University of Korea, Kangnam St. Mary' s Hospital, Seoul (Korea, Republic of); Lee, Sang Heon; Kim, Joo Hyun; Kim, Han Kyum [Korea University College of Medicine, Seoul (Korea, Republic of)

    2005-03-15

    Myofascial pain syndrome (MPS) is a common cause of musculoskeletal pain. Myofascial trigger points (MTrPs) have been repeatedly described by numerous authors. However, there have been few studies in which their existence and behavior was supported and their location confirmed. The purpose of this study was to determine whether diagnostic ultrasonography is an objective diagnostic tool which is able to significantly identify or detect the soft tissue changes in the region of clinically identified active MTrPs by using a rabbit experimental model. Ten MPS model rabbits were used in this study. We made an MPS animal model by causing the rabbits to overuse one leg for 3 weeks by cutting the contralateral L4 spinal nerve root. We compared the ultrasonographic findings of the taut band at pre-OP with those at post-OP during the consecutive three week period. To find the taut bands of the muscle, after skin exposure, the muscles were gently rubbed or pinched with the thumb and index finger on the two opposing surfaces of the muscle across the direction of the fibers. Then, the muscle was held in the same way, but with a 5-8 MHz stick probe being used in place of the thumb. After the palpation of various muscles, we selected the hardest and largest myofascial trigger nodule, in order to observe the ultrasonographic and power Doppler findings of the MPS. The size, shape, echogenecity and vascularity of the MTrPs were observed. The analysis of the results of the ultrasonography revealed that all MTrPs have a hyperechoic area. The mean thickness of the hyperechoic lesion in the biceps was 0.96{+-}0.14 cm in the MPS site (at pre-OP?), and 0.49{+-}0.12 cm at post-OP 3weeks (p < 0.01). The hyperechoic lesions in all of the studied biceps femoris of the rabbits were observed by high resolution ultrasonography. No definitively decreased vascularity was observed within the hyperechoic area by power Doppler imaging. Until now, there has been no objective method for the diagnosis of

  5. Trigger point dry needling versus strain-counterstrain technique for upper trapezius myofascial trigger points: a randomised controlled trial.

    Science.gov (United States)

    Segura-Ortí, E; Prades-Vergara, S; Manzaneda-Piña, L; Valero-Martínez, R; Polo-Traverso, J A

    2016-06-01

    Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS. Randomised controlled trial. 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured. The analysis of variance mixed model showed a significant time effect for pain (ppoints) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. NCT01290653. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. [Myofascial pain syndrome treated with sparrow-pecking moxibustion at trigger points: a randomized controlled trial].

    Science.gov (United States)

    Ma, Yao; Bu, He; Jia, Ji-rong; Liu, Zheng

    2014-11-01

    To compare the efficacy difference in treatment of myofasical pain syndrome between sparrow-pecking moxibustion and acupuncture at trigger points so as to provide the reference of the effective therapeutic method for myofascial pain syndrome. Ninety patients were randomized into a sparrow-pecking moxibustion group and an acupuncture group, 45 cases in each one. The trigger points were selected in pain areas in the two groups. In the sparrow-pecking moxibustion group, the sparrow-pecking moxibustion was applied, 30 min in each time. In the acupuncture group, the filiform needles were inserted obliquely at 45 degrees and retained for 40 min in each treatment. The treatment was given once a day and 10 treatments made one session in the two groups. The short-form McGill pain questionnaire was used as the observation index, and the changes in pain rating index (PRI), present pain intensity (PPI) and visual analogue scale (VAS) before and after treatment were used for efficacy assessment. The results of PRI, PPI and VAS after treatment were reduced apparently as compared with those before treatment in the sparrow-pecking moxibustion group and the acupuncture group (all P0.05). The curative and remarkably effective rate was 80.0% (36/45) in the sparrow-pecking moxibustion group, which was better than 40.0% (18/45, Pmyofascial pain syndrome as compared with acupuncture at trigger points. This therapy is simpler in operation additionally.

  7. A RANDOMIZED TRIAL TO STUDY THE COMPARISON OF TRIGGER POINT DRY NEEDLING VERSUS KINESIO TAPING TECHNIQUE IN MYOFASCIAL PAIN SYNDROME DURING A 3-MONTH FOLLOW UP

    OpenAIRE

    Emrullah Hayta; Nur Mine Umdu

    2016-01-01

    Background: Managemen of myofascial pain syndrome (MPS) is a current research subject since there is a small number of randomized studies comparing different management techniques. Multiple studies attempted to assess various treatment options including trigger point dry needling and kinesiotaping. We compared the effects of trigger point dry needling and kinesiotaping in the management of myofascial pain syndome during a 3-month follow-up period. Methods: In this prospective randomized st...

  8. Therapeutic effects of dry needling in patients with upper trapezius myofascial trigger points.

    Science.gov (United States)

    Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

    2017-04-01

    Active myofascial trigger points (MTrPs) are major pain generators in myofascial pain syndrome. Dry needling (DN) is an effective method for the treatment of MTrPs. To assess the immediate neurophysiological and clinical effects of DN in patients with upper trapezius MTrPs. This was a prospective, clinical trial study of 20 patients with upper trapezius MTrPs and 20 healthy volunteers (matched for height, weight, body mass index and age), all of whom received one session of DN. Primary outcome measures were neuromuscular junction response (NMJR) and sympathetic skin response (SSR). Secondary outcomes were pain intensity (PI) and pressure pain threshold (PPT). Data were collected at baseline and immediately post-intervention. At baseline, SSR amplitude was higher in patients versus healthy volunteers (p<0.003). With respect to NMJR, a clinically abnormal increment and normal reduction was observed in patients and healthy volunteers, respectively. Moreover, PPT of patients was less than healthy volunteers (p<0.0001). After DN, SSR amplitude decreased significantly in patients (p<0.01), but did not change in healthy volunteers. A clinically important reduction in the NMJR of patients and increment in healthy volunteers was demonstrated after DN. PPT increased after DN in patients, but decreased in healthy volunteers (p<0.0001). PI improved after DN in patients (p<0.001). The results of this study showed that one session of DN targeting active MTrPs appears to reduce hyperactivity of the sympathetic nervous system and irritability of the motor endplate. DN seems effective at improving symptoms and deactivating active MTrPs, although further research is needed. IRCT20130316128. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats

    Directory of Open Access Journals (Sweden)

    Fei Meng

    2015-01-01

    Full Text Available Myofascial trigger points (MTrPs are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P0.05. 30 min after the injection, MPTs at MTrSs were significantly lower than those of non-MTrSs (P<0.01. Therefore, we concluded that proliferated myelinated afferents existed at MTrSs, which were closely related to pathology of SEA and mechanical hyperalgesia of MTrSs.

  10. Chronic pain in a patient with Ehlers-Danlos syndrome (hypermobility type): The role of myofascial trigger point injections.

    Science.gov (United States)

    Tewari, Saipriya; Madabushi, Rajashree; Agarwal, Anil; Gautam, Sujeet K; Khuba, Sandeep

    2017-01-01

    Chronic widespread musculoskeletal pain is a cardinal symptom in hypermobility type of Ehler Danlos Syndrome (EDS type III). The management of pain in EDS, however, has not been studied in depth. A 30 year old female, known case of EDS, presented to the pain clinic with complaints of severe upper back pain for 6 months. Physical examination of the back revealed two myofascial trigger points over the left rhomboids and the left erector spinae. Local anaesthetic trigger point injections were given at these points, followed by stretching exercises under analgesic cover for the first week. After 1 week the patient reported 60-80% pain relief. This case highlights that we must keep a high index of suspicion for the more treatable causes of pain like myofascial pain syndrome in patients suffering from EDS, and should address it promptly and appropriately in order to maximise patient comfort. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Activator instrument versus dry needling of active upper trapezius myofascial trigger points in those with neck pain

    OpenAIRE

    2013-01-01

    M.Tech. (Chiropractic) Neck pain is a common and costly complaint in society and many are made to believe that their neck pain is caused by pinched nerve, compressed disk, arthritis or displaced cervical vertebrae, when in reality the pain may be solely due to referral from myofascial trigger points in overworked or traumatized muscles of their upper back and shoulders. Travel and Simons (1999) demonstrated trapezius muscle of the neck, back and shoulder as the main cause of mechanical nec...

  12. The Effect of Monochromatic Infrared Photo Energy on the Irritability of Myofascial Trigger Spot of Rabbit Skeletal Muscle

    Directory of Open Access Journals (Sweden)

    Ta-Shen Kuan

    2015-01-01

    Full Text Available Objective. To determine whether the vasodilatation effect of monochromatic infrared photo energy (MIRE had the potential for the treatment of myofascial trigger spot (MTrS in rabbits. Design. A randomized-controlled animal study. Subjects. Twelve adult New Zealand rabbits. Methods. For each rabbit, a MTrS (equivalent to a myofascial trigger point in humans in one side of the biceps femoris muscle was randomly selected for MIRE treatment (experimental side, while another MTrS in the other side (control side received a sham treatment. The intervention consisted of a daily 40 minutes treatment, three times per week for 2 weeks. The prevalence of endplate noise (EPN loci in the MTrS was assessed before, immediately after, and one week after the completion of the 2-week treatment. Results. MIRE could suppress the prevalence of EPN in the MTrS. The degree of reduction in EPN prevalence in the MTrS between the experimental side and the control side was significantly different immediately after MIRE treatment, but not significantly different one week after MIRE treatment. Conclusion. Our study suggests that MIRE may be a useful therapeutic option for the management of the myofascial trigger point in humans.

  13. SPECIFIC SEQUENTIAL MYOFASCIAL TRIGGER POINT THERAPY IN THE TREATMENT OF A PATIENT WITH MYOFASCIAL PAIN SYNDROME ASSOCIATED WITH REFLEX SYMPATHETIC DYSTROPHY

    Science.gov (United States)

    Hong, Chang-Zern

    2000-01-01

    A patient with traumatic rotator cuff tear of the left shoulder developed severe myofascial pain syndrome with reflex sympathetic dystrophy (RSD) involving the left upper extremity. He was unable to tolerate any type of manual therapy or needle treatment due to severe allodynia in the whole left upper limb. This patient presented for treatment approximately 6 months after the onset of trauma. Treatment consisting of specific myofascial trigger point (MTrP) therapy, beginning with desensitization and gentle massage on the MTrP of the first dorsal interosseous muscle, followed by treatment of MTrPs of the wrist-finger extensors and anterior deltoid muscles was commenced. Allodynia was remarkably reduced and further physical therapy with modalities was administered. After 2 weeks of daily MTrP therapy, he received local steroid injection to the left shoulder and continued MTrP therapy 2-3 times per week. Approximately 2 months after the injection the patient was almost pain free with nearly full range of motion in his left shoulder. The mechanism of MTrPs and their association with RSD is discussed in this paper. PMID:17987165

  14. Evolution of the methodological quality of controlled clinical trials for myofascial trigger point treatments for the period 1978-2015: A systematic review.

    Science.gov (United States)

    Stoop, Rahel; Clijsen, Ron; Leoni, Diego; Soldini, Emiliano; Castellini, Greta; Redaelli, Valentina; Barbero, Marco

    2017-08-01

    The methodological quality of controlled clinical trials (CCTs) of physiotherapeutic treatment modalities for myofascial trigger points (MTrP) has not been investigated yet. To detect the methodological quality of CCTs for physiotherapy treatments of MTrPs and demonstrating the possible increase over time. Systematic review. A systematic search was conducted in two databases, Physiotherapy Evidence Database (PEDro) and Medicine Medical Literature Analysis and Retrieval System online (MEDLINE), using the same keywords and selection procedure corresponding to pre-defined inclusion criteria. The methodological quality, assessed by the 11-item PEDro scale, served as outcome measure. The CCTs had to compare at least two interventions, where one intervention had to lay within the scope of physiotherapy. Participants had to be diagnosed with myofascial pain syndrome or trigger points (active or latent). A total of n = 230 studies was analysed. The cervico-thoracic region was the most frequently treated body part (n = 143). Electrophysical agent applications was the most frequent intervention. The average methodological quality reached 5.5 on the PEDro scale. A total of n = 6 studies scored the value of 9. The average PEDro score increased by 0.7 points per decade between 1978 and 2015. The average PEDro score of CCTs for MTrP treatments does not reach the cut-off of 6 proposed for moderate to high methodological quality. Nevertheless, a promising trend towards an increase of the average methodological quality of CCTs for MTrPs was recorded. More high-quality CCT studies with thorough research procedures are recommended to enhance methodological quality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  15. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females.

    Science.gov (United States)

    Yeganeh Lari, Ameneh; Okhovatian, Farshad; Naimi, Sedigheh sadat; Baghban, Alireza Akbarzadeh

    2016-02-01

    The purpose of this clinical trial experiment was to compare the effects of the combination of dry needling (DN) and the muscle energy technique (MET) on the upper trapezius latent myofascial trigger point. Sixty female patients, aged 18-30 with latent myofascial trigger points in the upper trapezius muscle were randomly divided into three groups: group 1 (n = 20) received DN and MET, group 2 (n = 20) received only MET, and group 3 (n = 20) received only DN. The visual analogue scale (VAS), pressure pain threshold (PPT), and range of active contra lateral flexion (CLF) were measured before each treatment. The patients were treated for three sessions in a one-week period with at least a two-day break between each session, and in session four, an assessment of primary outcomes was conducted without any treatment. All three treatment groups showed decreases in pain (p = 0.001) and increases in PPT levels (p = 0.001) as well as increases in CLF (p = 0.001). But the group receiving trigger point DN together with MET showed more significant improvement than the other two groups in VAS, PPT and ROM. No significant differences were found between the MET-only group and the DN-only group. Our results indicate that all three treatments used in this study were effective for treating MTP. According to this study, DN and MET is suggested as a new method for the treatment of MTP. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. The use of trigger point "dry" needling under ultrasound guidance for the treatment of myofascial pain (technological innovation and literature review).

    Science.gov (United States)

    Bubnov, Rostyslav V

    2010-01-01

    The aim of the study was to examine the use of trigger point dry needling under ultrasound guidance and myofascial release for the treatment of myofascial pain and to increase the provability of the puncture treatment by visual verification. A review of modern and traditional approaches to myofascial pain treatment is presented in the article. For the first time the trigger point was visualized by ultrasound (US) in this study and ultrasound guided needling therapy of muscles was performed as well. The group of 91 patients, suffered from myofascial pain of different location was included in the study. The patients were treated during last year by patented method (UA patent A 2010 06283). The pain relief effect was registered in 93.3% patients.

  17. Myofascial trigger points:the common cause of clinical tissue pain%肌筋膜疼痛触发点

    Institute of Scientific and Technical Information of China (English)

    刘琳; 黄强民; 汤莉

    2014-01-01

    BACKGROUND:Myofascial trigger points have been widely applied in clinical rehabilitation and tissue pain field in the United States and Europe countries, and they have been recognized as the common cause of clinical musculoskeletal pain, joint function limitation, tissue injuries and muscle fatigue by many physiotherapists abroad. However, in China, many experts stil have some mistaken ideas and limitations to understand the pathological mechanism and to diagnosis and treat myofascial trigger points. OBJECTIVE:From the aspects of the etiology, pathological mechanism, diagnosis and positioning, treatments, to elaborate the method issues and the clinical experience of treatments of myofascial trigger points. METHODS:PubMed, ScienceDirect, EBSCO and CNKI databases were searched by the keywords of “myofascial trigger points, myofascial pain syndrome” in Chinese and English, respectively, in the titles and abstract to retrieve relevant articles published from the time of database construction to August 2014. RESULTS AND CONCLUSION:It is concluded that a child has myofascial trigger points in some skeletal muscles after age of 4 years. The main causes of myofascial trigger points include issue trauma, the wrong posture, bone and joint degeneration, nutrition deficiency, mental stress, chronic infection and so on. The pathological mechanism of myofascial trigger points remains unknown, but what has been widely accepted is the integrated trigger point hypothesis introduced by Simons. And how to find and position myofascial trigger points is the key point to treat this disease successfuly. The application of myofascial trigger points techniques is important for the rehabilitation of clinical tissue pain and the occurrence and spread of bone and joint injuries, myofascitis, muscle pain, muscle fatigue and so on.%背景:肌筋膜疼痛触发点技术在欧美国家临床康复和组织疼痛领域已得到广泛性应用,国内相关专家对其病理机制认识,

  18. Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Espejo-Antúnez, Luis; Tejeda, Jaime Fernández-Huertas; Albornoz-Cabello, Manuel; Rodríguez-Mansilla, Juan; de la Cruz-Torres, Blanca; Ribeiro, Fernando; Silva, Anabela G

    2017-08-01

    This systematic review of randomized controlled trials aimed to examine the effectiveness of dry needling in the treatment of myofascial trigger points and to explore the impact of specific aspects of the technique on its effectiveness. Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus, The Cochrane Library and Physiotherapy Evidence Database. Studies identified by electronic searches were screened against a set of pre-defined inclusion criteria. Fifteen studies were included in this systematic review. The main outcomes that were measured were pain, range of motion, disability, depression and quality of life. The results suggest that dry needling is effective in the short term for pain relief, increase range of motion and improve quality of life when compared to no intervention/sham/placebo. There is insufficient evidence on its effect on disability, analgesic medication intake and sleep quality. Despite some evidence for a positive effect in the short term, further randomized clinical trials of high methodological quality, using standardized procedures for the application of dry needling are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine.

    Science.gov (United States)

    Fernández-de-Las-Peñas, C; Cuadrado, M L; Pareja, J A

    2006-09-01

    This paper describes the differences in the presence of myofascial trigger points (TrPs) in the upper trapezius, sternocleidomastoid, temporalis and suboccipital muscles between unilateral migraine subjects and healthy controls, and the differences in the presence of TrPs between the symptomatic side and the non-symptomatic side in migraine subjects. In addition, we assess the differences in the presence of both forward head posture (FHP) and active neck mobility between migraine subjects and healthy controls and the relationship between FHP and neck mobility. Twenty subjects with unilateral migraine without side-shift and 20 matched controls participated. TrPs were identified when there was a hypersensible tender spot in a palpable taut band, local twitch response elicited by the snapping palpation of the taut band and reproduction of the referred pain typical of each TrP. Side-view pictures were taken in both sitting and standing positions to measure the cranio-vertebral angle. A cervical goniometer was employed to measure neck mobility. Migraine subjects showed a significantly greater number of active TrPs (Pangle than controls (Pangle and neck mobility. Nociceptive inputs from TrPs in head and neck muscles may produce continuous afferent bombardment of the trigeminal nerve nucleus caudalis and, thence, activation of the trigeminovascular system. Active TrPs located ipsilateral to migraine headaches might be a contributing factor in the initiation or perpetuation of migraine.

  20. Remote Subcutaneous Needling to Suppress the Irritability of Myofascial Trigger Spots: An Experimental Study in Rabbits

    Directory of Open Access Journals (Sweden)

    Zhonghua Fu

    2012-01-01

    Full Text Available Objective. To obtain electrophysiological effects of Fu’s subcutaneous needling (FSN on needling distance by assessment of endplate noise (EPN recorded from the myofascial trigger spots (MTrSs in rabbit skeletal muscle. Method. Eighteen New Zealand rabbits weighing 2.5–3.0 kg were randomly divided into two groups as follows: proximal needling (PN group and distal needling (DN group. The needling procedure followed the instructions described by the inventor of FSN, including needling insertion and swaying movement. The amplitudes of EPN on the MTrS region of BF muscle were recorded as an index of MTrS irritability. Random sampling of EPN tracings were taken for further analyses before, during, and after FSN treatment. Results. In PN and DN groups, the trends of EPN amplitude alterations were similar at conditions before, during, and after FSN treatment. The degree of reduction in the EPN amplitude in PN group was significantly higher than that in DN group. There were no significant changes in EPN amplitudes in the MTrS of contralateral BF without FSN intervention either in DN or PN group. Conclusion. The irritability of proximal MTrSs could be modulated after ipsilateral FSNs. The placement of FSN may affect the effectiveness of suppression of irritability of MTrSs.

  1. Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy.

    Science.gov (United States)

    Moldwin, Robert M; Fariello, Jennifer Yonaitis

    2013-10-01

    Myofascial trigger points (MTrP), or muscle "contraction knots," of the pelvic floor may be identified in as many as 85 % of patients suffering from urological, colorectal and gynecological pelvic pain syndromes; and can be responsible for some, if not all, symptoms related to these syndromes. Identification and conservative treatment of MTrPs in these populations has often been associated with impressive clinical improvements. In refractory cases, more "aggressive" therapy with varied trigger point needling techniques, including dry needling, anesthetic injections, or onabotulinumtoxinA injections, may be used, in combination with conservative therapies.

  2. Remote Dose-Dependent Effects of Dry Needling at Distant Myofascial Trigger Spots of Rabbit Skeletal Muscles on Reduction of Substance P Levels of Proximal Muscle and Spinal Cords

    OpenAIRE

    Yueh-Ling Hsieh; Chen-Chia Yang; Szu-Yu Liu; Li-Wei Chou; Chang-Zern Hong

    2014-01-01

    Background. Dry needling at distant myofascial trigger points is an effective pain management in patients with myofascial pain. However, the biochemical effects of remote dry needling are not well understood. This study evaluates the remote effects of dry needling with different dosages on the expressions of substance P (SP) in the proximal muscle, spinal dorsal horns of rabbits. Methods. Male New Zealand rabbits (2.5–3.0 kg) received dry needling at myofascial trigger spots of a gastrocnemiu...

  3. Extracorporeal Shock Wave Therapy Versus Trigger Point Injection in the Treatment of Myofascial Pain Syndrome in the Quadratus Lumborum.

    Science.gov (United States)

    Hong, Jin Oh; Park, Joon Sang; Jeon, Dae Geun; Yoon, Wang Hyeon; Park, Jung Hyun

    2017-08-01

    To compare the effectiveness of extracorporeal shock wave therapy (ESWT) and trigger point injection (TPI) for the treatment of myofascial pain syndrome in the quadratus lumborum. In a retrospective study at our institute, 30 patients with myofascial pain syndrome in the quadratus lumborum were assigned to ESWT or TPI groups. We assessed ESWT and TPI treatment according to their affects on pain relief and disability improvement. The outcome measures for the pain assessment were a visual analogue scale score and pain pressure threshold. The outcome measures for the disability assessment were Oswestry Disability Index, Roles and Maudsley, and Quebec Back Pain Disability Scale scores. Both groups demonstrated statistically significant improvements in pain and disability measures after treatment. However, in comparing the treatments, we found ESWT to be more effective than TPI for pain relief. There were no statistically significant differences between the groups with respect to disability. Compared to TPI, ESWT showed superior results for pain relief. Thus, we consider ESWT as an effective treatment for myofascial pain syndrome in the quadratus lumborum.

  4. Dry needling of trigger points with and without paraspinal needling in myofascial pain syndromes in elderly patients.

    Science.gov (United States)

    Ga, Hyuk; Choi, Ji-Ho; Park, Chang-Hae; Yoon, Hyun-Jung

    2007-01-01

    To compare the efficacies of dry needling of trigger points (TrPs) with and without paraspinal needling in myofascial pain syndrome of elderly patients. Single-blinded, randomized controlled trial. Forty (40) subjects, between the ages of 63 and 90 with myofascial pain syndrome of the upper trapezius muscle. Eighteen (18) subjects were treated with dry needling of all the TrPs only and another 22 with additional paraspinal needling on days 0, 7, and 14. At 4-week follow-up the results were as follows: (1) TrP and paraspinal dry needling resulted in more continuous subjective pain reduction than TrP dry needling only; (2) TrP and paraspinal dry needling resulted in significant improvements on the geriatric depression scale but TrP dry needling only did not; (3) TrP and paraspinal dry needling resulted in improvements of all the cervical range of motions but TrP dry needling only did not in extensional cervical range of motion; and (4) no cases of gross hemorrhage were noted. TrP and paraspinal dry needling is suggested to be a better method than TrP dry needling only for treating myofascial pain syndrome in elderly patients.

  5. Skin Resistivity Value of Upper Trapezius Latent Trigger Points

    Directory of Open Access Journals (Sweden)

    Elżbieta Skorupska

    2015-01-01

    Full Text Available Introduction. The skin resistivity (SkR measurement is commonly recommended for acupoints measurement, but for trigger points (TrPs only one study is available. The purpose of the study was to evaluate SkR for latent TrPs compared to non-TrPs and the surrounding tissue. Material and Methods. Forty-two healthy volunteers with unilateral latent upper trapezius TrPs (12 men, 30 women aged 21–23 (mean age: 22.1 ± 0.6 y participated in the study. Keithley electrometer 610B was used for measuring SkR (Ag/AgCl self-adhesive, disposable ground electrode: 30 mm diameter. SkR was measured for latent TrPs and compared to opposite non-TrPs sites and the surrounding tissue. Results. The SkR decrease of TrPs-positive sites as compared to TrPs-negative sites and the surrounding tissue was confirmed. However, no statistically significant difference in the SkR value occurred when all data were analyzed. The same was confirmed after gender division and for TrPs-positive subjects examined for referred pain and twitch response presence. Conclusion. SkR reactive changes at latent TrPs are possible but the results were not consistent with the previous study. Thus, caution in applying SkR to latent TrPs isolation is recommended and its clinical use should not be encouraged yet. Further studies, especially on active TrPs, are yet required.

  6. Effect of Hyaluronidase Addition to Lidocaine for Trigger Point Injection in Myofascial Pain Syndrome.

    Science.gov (United States)

    Choi, Ji Won; Lee, Chul Joong; Lee, Sangmin M; Shin, Byung Seop; Jun, Byunghui; Sim, Woo Seog

    2015-10-07

    This randomized, double-blind study compared the efficacy of hyaluronidase co-injection with that of local anesthesia alone on the degree of pain and quality of life in patients with myofascial pain syndrome (MPS). Sixty-one adults, aged 25 to 75 years, with MPS affecting both trapezius muscles were randomly assigned to one of the 2 treatment groups: lidocaine (group L: n = 31) or hyaluronidase (group H: n = 30). All patients received Trigger point injection (TPI). Group L received 3.2 mL 0.5% lidocaine alone. Group H received the same solution of lidocaine mixed with hyaluronidase (600 iu/mL). Patients were followed for 14 days (pre- and post-TPI days 0, 1, 4, 7, and 14) with the verbal numerical rating scale (VNRS), and the primary outcome was VNRS on day 7. Also, we evaluated the neck disability index (NDI) and the short form of brief pain inventory (BPI-SF) on pre- and post-TPI day 14. In both groups, VNRS decreased on days 4, 7, and 14 compared to the pre-TPI. However, in group H, VNRS decreased on day 1 also. There were no significant differences of VNRS between the 2 groups during 14 days. NDI and BPI-SF scores also significantly decreased after TPI in both groups. There were no significant differences between groups in terms of VNRS, NDI, or BPI-SF scores. However, TPI consisting of lidocaine mixed with hyaluronidase worked more effectively than lidocaine alone on post-TPI day 1. Further, hyaluronidase showed a tendency to reduce TPI-related soreness. © 2015 World Institute of Pain.

  7. Evaluation of dry needling and 0.5% lidocaine injection therapies in myofascial pain trigger points in masticatory muscles

    Directory of Open Access Journals (Sweden)

    Renato Oliveira Ferreira da Silva

    2012-04-01

    Full Text Available OBJECTIVE: The purpose of this study was to compare the effectiveness of trigger points injections using lidocaine 0.5% and dry needling without any kind of home-based rehabilitation program. METHODS: Sixteen patients with myofascial pain and trigger points in masticatory muscles were randomly assigned to two groups and received only one application session. The pressure pain threshold (PPT was recorded before and after the injection: Ten minutes, 24 hours later, 7, 15, 21 and 30 days after the treatment. Visual analogue scale (VAS was used to in all evaluation periods. RESULTS: There were no difference between groups for PPT, but for all groups the PPT during the time significantly increased when compared the before treatment. VAS showed differences between groups and during the time. The 0.5% lidocaine had the lowest VAS values when compared to dry needling, but at 30 days there were no differences among them. CONCLUSIONS: Despite the differences in VAS and considering there were no differences in PPT increases, we concluded that, in this study, both groups were able to disrupt the mechanisms of trigger point and relieve the myofascial pain symptoms.

  8. Chronic whiplash and central sensitization; an evaluation of the role of a myofascial trigger points in pain modulation

    Directory of Open Access Journals (Sweden)

    Freeman Michael D

    2009-04-01

    Full Text Available Abstract Objective it has been established that chronic neck pain following whiplash is associated with the phenomenon of central sensitization, in which injured and uninjured parts of the body exhibit lowered pain thresholds due to an alteration in central pain processing. it has furthermore been hypothesized that peripheral sources of nociception in the muscles may perpetuate central sensitization in chronic whiplash. the hypothesis explored in the present study was whether myofascial trigger points serve as a modulator of central sensitization in subjects with chronic neck pain. Design controlled case series. Setting outpatient chronic pain clinic. Subjects seventeen patients with chronic and intractable neck pain and 10 healthy controls without complaints of neck pain. Intervention symptomatic subjects received anesthetic infiltration of myofascial trigger points in the upper trapezius muscles and controls received the anesthetic in the thigh. Outcome measures: pre and post injection cervical range of motion, pressure pain thresholds (ppt over the infraspinatus, wrist extensor, and tibialis anterior muscles. sensitivity to light (photophobia and subjects' perception of pain using a visual analog scale (vas were also evaluated before and after injections. only the ppt was evaluated in the asymptomatic controls. Results immediate (within 1 minute alterations in cervical range of motion and pressure pain thresholds were observed following an average of 3.8 injections with 1–2 cc of 1% lidocaine into carefully identified trigger points. cervical range of motion increased by an average of 49% (p = 0.000 in flexion and 44% (p = 0.001 in extension, 47% (p = 0.000 and 28% (p Conclusion the present data suggest that myofascial trigger points serve to perpetuate lowered pain thresholds in uninjured tissues. additionally, it appears that lowered pain thresholds associated with central sensitization can be immediately reversed, even when associated

  9. Dry Needling at Myofascial Trigger Spots of Rabbit Skeletal Muscles Modulates the Biochemicals Associated with Pain, Inflammation, and Hypoxia

    Directory of Open Access Journals (Sweden)

    Yueh-Ling Hsieh

    2012-01-01

    Full Text Available Background and Purpose. Dry needling is an effective therapy for the treatment of pain associated with myofascial trigger point (MTrP. However, the biochemical effects of dry needling that are associated with pain, inflammation, and hypoxia are unclear. This study investigated the activities of β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF after different dosages of dry needling at the myofascial trigger spots (MTrSs of a skeletal muscle in rabbit. Materials and Methods. Dry needling was performed either with one dosage (1D or five dosages (5D into the biceps femoris with MTrSs in New Zealand rabbits. Biceps femoris, serum, and dorsal root ganglion (DRG were sampled immediately and 5 d after dry needling for β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF immunoassays. Results. The 1D treatment enhanced the β-endorphin levels in the biceps femoris and serum and reduced substance P in the biceps femoris and DRG. The 5D treatment reversed these effects and was accompanied by increase of TNF-α, COX-2, HIF-1α, iNOS, and VEGF production in the biceps femoris. Moreover, the higher levels of these biochemicals were still maintained 5 d after treatment. Conclusion. Dry needling at the MTrSs modulates various biochemicals associated with pain, inflammation, and hypoxia in a dose-dependent manner.

  10. Dry Needling at Myofascial Trigger Spots of Rabbit Skeletal Muscles Modulates the Biochemicals Associated with Pain, Inflammation, and Hypoxia

    Science.gov (United States)

    Hsieh, Yueh-Ling; Yang, Shun-An; Yang, Chen-Chia; Chou, Li-Wei

    2012-01-01

    Background and Purpose. Dry needling is an effective therapy for the treatment of pain associated with myofascial trigger point (MTrP). However, the biochemical effects of dry needling that are associated with pain, inflammation, and hypoxia are unclear. This study investigated the activities of β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF after different dosages of dry needling at the myofascial trigger spots (MTrSs) of a skeletal muscle in rabbit. Materials and Methods. Dry needling was performed either with one dosage (1D) or five dosages (5D) into the biceps femoris with MTrSs in New Zealand rabbits. Biceps femoris, serum, and dorsal root ganglion (DRG) were sampled immediately and 5 d after dry needling for β-endorphin, substance P, TNF-α, COX-2, HIF-1α, iNOS, and VEGF immunoassays. Results. The 1D treatment enhanced the β-endorphin levels in the biceps femoris and serum and reduced substance P in the biceps femoris and DRG. The 5D treatment reversed these effects and was accompanied by increase of TNF-α, COX-2, HIF-1α, iNOS, and VEGF production in the biceps femoris. Moreover, the higher levels of these biochemicals were still maintained 5 d after treatment. Conclusion. Dry needling at the MTrSs modulates various biochemicals associated with pain, inflammation, and hypoxia in a dose-dependent manner. PMID:23346198

  11. Myofascial pain syndrome treatments.

    Science.gov (United States)

    Borg-Stein, Joanne; Iaccarino, Mary Alexis

    2014-05-01

    Myofascial pain syndrome (MPS) is a regional pain disorder caused by taut bands of muscle fibers in skeletal muscles called myofascial trigger points. MPS is a common disorder, often diagnosed and treated by physiatrists. Treatment strategies for MPS include exercises, patient education, and trigger point injection. Pharmacologic interventions are also common, and a variety of analgesics, antiinflammatories, antidepressants, and other medications are used in clinical practice. This review explores the various treatment options for MPS, including those therapies that target myofascial trigger points and common secondary symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders H

    2011-01-01

    A diagnosis of Myofascial Pain Syndrome (MPS) requires palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies currently exist from which to draw firm conclusions regarding the robustness of TP examination. An inter...

  13. Effects of myofascial trigger point dry needling in patients with sleep bruxism and temporomandibular disorders: a prospective case series.

    Science.gov (United States)

    Blasco-Bonora, Paloma María; Martín-Pintado-Zugasti, Aitor

    2017-03-01

    To investigate the effects of deep dry needling (DN) of myofascial trigger points (MTrPs) of the masseter and temporalis on pain, pressure pain threshold (PPT), pain-free maximal jaw opening and temporomandibular disorder (TMD)-related disability in patients with sleep bruxism (SB) and myofascial TMD. Seventeen subjects (11 women, 6 men) aged 39±13 years (range 23-66) diagnosed with SB and myofascial TMD were invited to participate in this prospective case series study. Each subject received a deep DN intervention in the masseter and temporalis MTrPs. Pain intensity, PPT, pain-free maximal jaw opening and TMD-related disability were assessed before treatment, immediately after treatment and at 1-week follow-up. Jaw disability was assessed using the jaw disability checklist (JDC) at baseline and 1 week post-treatment only. One-way analyses of variance showed significant improvements in pain intensity, PPT and jaw opening (ppoints in pain (immediate: Cohen's d=1.72, p<0.001; 1 week: d=3.24, p<0.001), jaw opening (immediate: d=0.77, p<0.001; 1 week: d=1.02, p<0.001) and PPT in the masseter (immediate: d=1.02, p<0.001; 1 week: d=1.64, p<0.001) and temporalis (immediate: d=0.91, p=0.006; 1 week: d=1.8, p<0.001). A dependent t-test showed a significant improvement in jaw functioning, reflected by a large reduction in 1-week JDC scores relative to baseline (d=3.15, p<0.001). Deep DN of active MTrPs in the masseter and temporalis in patients with myofascial TMD and SB was associated with immediate and 1-week improvements in pain, sensitivity, jaw opening and TMD-related disability. NCT02587182; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. A narrative review of new trends in the diagnosis of myofascial trigger points: diagnostic ultrasound imaging and biomarkers

    Science.gov (United States)

    Srbely, John Z; Kumbhare, Dinesh; Grosman-Rimon, Liza

    2016-01-01

    Myofascial pain syndrome (MPS) is one of the most common conditions of chronic musculoskeletal pain encountered by primary healthcare practitioners on a daily basis. It is generally accepted amongst the broad profile of healthcare practitioners treating MPS that the presence of discrete, palpable and tender nodules within the muscle, known as myofascial trigger points (MTrP), is necessary to confirm the diagnosis of MPS. Manual palpation is currently the most common technique used to detect MTrP, however, previous research has shown that the reliability of manual palpation for detecting MTrP is poor, and in our opinion unacceptably poor, leading to inconsistent diagnosis of MPS and poor patient outcomes. There are currently no objective accepted diagnostic criteria for the clinical detection of MTrP, nor are there standardized diagnostic criteria for MPS. Two promising areas of research with potential for enhancing the diagnosis of MPS include the use of diagnostic ultrasound and biomarkers. Further research is needed to advance the development of composite diagnostic criteria employing ultrasound imaging, biomarker assessments and physical assessment to enhance the accuracy and objectivity of MTrP detection and diagnosis of chronic MPS disorder. PMID:27713577

  15. [Clinical observation on therapeutic effect of cupping combined with acupuncture stimulation at trigger points for lumbar myofascial pain syndrome].

    Science.gov (United States)

    Zhao, Hong

    2014-08-01

    To observe the clinical effect of cupping combined with acupuncture stimulation of trigger points on lumbar myofascial pain syndrome (MPS). Sixty MPS patients were randomly divided into acupuncture + TDP group (n = 30), and cupping + acupuncture group (n = 30). Patients in the acupuncture + TDP group were treated by acupuncture stimulation of trigger points and local TDP irradiation, and patients of the cupping + acupuncture group treated by intensive cupping applied to the myofascial band and acupuncture stimulation of the locus according to the position of muscular tension band. The therapeutic effects were assessed according to the score of the McGill pain questionnaire composing of pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI) before, immediately and 1 month after the treatment. After the treatment, the total effective rates of the acupuncture+ TDP and cupping + acupuncture groups were 83.3% (25/30) and 96.6% (29/30), respectively, without significant difference between the two groups (P > 0.05). One month's follow-up showed that the total effective rates of the acupuncture + TDP and cupping + acupuncture groups were 40.0% and 90.0% respectively, and the latter group was significantly better than the acupuncture + TDP group in the therapeutic effect (P < 0.05). The scores of PRI, VAS, PPI after the treatment were markedly decreased in both groups (P < 0.05). One month later, the scores of PRI, VAS and PPI in the cupping + acupuncture group were obviously lower than those of the acupuncture group (P < 0.05). Both acupuncture stimulation of trigger points plus TDP and cupping plus acupuncture can effectively relieve pain in MPS patients, while the therapeutic effect of cupping plus acupuncture treatment lasts longer analgesic effect.

  16. Myofascial syndrome

    Directory of Open Access Journals (Sweden)

    Giancarlo Carli

    2008-12-01

    Full Text Available Myofascial pain syndrome is common cause one of musculoskeletal pain and it is characterized by trigger points (TP, limited range of motion in joints and local twitch response (LTR during mechanical stimulation of the TP. Trigger point is a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is tender when pressed and can give rise to characteristic referred pain, motor dysfunction and autonomic phenomena. Palpation is reliable diagnostic criterion for locating TP in patients. Treatment is based on anesthetise TP, stretch and spray, local pression and physical activity.

  17. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points

    DEFF Research Database (Denmark)

    Ge, Hong You; Wang, Ying; Danneskiold-Samsøe, Bente;

    2010-01-01

    The aim of this present study is to test the hypotheses that the 18 predetermined sites of examination for tender points (TP sites) in fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs), and that the induced pain from active MTrPs at TP sites may mimic fibromyalgia pain. Each TP site...... was evaluated with manual palpation followed by intramuscular electromyographic (EMG) registration of spontaneous electrical activity to confirm or refute the existence of an MTrP in 30 FMS patients. Overall spontaneous pain intensity and pain pattern were recorded before manual identification of MTrPs. Local...... and referred pain pattern from active MTrPs were drawn following manual palpation at TP sites. RESULTS: Showed that most of the TP sites are MTrPs. Local and referred pain from active MTrPs reproduced partly the overall spontaneous pain pattern. The total number of active MTrPs (r = .78, P

  18. Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.

    Science.gov (United States)

    Anderson, Rodney U; Harvey, Richard H; Wise, David; Nevin Smith, J; Nathanson, Brian H; Sawyer, Tim

    2015-03-01

    This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).

  19. Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Tough, Elizabeth A; White, Adrian R; Cummings, T Michael; Richards, Suzanne H; Campbell, John L

    2009-01-01

    Pain from myofascial trigger points is often treated by needling, with or without injection, although evidence is inconclusive on whether this is effective. We aimed to review the current evidence on needling without injection, by conducting a systematic literature review. We searched electronic databases to identify relevant randomised controlled trials, and included studies where at least one group were treated by needling directly into the myofascial trigger points, and where the control was either no treatment, or usual care; indirect local dry needling or some form of placebo intervention. We extracted data on pain, using VAS scores as the standard. Seven studies were included. One study concluded that direct dry needling was superior to no intervention. Two studies, comparing direct dry needling to needling elsewhere in the muscle, produced contradictory results. Four studies used a placebo control and were included in a meta-analysis. Combining these studies (n=134), needling was not found to be significantly superior to placebo (standardised mean difference, 14.9 [95%CI, -5.81 to 33.99]), however marked statistical heterogeneity was present (I(2)=88%). In conclusion, there is limited evidence deriving from one study that deep needling directly into myofascial trigger points has an overall treatment effect when compared with standardised care. Whilst the result of the meta-analysis of needling compared with placebo controls does not attain statistically significant, the overall direction could be compatible with a treatment effect of dry needling on myofascial trigger point pain. However, the limited sample size and poor quality of these studies highlights and supports the need for large scale, good quality placebo controlled trials in this area.

  20. A systematic, critical review of manual palpation for identifying myofascial trigger points

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Larsen, Anders Holsgaard; Hartvigsen, Jan

    2008-01-01

    To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature.......To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature....

  1. Myofascial low back pain.

    Science.gov (United States)

    Ramsook, Ryan R; Malanga, Gerard A

    2012-10-01

    Low back pain is a common condition that is encountered by both primary care physicians as well as various specialists, which include: orthopedic surgeons, physical medicine and rehabilitation specialists, neurologists, rheumatologists, and pain management specialists. Associated muscular pain is very common and often a reactive response from nociception from other structures. Myofascial pain may arise, which is characterized by the presence of myofascial trigger points (MTrPs) that are located in fascia, tendons, and/or muscle. This article reviews the current evidence regarding the pathophysiology, assessment, and recommended treatment options for myofascial low back pain.

  2. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger

  3. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger p

  4. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger p

  5. Effects of postural and visual stressors on myofascial trigger point development and motor unit rotation during computer work.

    Science.gov (United States)

    Hoyle, Jeffrey A; Marras, William S; Sheedy, James E; Hart, Dennis E

    2011-02-01

    Musculoskeletal complaint rates are high among those performing low-level static exertions (LLSEs), such as computer users. However, our understanding of the causal mechanisms is lacking. It was hypothesized that myofascial trigger point (MTrP) development might be one causal mechanism to help explain these complaints and that static postural and visual demands may be contributing factors. Therefore, the purpose of this experiment was to examine MTrP development and the behavior of multiple parts of the trapezius muscle under postural and mental stress (represented by visual stress) conditions during computer work. Twelve subjects (six male and six female) were monitored for MTrP development via expert opinion, subject self-report, and cyclic changes in EMG median frequency across fourteen spatial locations. Results showed that MTrPs developed after one hour of continuous typing, despite the stress condition. Interestingly, both the high postural and high visual stress conditions resulted in significantly fewer median frequency cycles (3.76 and 5.35 cycles, respectively), compared to the baseline low stress condition (6.26 cycles). Lastly, the MTrP location as well as locations more medial to the spine showed significantly fewer cycles than other locations. Findings suggest that MTrPs may be one causal pathway for pain during LLSEs and both postural and visual demands may play a role in muscle activation patterns, perhaps attributing to MTrP development and resultant discomfort. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Glimpse of Views in Ashi and Myofascial Trigger Point%阿是穴与激痛点浅议

    Institute of Scientific and Technical Information of China (English)

    王列; 马铁明; 曹锐; 王颖; 马帅; 王建华; 王莹; 陈玲

    2016-01-01

    阿是穴与激痛点虽于不同时代提出,但二者之间有诸多相似之处,本文从二者的起源、定位、病理机制、临床应用及干预方法等多方面进行分析阐述,揭示二者之间的联系与区别,希望从一个全新的视角出发,对二者的理论及实践的发展提供借鉴.%Ashi and myofascial trigger point,although proposed at different times,but there are many similarities between them,due to its unique efficacy and widespread concern in Western medical community.From the origin,location,pathological mechanisms,clinical application and intervention aspects of both methods were analyzed and discussed,reveals links and differences between them.We hope from a new perspective on the development of both the theory and practice for reference.

  7. Myofascial Pain Syndrome: A Treatment Review

    OpenAIRE

    Desai, Mehul J.; Saini, Vikramjeet; Saini, Shawnjeet

    2013-01-01

    Myofascial pain syndrome (MPS) is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation, and regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the treatment modalities for myofascial trigge...

  8. Myofascial pain syndrome: a treatment review.

    Science.gov (United States)

    Desai, Mehul J; Saini, Vikramjeet; Saini, Shawnjeet

    2013-06-01

    Myofascial pain syndrome (MPS) is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation, and regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the treatment modalities for myofascial trigger points and muscle pain. Through a critical evidence-based review of the pharmacologic and nonpharmacologic treatments, the authors aim to provide clinicians with a more comprehensive knowledge of the interventions for myofascial pain.

  9. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Cotchett Matthew P

    2010-09-01

    Full Text Available Abstract Background Plantar heel pain (plantar fasciitis is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. Methods We searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool. Results Three quasi-experimental trials matched the inclusion criteria: two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials. Conclusions There is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the

  10. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review.

    Science.gov (United States)

    Cotchett, Matthew P; Landorf, Karl B; Munteanu, Shannon E

    2010-09-01

    Plantar heel pain (plantar fasciitis) is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs) however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. We searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI) in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline) alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool. Three quasi-experimental trials matched the inclusion criteria: two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials. There is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the Standards for Reporting Interventions in Controlled Trials of

  11. Mechanisms of Myofascial Pain

    Science.gov (United States)

    Jafri, M. Saleet

    2014-01-01

    Myofascial pain syndrome is an important health problem. It affects a majority of the general population, impairs mobility, causes pain, and reduces the overall sense of well-being. Underlying this syndrome is the existence of painful taut bands of muscle that contain discrete, hypersensitive foci called myofascial trigger points. In spite of the significant impact on public health, a clear mechanistic understanding of the disorder does not exist. This is likely due to the complex nature of the disorder which involves the integration of cellular signaling, excitation-contraction coupling, neuromuscular inputs, local circulation, and energy metabolism. The difficulties are further exacerbated by the lack of an animal model for myofascial pain to test mechanistic hypothesis. In this review, current theories for myofascial pain are presented and their relative strengths and weaknesses are discussed. Based on new findings linking mechanoactivation of reactive oxygen species signaling to destabilized calcium signaling, we put forth a novel mechanistic hypothesis for the initiation and maintenance of myofascial trigger points. It is hoped that this lays a new foundation for understanding myofascial pain syndrome and how current therapies work, and gives key insights that will lead to the improvement of therapies for its treatment. PMID:25574501

  12. Treatment of myofascial pain.

    Science.gov (United States)

    Desai, Mehul J; Bean, Matthew C; Heckman, Thomas W; Jayaseelan, Dhinu; Moats, Nick; Nava, Andrew

    2013-01-01

    SUMMARY The objective of this article was to perform a narrative review regarding the treatment of myofascial pain syndrome and to provide clinicians with treatment recommendations. This paper reviews the efficacy of various myofascial pain syndrome treatment modalities, including pharmacological therapy, injection-based therapies and physical therapy interventions. Outcomes evaluated included pain (visual analog scale), pain pressure threshold and range of motion. The evidence found significant benefit with multiple treatments, including diclofenac patch, thiocolchicoside and lidocaine patches. Trigger point injections, ischemic compression therapy, transcutaneous electrical nerve stimulation, spray and stretch, and myofascial release were also efficacious. The authors recommend focusing on treating underlying pathologies, including spinal conditions, postural abnormalities and underlying behavioral issues. To achieve maximum pain reduction and improve function, we recommend physicians approach myofascial pain syndrome with a multimodal plan, which includes a combination of pharmacologic therapies, various physical therapeutic modalities and injection therapies.

  13. 肌筋膜“扳机点”动物模型的构建及针灸干预机制%Myofascial Trigger Points:Construction of Animal Models and Mechanism of Acupuncture Intervention

    Institute of Scientific and Technical Information of China (English)

    邵开超; 查和萍; 范志勇; 吴世芳; 李珊珊

    2013-01-01

    肌筋膜炎是临床常见病之一,从肌筋膜“扳机点”入手治疗具有较好的疗效。本文分别从中医学和现代医学的角度,进一步深入了解肌筋膜“扳机点”,并对目前肌筋膜“扳机点”动物模型的构建进行阐述,阐明针灸干预肌筋膜“扳机点”的机制,对肌筋膜“扳机点”的进一步研究具有积极的意义。%Myofascitis is one of clinical common diseases ,and myofascial trigger point therapy usually plays a good curative effect .Respectively from the angle of medicine and modern medicine , in order to further under-stand myofascial trigger points , and myofascial trigger point elaborates the construction of animal models , to clarify the mechanism of acupuncture intervention myofascial trigger point .The further study of myofascial trigger points has a positive significance .

  14. Quantification of dry needling and posture effects on myofascial trigger points using ultrasound shear-wave elastography.

    Science.gov (United States)

    Maher, Ruth M; Hayes, Dawn M; Shinohara, Minoru

    2013-11-01

    To determine (1) whether the shear modulus in upper trapezius muscle myofascial trigger points (MTrPs) reduces acutely after dry needling (DN), and (2) whether a change in posture from sitting to prone affects the shear modulus. Ultrasound images were acquired in B mode with a linear transducer oriented in the transverse plane, followed by performance of shear-wave elastography (SWE) before and after DN and while sitting and prone. University. Women (N=7; mean age ± SD, 46±17y) with palpable MTrPs were recruited. All participants were dry needled in the prone position using solid filament needles that were inserted and manipulated inside the MTrPs. SWE was performed before and after DN in the sitting and prone positions. MTrPs were evaluated by shear modulus using SWE. Palpable reductions in stiffness were noted after DN and in the prone position. These changes were apparent in the shear modulus map obtained with ultrasound SWE. With significant main effects, the shear modulus reduced from before to after DN (P<.01) and from the sitting to the prone position (P<.05). No significant interaction effect between time and posture was observed. The shear modulus measured with ultrasound SWE reduced after DN and in the prone position compared with sitting, in agreement with reductions in palpable stiffness. These findings suggest that DN and posture have significant effects on the shear modulus of MTrPs, and that shear modulus measurement with ultrasound SWE may be sensitive enough to detect these effects. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Difference in effect between ischemic compression and muscle energy technique on upper trepezius myofascial trigger points: Comparative study

    Directory of Open Access Journals (Sweden)

    Gopal S Nambi

    2013-01-01

    Full Text Available Background: Myofascial trigger point (MTrP is a hyperirritable point or spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression and can give rise to characteristic-referred pain and motor dysfunction. Studies suggest that various types of massage forms are available for treating MTrPs. Aims: To find the difference in effect of two forms of massage techniques: Ischemic compression and muscle energy technique (MET on upper trepezius MTrPs. Settings and Design: Quasi experimental design was conducted with convenient sampling method. Materials and Methods: Patients ( n = 30 who fulfil the screening criteria were randomly assigned to Group A ( n = 15 treated with ischemic compression and ultrasound and Group B ( n = 15 treated with MET and ultrasound for 4 weeks and they were assessed at baseline and after 4 weeks. Outcome measures included pain intensity by visual analog scale (VAS and range of motion by universal goniometer. Statistical Analysis Used: Intergroup analysis was done with Mann-Whitney test and intragroup analysis was done with Wilcoxon signed-rank test. Results: Statistically, no significant ( P > 0.05 changes in the scores were found in the Groups A and B for VAS, and statistically significant ( P < 0.05 changes in the scores were found in the Groups A and B for Range of Motion (ROM with greater change scores in the Group B compared with Group A. Conclusion: Treatment program consisting of MET with ultrasound may be more effective in reducing pain and improve ROM in patients in upper trepezius MTrPs.

  16. A case study utilizing myofascial release, acupressure and trigger point therapy to treat bilateral "Stringhalt" in a 12 year old Akhal-Teke horse.

    Science.gov (United States)

    Brockman, Tammy

    2017-07-01

    "Stringhalt" is a horse condition that causes one or both hind legs to spasm when walking, trotting or backing. The condition is thought to be related to a neurological cause from either plant toxicity or peripheral nerve injury. The prognosis is poor and the horse's performance and quality of life can be affected. Treatment has included surgically cutting the digital extensors with varied results. The objective of the study is to utilize soft tissue release via acupressure, trigger point and myofascial release to decrease symptoms of stringhalt. The case study is a 12 year old Akhal-Teke horse of excellent pedigree. In 2011, she was caught in barbed wire overnight and sustained lacerations to the bone in her hindlimbs. Shortly after the injury the horse was placed in a stall for several months and was unable to walk or run, developing stringhalt. Currently, her condition is aggravated by stress and alleviated by certain types of massage (myofascial, acupressure, and trigger point release). The incidence of stringhalt occurs every 3-5 min, with more frequent and severe symptoms on the right hindlimb. The horse is unable to run or back up. Six 1 to 1½ hour bi-weekly treatments were performed. The treatments consisted of myofascial release at the cervical, sacrum and iliums, acupressure of the bladder meridian (including c-spine, t-spine, l-spine, and hamstring), and trigger point release of the iliacus. The stringhalt symptoms were monitored for 30 min prior to each of the 6 treatment sessions. After 6 treatments, the horse was observed running and standing in a position that promotes hip extension. She has not been able to do either since the injury. The frequency and severity of the spasms have decreased to every 10-20 min. The horse's owners report that her disposition, stress and quality of life are much improved. The results suggest that myofascial release, acupressure and trigger point therapy may be utilized to provide a positive treatment outcome in the

  17. A RANDOMIZED TRIAL TO STUDY THE COMPARISON OF TRIGGER POINT DRY NEEDLING VERSUS KINESIO TAPING TECHNIQUE IN MYOFASCIAL PAIN SYNDROME DURING A 3-MONTH FOLLOW UP

    Directory of Open Access Journals (Sweden)

    Emrullah Hayta

    2016-10-01

    Full Text Available Background: Managemen of myofascial pain syndrome (MPS is a current research subject since there is a small number of randomized studies comparing different management techniques. Multiple studies attempted to assess various treatment options including trigger point dry needling and kinesiotaping. We compared the effects of trigger point dry needling and kinesiotaping in the management of myofascial pain syndome during a 3-month follow-up period. Methods: In this prospective randomized studyin MPS patients with upper trapezius muscle trigger points, the effects of dry needling (n=28 and kinesiotaping (n=27 was compared with regard to the visual analog scale (VAS, neck disability index (NDI, and Nottingham health profile (NHP scores measured at the weeks 0, 4, and 12. Results: Both dry needling and kinesiotaping comparably reduced VAS scores measured at the weeks 4 and 12 and their efficacies were more remarkable at the week 12 (p<0.05. These interventions significantly reduced the NDI and NHP score and their effects were also more remarkable at the week 12; however, dry needling was found more effective (p<0.05. Conclusion: Overall, in current clinical settings, during the management of MPS, pain can be reduced comparably by both dry needling and kinesiotaping; however, restriction in the range of motionin neck region and quality of life are more remarkably reduced by dry needling. Both dry needling and kinesiotaping can provide an increasing effectiveness up to 12 weeks.

  18. Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome.

    Science.gov (United States)

    Kamanli, A; Kaya, A; Ardicoglu, O; Ozgocmen, S; Zengin, F Ozkurt; Bayik, Y

    2005-10-01

    Myofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. Several methods have been recommended for the inactivation of trigger points (TrP). This prospective, single-blind study was proposed to compare TrP injection with botulinum toxin type A (BTX-A) to dry needling and lidocaine injection in MPS. Eighty-seven trigger points (cervical and/or periscapular regions) in 23 female and six male patients with MPS were treated and randomly assigned to three groups: lidocaine injection (n=10, 32 TrP), dry needling (n=10, 33 TrP), and BTX-A injection (n=9, 22 TrP). Clinical assessment including cervical range of motion, TrP pain pressure threshold (PPT), pain scores (PS), and visual analog scales for pain, fatigue, and work disability were evaluated at entry and the end of the 4th week. Additionally, depression and anxiety were evaluated with the Hamilton depression and anxiety rating scales, and quality of life was assessed using the Nottingham health profile (NHP). The subjects were also asked to describe side effects. INJECTION PROCEDURE: One milliliter of 0.5% lidocaine was administered to each TrP in the lidocaine injection group, 10-20 IU of BTX-A to each TrP in the BTX-A group, and dry needling to each TrP in the last group, followed by stretching of the muscle groups involved. The patients were instructed to continue their home exercise programs. Pain pressure thresholds and PS significantly improved in all three groups. In the lidocaine group, PPT values were significantly higher than in the dry needle group, and PS were significantly lower than in both the BTX-A and dry needle groups. In all, visual analog scores significantly decreased in the lidocaine injection and BTX-A groups and did not significantly change in the dry needle group. Disturbance during the injection procedure was lowest in the lidocaine injection group. Quality of life scores assessed by NHP significantly improved in the lidocaine and BTX-A groups but not

  19. Diagnosis of myofascial pain syndrome.

    Science.gov (United States)

    Gerwin, Robert D

    2014-05-01

    Myofascial pain is one of the most common causes of pain. The diagnosis of myofascial pain syndrome (MPS) is made by muscle palpation. The source of the pain in MPS is the myofascial trigger point, a very localized region of tender, contracted muscle that is readily identified by palpation. The trigger point has well-described electrophysiologic properties and is associated with a derangement of the local biochemical milieu of the muscle. A proper diagnosis of MPS includes evaluation of muscle as a cause of pain, and assessment of associated conditions that have an impact on MPS. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Fluence-dependent effects of low-level laser therapy in myofascial trigger spots on modulation of biochemicals associated with pain in a rabbit model.

    Science.gov (United States)

    Hsieh, Yueh-Ling; Hong, Chang-Zern; Chou, Li-Wei; Yang, Shun-An; Yang, Chen-Chia

    2015-01-01

    Evidence strongly supports that low-level laser therapy (LLLT) is an effective physical modality for the treatment of pain associated with myofascial trigger points (MTrP). However, the effect of laser fluence (energy intensity in J/cm(2)) on biochemical regulation related to pain is unclear. To better understand the biochemical mechanisms modulated by high- and low-fluence LLLT at myofascial trigger spots (MTrSs; similar to human MTrPs) in skeletal muscles of rabbits, the levels of β-endorphin (β-ep), substance P (SP), tumor necrosis factor-α (TNF-α), and cyclooxygenase-2 (COX-2) were investigated in this study. New Zealand rabbits (2.5-3.0 kg in weight) were used in this study. High-fluence LLLT (27 J/cm(2)), low-fluence LLLT (4.5 J/cm(2)), or sham operations were applied on MTrSs of biceps femoris of rabbits for five sessions (one session per day). Effects of LLLT at two different fluences on biceps femoris, dorsal root ganglion (DRG), and serum were determined by β-ep, SP, TNF-α, and COX-2 immunoassays. LLLT irradiation with fluences of 4.5 and 27 J/cm(2) at MTrSs can significantly reduce SP level in DRG. LLLT with lower fluence of 4.5 J/cm(2) exerted lower levels of TNF-α and COX-2 expression in laser-treated muscle, but LLLT with higher fluence of 27 J/cm(2) elevated the levels of β-ep in serum, DRG, and muscle. This study demonstrated fluence-dependent biochemical effects of LLLT in an animal model on management of myofascial pain. The findings can contribute to the development of dosage guideline for LLLT for treating MTrP-induced pain.

  1. The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Simons, David; Cuadrado, Maria Luz; Pareja, Juan

    2007-10-01

    Neck and head pain syndromes are common problems seen in clinical practice. Pain features of commonly designated idiopathic neck pain and some primary headaches (ie, tension-type headache or migraine) fit the descriptions of referred pain originating in muscle trigger points (TrPs). This article discusses the scientific evidence supporting the role of muscle TrPs in chronic musculo-skeletal disorders of the neck and head. The relevance of referred pain elicited by muscle TrPs in patients with neck pain has been investigated in few studies. Some authors found that both muscle TrPs in neck-shoulder muscles and cervical joint dysfunctions contribute at the same time to neck pain perception. Furthermore, it seems that referred pain originated in muscle TrPs could also contribute to neck symptoms perceived by subjects after a rear-end crash. In addition, several recent studies reported that both TTH and migraine are associated with referred pain from TrPs in the suboccipital, upper trapezius, sternocleidomastoid, temporalis, or superior oblique muscles. Referred pain elicited by active TrPs mimics the pain areas observed during head pain attacks in these primary headaches. Based on available data, it seems that the pain profile of neck and head syndromes may be provoked referred pain from TrPs in the posterior cervical, head, and shoulder muscles. Additional studies are needed to delineate more information on the relation between muscle TrPs and musculoskeletal pain syndromes of the head and neck.

  2. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    OpenAIRE

    Njoo, Khing Hua; Does, Emiel

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger point symptoms. Using the symptoms and signs as described by Simons' 1990 definition and two other former sets of criteria, 61 non-specific low back pain patients and 63 controls were examined in ge...

  3. Referred pain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Ge, Hong-You; Alonso-Blanco, Cristina; González-Iglesias, Javier; Arendt-Nielsen, Lars

    2010-10-01

    Our aim was to analyze the differences in the referred pain patterns and size of the areas of those myofascial trigger points (TrPs) involved in chronic tension type headache (CTTH) including a number of muscles not investigated in previous studies. Thirteen right handed women with CTTH (mean age: 38 ± 6 years) were included. TrPs were bilaterally searched in upper trapezius, sternocleidomastoid, splenius capitis, masseter, levator scapulae, superior oblique (extra-ocular), and suboccipital muscles. TrPs were considered active when both local and referred pain evoked by manual palpation reproduced total or partial pattern similar to a headache attack. The size of the referred pain area of TrPs of each muscle was calculated. The mean number of active TrPs within each CTTH patient was 7 (95% CI 6.2-8.0). A greater number (T = 2.79; p = 0.016) of active TrPs was found at the right side (4.2 ± 1.5) when compared to the left side (2.9 ± 1.0). TrPs in the suboccipital muscles were most prevalent (n = 12; 92%), followed by the superior oblique muscle (n =11/n = 9 right/left side), the upper trapezius muscle (n = 11/n = 6) and the masseter muscle (n = 9/n=7). The ANOVA showed significant differences in the size of the referred pain area between muscles (F = 4.7, p = 0.001), but not between sides (F = 1.1; p = 0.3): as determined by a Bonferroni post hoc analysis the referred pain area elicited by levator scapulae TrPs was significantly greater than the area from the sternocleidomastoid (p = 0.02), masseter (p = 0.003) and superior oblique (p = 0.001) muscles. Multiple active TrPs exist in head, neck and shoulder muscles in women with CTTH. The referred pain areas of TrPs located in neck muscles were larger than the referred pain areas of head muscles. Spatial summation of nociceptive inputs from multiple active TrPs may contribute to clinical manifestations of CTTH. Copyright © 2009 Elsevier Ltd. All rights reserved.

  4. Botulinum type A toxin complex for the relief of upper back myofascial pain syndrome: how do fixed-location injections compare with trigger point-focused injections?

    Science.gov (United States)

    Benecke, Reiner; Heinze, Axel; Reichel, Gerhard; Hefter, Harald; Göbel, Hartmut

    2011-11-01

    This was a prospective, randomized, double-blind, placebo-controlled, 12-week, multicenter study to evaluate the efficacy and tolerability of fixed location injections of botulinum type A toxin (BoNT-A, Dysport) in predetermined injection sites in patients with myofascial pain syndrome of the upper back. Patients with moderate-to-severe myofascial pain syndrome affecting cervical and/or shoulder muscles (10 trigger points, disease duration 6-24 months) and moderate-to-severe pain intensity were randomized to BoNT-A (N = 81) or saline (N = 72). Patients received treatment into 10 predetermined fixed injection sites in the head, neck, and shoulder (40 units of BoNT-A per site or saline, a total of 400 units of BoNT-A). The primary efficacy outcome was the proportion of patients with mild or no pain at week 5 (responders). Secondary outcomes included changes in pain intensity and the number of pain-free days per week. At week 5, 49% (37/76) of BoNT-A patients and 38% (27/72) of placebo patients had responded to treatment (P = 0.1873). Duration of daily pain was reduced in the BoNT-A group compared with the placebo group from week 5, with statistically significant differences at weeks 9 and 10 (P = 0.04 for both). Treatment was well tolerated. Fixed-location treatment with BoNT-A of patients with upper back myofascial pain syndrome did not lead to a significant improvement of the main target parameter in week 5 after treatment. Only in week 8 were significant differences found. Several secondary parameters, such as physicians' global assessment and patients' global assessment, significantly favored BoNT-A over placebo at weeks 8 and 12. Wiley Periodicals, Inc.

  5. 腰背部肌筋膜疼痛综合征激痛点的剪切波弹性模量研究%Study on the elastic modulus of shear wave for myofascial trigger points of lumber and back myofascial pain syndrome

    Institute of Scientific and Technical Information of China (English)

    李真; 吕恒勇; 任泽阳; 梁晓宁; 贾晓霞; 李硕; 牛雅莉; 李迎新; 郭瑞君

    2016-01-01

    Objective To investigate the clinical diagnostic value of elastography in myofascial pain syndrome by measuring the elastic properties of myofascial trigger points.Methods The elastic modulus of 30 myofascial trigger points from 15 female patients with myofascial pain syndrome and 8 normal points from 8 female healthy volunteers were measured by shear wave elastography.The mean,min,max,and standard deviation (SD) of elastic modulus in lesions,surrounding tissue of myofascial trigger point and normal points were recorded and compared,and the correlation between elasticity of myofascial trigger points and age,location were analyzed.Results The mean,min,max,and standard deviation of elastic modulus in lesion area of myofascial trigger point were significantly higher than that in surrounding tissue and normal points (P<0.05).There were no significant differences between lesion area of myofascial trigger point and normal points (P>0.05),and elastic modulus of myofascial trigger points bore no relation to age and location (P>0.05).Conclusions Shear wave elastic modulus can be used to differentiate lesion area and its adjacent area of trigger points and normal points,which will provide a new way to identify myofascial trigger point and new basis for palpation,thus has higher application value in clinical and research prospect.%目的 通过剪切波弹性成像(SWE)技术研究肌筋膜疼痛综合征激痛点的弹性特征,探索弹性超声技术在肌筋膜疼痛综合征临床诊断中的应用价值.方法 对8例女性健康志愿者的8个正常点和15例女性肌筋膜疼痛综合征患者腰背部30个激痛点行弹性超声检查,分别获得正常点、激痛点病灶区及邻近区定量分析取样框(Q-box)内弹性模量的均值(Mean)、最小值(Min)、最大值(Max)及标准差(SD);比较正常点、激痛点病灶区及临近区的弹性模量差异,探索激痛点弹性模量与患者年龄、所在部位的关系.结果 激痛点病灶区弹

  6. Experienced versus Inexperienced Interexaminer Reliability on Location and Classification of Myofascial Trigger Point Palpation to Diagnose Lateral Epicondylalgia: An Observational Cross-Sectional Study

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    Raquel Mora-Relucio

    2016-01-01

    Full Text Available The purpose was to evaluate the interexaminer reliability of experienced and inexperienced examiners on location and classification of myofascial trigger points (MTrPs in two epicondylar muscles and the association between the MTrP found and the diagnosis of lateral epicondylalgia (LE. Fifty-two pianists (some suffered LE voluntarily participated in the study. Three physiotherapists (one inexperienced in myofascial pain examined, located, and marked MTrPs in the extensor carpi radialis brevis (ECRB and extensor digitorum communis (EDC muscles. Forearms were photographed and analyzed to establish the degree of agreement on MTrPs diagnosis. Data showed 81.73% and 77.88% of agreement on MTrP classification and 85.58% and 72.12% on MTrP location between the expert evaluators for ECRB and EDC, respectively. The agreement on MTrP classification between experienced and inexperienced examiners was 54.81% and 51.92% for ECRB and 50.00% and 55.77% for EDC. Also, agreement on MTrP location was 54.81% and 60.58% for ECRB and 48.08% and 48.08% for EDC. A strong association was found between presence of relevant MTrPs, LE diagnosis, and forearm pain when the examiners were experts. The analysis of location and classification of MTrPs in the epicondylar muscles through physical examination by experienced evaluators is reliable, reproducible, and suitable for diagnosing LE.

  7. Short-term effects of dry needling of active myofascial trigger points in the masseter muscle in patients with temporomandibular disorders.

    Science.gov (United States)

    Fernández-Carnero, Josué; La Touche, Roy; Ortega-Santiago, Ricardo; Galan-del-Rio, Fernando; Pesquera, Jorge; Ge, Hong-You; Fernández-de-Las-Peñas, César

    2010-01-01

    To investigate the effects of dry needling over active trigger points (TrPs) in the masseter muscle in patients with temporomandibular disorders (TMD). Twelve females, aged 20 to 41 years old (mean = 25, standard deviation +/- 6 years) diagnosed with myofascial TMD were recruited. Each patient attended two treatment sessions on two separate days and received one intervention assigned in a random fashion, at each visit: deep dry needling (experimental) or sham dry needling (placebo) at the most painful point on the masseter muscle TrP. Pressure pain threshold (PPT) over the masseter muscle TrP and the mandibular condyle and pain-free active jaw opening were assessed pre- and 5 minutes postintervention by an examiner blinded to the treatment allocation of the subject. A two-way repeated-measures analysis of variance (ANOVA) with intervention as the between-subjects variable and time as the within-subjects variable was used to examine the effects of the intervention. The ANOVA detected a significant interaction between intervention and time for PPT levels in the masseter muscle (F = 62.5; P dry needling compared to the sham dry needling (P dry needling into active TrPs in the masseter muscle induced significant increases in PPT levels and maximal jaw opening when compared to the sham dry needling in patients with myofascial TMD.

  8. Short-term effects of acupuncture and stretching on myofascial trigger point pain of the neck: a blinded, placebo-controlled RCT.

    Science.gov (United States)

    Wilke, J; Vogt, L; Niederer, D; Hübscher, M; Rothmayr, J; Ivkovic, D; Rickert, M; Banzer, W

    2014-10-01

    This trial aimed to evaluate the short-term effectiveness of acupuncture plus stretching to reduce pain and improve range of motion in patients afflicted by cervical myofascial pain syndrome. Randomized, blinded, placebo-controlled crossover study. Nineteen patients (11 females, eight males, 33 ± 14 years) with myofascial neck pain in randomized order received the following treatments with one week washout between: acupuncture, acupuncture plus stretching, and placebo laser acupuncture. Mechanical pain threshold (MPT, measured with a pressure algometer) represented the primary outcome. Secondary outcomes were motion-related pain (Visual Analogue Scale, VAS) and cervical range of motion (ROM, recorded by means of an ultrasonic 3D movement analysis system). Outcomes were assessed immediately prior as well as 5, 15 and 30 min post treatment. Friedman tests with post hoc Bonferroni-Holm correction were applied to compare differences between treatments. Both acupuncture as well as acupuncture plus stretching increased MPT by five, respectively, 11 percent post treatment. However, only acupuncture in combination with stretching was superior to placebo (pstretching, ROM was significantly increased in the frontal and the transversal plane compared to placebo (pstretching could represent a suitable treatment option to improve cervical movement behavior and reduce trigger point pain in the short-term. However, additional studies further discriminating the placebo effects are still warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Change and role of biochemical milieu in the site near to myofascial trigger points%肌筋膜疼痛触发点内理化环境的改变及其作用

    Institute of Scientific and Technical Information of China (English)

    黄丹婧; 吕娇娇; 黄强民; 吴小丽

    2011-01-01

    背景:以往研究对肌筋膜疼痛触发点的研究主要集中在发病特点和临床治疗方面,有关肌筋膜疼痛触发点局部组织的理化环境变化及其作用的研究较少.目的:总结并讨论肌筋膜疼痛触发点局部组织的理化环境变化及各种理化因子在肌筋膜疼痛中的作用.方法:由第一作者用计算机检索中国期刊全文数据库(CNKI:2000/2010)和Medline数据库(2000/2010),检索词分别为"肌筋膜疼痛触发点、致痛因子、神经系统致敏、伤害性感受器"和"myofascial trigger points,algogenic substance,nervous system sensitization,nociceptors".共检索到159篇文章,按纳入和排除标准对文献进行筛选,共纳入30篇文章.从肌筋膜疼痛触发点局部理化环境变化及各种理化因子的作用两方面进行总结,对理化环境在肌筋膜疼痛触发点发病中的重要作用进行介绍.结果与结论:肌筋膜疼痛触发点局部肌肉组织各种理化因子发生显著性变化,表现为各神经血管反应物质增多,炎症递质和致痛因子浓度明显升高.但是国内外对肌筋膜疼痛触发点理化环境变化及其作用的相关研究较少,了解仍不深入.%BACKGROUND: Most previous studies of sites near to myofascial trigger points focus on pathological characteristics and clinical treatments. The biochemical milieu and role in the sites near to myofascial trigger points are poorly understood.OBJECTIVE: To summarize the biochemical milieu in the sites near to myofascial trigger points and the role of various biochemical factors in myofascial pains.METHODS: A computer-based retrieval was performed by the first author using the key words“myofascial trigger points, algogenic substance, nervous system sensitization, nociceptors” in English and Chinese to search papers published between 2000 and 2010 in CNKI and Medline databases. A total of 159 papers were retrieved. According to inclusion and exclusion criteria, 30 papers were incl

  10. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: A randomized controlled trial [ISRCTN75722066

    Directory of Open Access Journals (Sweden)

    Franssen Jo LM

    2007-11-01

    Full Text Available Abstract Background Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior over others. Systematic reviews provide some evidence that certain physical therapy interventions (i.e. supervised exercises and mobilisation are effective in particular shoulder disorders (i.e. rotator cuff disorders, mixed shoulder disorders and adhesive capsulitis, but there is an ongoing need for high quality trials of physical therapy interventions. Usually, physical therapy consists of active exercises intended to strengthen the shoulder muscles as stabilizers of the glenohumeral joint or perform mobilisations to improve restricted mobility of the glenohumeral or adjacent joints (shoulder girdle. It is generally accepted that a-traumatic shoulder problems are the result of impingement of the subacromial structures, such as the bursa or rotator cuff tendons. Myofascial trigger points (MTrPs in shoulder muscles may also lead to a complex of symptoms that are often seen in patients diagnosed with subacromial impingement or rotator cuff tendinopathy. Little is known about the treatment of MTrPs in patients with shoulder disorders. The primary aim of this study is to investigate whether physical therapy modalities to inactivate MTrPs can reduce symptoms and improve shoulder function in daily activities in a population of chronic a-traumatic shoulder patients when compared to a wait-and-see strategy. In addition we investigate the recurrence rate during a one-year-follow-up period. Methods/Design This paper presents the design for a randomized controlled trial to be conducted between September 2007 – September 2008, evaluating the effectiveness of a physical therapy treatment for non-traumatic shoulder complaints. One hundred subjects are included in this study. All subjects

  11. The neurophysiological effects of dry needling in patients with upper trapezius myofascial trigger points: study protocol of a controlled clinical trial.

    Science.gov (United States)

    Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

    2013-05-28

    Dry needling (DN) is an effective method for the treatment of myofascial trigger points (MTrPs). There is no report on the neurophysiological effects of DN in patients with MTrPs. The aim of the present study will be to assess the immediate neurophysiological efficacy of deep DN in patients with upper trapezius MTrPs. A prospective, controlled clinical trial was designed to include patients with upper trapezius MTrPs and volunteered healthy participants to receive one session of DN. The primary outcome measures are neuromuscular junction response and sympathetic skin response. The secondary outcomes are pain intensity and pressure pain threshold. Data will be collected at baseline and immediately after intervention. This study protocol has been approved by the Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences. The results of the study will be disseminated in a peer-reviewed journal and presented at international congresses.

  12. A afferent fibers are involved in the pathology of central changes in the spinal dorsal horn associated with myofascial trigger spots in rats.

    Science.gov (United States)

    Meng, Fei; Ge, Hong-You; Wang, Yong-Hui; Yue, Shou-Wei

    2015-11-01

    A afferent fibers have been reported to participate in the development of the central sensitization induced by inflammation and injuries. Current evidence suggests that myofascial trigger points (MTrPs) induce central sensitization in the related spinal dorsal horn, and clinical studies indicate that A fibers are associated with pain behavior. Because most of these clinical studies applied behavioral indexes, objective evidence is needed. Additionally, MTrP-related neurons in dorsal root ganglia and the spinal ventral horn have been reported to be smaller than normal, and these neurons were considered to be related to A fibers. To confirm the role of A fibers in MTrP-related central changes in the spinal dorsal horn, we studied central sensitization as well as the size of neurons associated with myofascial trigger spots (MTrSs, equivalent to MTrPs in humans) in the biceps femoris muscle of rats and provided some objective morphological evidence. Cholera toxin B subunit-conjugated horseradish peroxidase was applied to label the MTrS-related neurons, and tetrodotoxin was used to block A fibers specifically. The results showed that in the spinal dorsal horn associated with MTrS, the expression of glutamate receptor (mGluR1α/mGluR5/NMDAR1) increased, while the mean size of MTrS-related neurons was smaller than normal. After blocking A fibers, these changes reversed to some extent. Therefore, we concluded that A fibers participated in the development and maintenance of the central sensitization induced by MTrPs and were related to the mean size of neurons associated with MTrPs in the spinal dorsal horn.

  13. A Comparative Pilot Study to Evaluate the Adjunctive Role of Levosulpride with Trigger Point Injection Therapy in the Management of Myofascial Pain Syndrome of Orofacial Region.

    Science.gov (United States)

    Gupta, Pranav; Singh, Virendra; Sethi, Sujata; Kumar, Arun

    2014-12-01

    To evaluate the effect of therapy with levosulpride combined with conventional trigger point injection therapy in terms of pain and depression in the chronic myofascial pain syndrome patients. This was a comparative prospective study in which subjects with at least one trigger point and symptom duration of at least 3 months were recruited and randomized into two groups. Group A subjects received trigger point injections with 0.5 % bupivacaine and tablet levosulpride and group B received trigger point injections and a placebo. Subjects were assessed for pain with visual analog scale (VAS) and depression with Beck's depression inventory (BDI) at the follow-up periods of 1, 4, 6 and 12 weeks. The treatment effect was measured in terms of mean difference of BDI and VAS scores at various studied intervals from the baseline values. The sample was composed of 15 subjects with 8 in group A (6 females and 2 males, with a mean age of 41.88 ± 15.13 years, disease duration of 12.37 ± 16.11 months) and 7 in group B (6 females and 1 male, with a mean age of 43.86 ± 12.34 years, disease duration of 9.64 ± 9.34 months). The mean baseline VAS score and BDI score was 6.75 ± 1.03 in group A and 6.86 ± 1.06 in group B and 24.25 ± 10.20 in group A and 24.43 ± 11.16 in group B respectively. The mean difference of VAS scores at 12th week interval from the baseline values was highly significant. Although the mean difference of VAS scores at all the other intervals and mean difference of BDI scores at all the intervals was statistically nonsignificant, there was improvement in the mean differences at all the follow-up intervals in terms of both pain as well as depression. The combined therapy with conventional trigger point injection and levosulpride as antidepressant significantly reduce pain and depression in the study subjects suffering from chronic myofascial pain with moderate to severe depression in the orofacial region.

  14. One-Piece Triboelectric Nanosensor for Self-Triggered Alarm System and Latent Fingerprint Detection.

    Science.gov (United States)

    Jie, Yang; Zhu, Huarui; Cao, Xia; Zhang, Yue; Wang, Ning; Zhang, Liqun; Wang, Zhong Lin

    2016-11-22

    Tactile sensing is of great importance in developing human-machine interface, remote control, and security systems. Here, a self-triggered alarm system based on the one-piece triboelectric nanosensor (TENS) is reported. By using nitrocellulose (NC) membrane as the triboelectric material, the as-designed TENS can not only sensitively respond to physical contacts in a self-triggered mode but also securely detect the third-level details of latent fingerprint. The self-triggered idea based on the triboelectric nanogenerator is compatible with intelligent interactive interface. Besides, this TENS can be conveniently fabricated and integrated into arrays at a large scale due to its freestanding, simple, and low-cost characteristics. This work presents alternative perspectives for the practical applications of the multifunctionalized TENS.

  15. Fascial components of the myofascial pain syndrome.

    Science.gov (United States)

    Stecco, Antonio; Gesi, Marco; Stecco, Carla; Stern, Robert

    2013-08-01

    Myofascial pain syndrome (MPS) is described as the muscle, sensory, motor, and autonomic nervous system symptoms caused by stimulation of myofascial trigger points (MTP). The participation of fascia in this syndrome has often been neglected. Several manual and physical approaches have been proposed to improve myofascial function after traumatic injuries, but the processes that induce pathological modifications of myofascial tissue after trauma remain unclear. Alterations in collagen fiber composition, in fibroblasts or in extracellular matrix composition have been postulated. We summarize here recent developments in the biology of fascia, and in particular, its associated hyaluronan (HA)-rich matrix that address the issue of MPS.

  16. Remote Dose-Dependent Effects of Dry Needling at Distant Myofascial Trigger Spots of Rabbit Skeletal Muscles on Reduction of Substance P Levels of Proximal Muscle and Spinal Cords

    Directory of Open Access Journals (Sweden)

    Yueh-Ling Hsieh

    2014-01-01

    Full Text Available Background. Dry needling at distant myofascial trigger points is an effective pain management in patients with myofascial pain. However, the biochemical effects of remote dry needling are not well understood. This study evaluates the remote effects of dry needling with different dosages on the expressions of substance P (SP in the proximal muscle, spinal dorsal horns of rabbits. Methods. Male New Zealand rabbits (2.5–3.0 kg received dry needling at myofascial trigger spots of a gastrocnemius (distant muscle in one (1D or five sessions (5D. Bilateral biceps femoris (proximal muscles and superficial laminaes of L5-S2, T2-T5, and C2-C5 were sampled immediately and 5 days after dry needling to determine the levels of SP using immunohistochemistry and western blot. Results. Immediately after dry needling for 1D and 5D, the expressions of SP were significantly decreased in ipsilateral biceps femoris and bilateral spinal superficial laminaes (P<.05. Five days after dry needling, these reduced immunoactivities of SP were found only in animals receiving 5D dry needling (P<.05. Conclusions. This remote effect of dry needling involves the reduction of SP levels in proximal muscle and spinal superficial laminaes, which may be closely associated with the control of myofascial pain.

  17. Remote dose-dependent effects of dry needling at distant myofascial trigger spots of rabbit skeletal muscles on reduction of substance P levels of proximal muscle and spinal cords.

    Science.gov (United States)

    Hsieh, Yueh-Ling; Yang, Chen-Chia; Liu, Szu-Yu; Chou, Li-Wei; Hong, Chang-Zern

    2014-01-01

    Dry needling at distant myofascial trigger points is an effective pain management in patients with myofascial pain. However, the biochemical effects of remote dry needling are not well understood. This study evaluates the remote effects of dry needling with different dosages on the expressions of substance P (SP) in the proximal muscle, spinal dorsal horns of rabbits. Male New Zealand rabbits (2.5-3.0 kg) received dry needling at myofascial trigger spots of a gastrocnemius (distant muscle) in one (1D) or five sessions (5D). Bilateral biceps femoris (proximal muscles) and superficial laminaes of L5-S2, T2-T5, and C2-C5 were sampled immediately and 5 days after dry needling to determine the levels of SP using immunohistochemistry and western blot. Immediately after dry needling for 1D and 5D, the expressions of SP were significantly decreased in ipsilateral biceps femoris and bilateral spinal superficial laminaes (P dry needling, these reduced immunoactivities of SP were found only in animals receiving 5D dry needling (P dry needling involves the reduction of SP levels in proximal muscle and spinal superficial laminaes, which may be closely associated with the control of myofascial pain.

  18. Does myofascial and trigger point treatment reduce pain and analgesic intake in patients undergoing OnabotulinumtoxinA injection due to chronic intractable migraine? A pilot, single-blind randomized controlled trial.

    Science.gov (United States)

    Gandolfi, Marialuisa; Geroin, Christian; Valè, Nicola; Marchioretto, Fabio; Turrina, Andrea; Dimitrova, Eleonora; Tamburin, Stefano; Serina, Anna; Castellazzi, Paola; Meschieri, Andrea; Ricard, François; Saltuari, Leopold; Picelli, Alessandro; Smania, Nicola

    2017-07-27

    Chronic migraine is a disabling disorder associated with myofascial and trigger point disorders in the neck. Pharmacological management is the first line of treatment; however, rehabilitation procedures aimed at lessening symptoms of myofascial and trigger point disorders may add value in the management of headache symptoms. To evaluate the feasibility of myofascial and trigger point treatment in chronic migraine patients receiving prophylactic treatment with onabotulinumtoxinA. To evaluate the treatment effects on headache frequency and intensity, analgesic consumption, cervical range of motion, trigger point pressure pain threshold, quality of life, and disability. Pilot, single-blind randomized controlled trial with two parallel groups. Neurorehabilitation unit. 22 outpatients with chronic migraine. Patients were randomly assigned to receive either cervicothoracic manipulative treatment (n=12) or transcutaneous electrical nerve stimulation (TENS) in the upper trapezius (n=10). Treatment consisted of 4 sessions (30 min/session, 1 session/week for 4 weeks). A rater blinded to treatment allocation evaluated outcomes before treatment, during treatment, and 1 month after the end of treatment. Consistent with the pilot nature of the study, feasibility was considered the primary outcome and efficacy the secondary outcome. All patients completed the study. No adverse events were reported. No significant between-group differences in pain intensity were observed during the study period. At post-treatment evaluation, the total consumption of analgesics (p=.02) and non-steroidal anti-inflammatory (p=.02) drugs was significantly lower in the manipulative treatment group than in the TENS group. These effects paralleled significant improvements in trigger point sensitivity and cervical active range of motion. Manipulative techniques aimed at reducing peripheral nociceptive triggers might add value in the management of chronic migraine symptoms and lower acute medication use

  19. Eficácia da desativação dos pontos-gatilho miofasciais para o controle do zumbido Efficacy of myofascial trigger point deactivation for tinnitus control

    Directory of Open Access Journals (Sweden)

    Carina Bezerra Rocha

    2012-12-01

    Full Text Available Dor crônica nas imediações do ouvido pode influenciar o zumbido. OBJETIVO: Investigar a eficácia da desativação de pontos-gatilho miofasciais na melhora do zumbido. MÉTODO: Ensaio clínico randomizado com 71 pacientes com zumbido e síndrome dolorosa miofascial. O Grupo Experimental (n = 37 foi submetido a 10 sessões de desativação dos pontos-gatilho miofasciais e o Grupo Controle (n = 34, a 10 sessões de desativação placebo. RESULTADOS: O tratamento do Grupo Experimental foi eficaz para o controle do zumbido (p Chronic pain in areas surrounding the ear may influence tinnitus. OBJECTIVE: To investigate the efficacy of myofascial trigger point deactivation for the relief of tinnitus. METHOD: A double-blind randomized clinical trial enrolled 71 patients with tinnitus and myofascial pain syndrome. The experimental group (n = 37 underwent 10 sessions of myofascial trigger point deactivation and the control group (n = 34, 10 sessions with sham deactivation. RESULTS: Treatment of the experimental group was effective for tinnitus relief (p < 0.001. Pain and tinnitus relieves were associated (p = 0.013, so were the ear with worst tinnitus and the side of the body with more pain (p < 0.001. The presence of temporary tinnitus modulation (increase or decrease upon initial muscle palpation was frequent in both groups, but its temporary decrease was related to the persistent relief at the end of treatment (p = 0.002. CONCLUSION: Besides medical and audiological investigation, patients with tinnitus should also be checked for: 1 presence of myofascial pain surrounding the ear; 2 laterality between both symptoms; 3 initial decrease of tinnitus during muscle palpation. Treating this specific subgroup of tinnitus patients with myofascial trigger point release may provide better results than others described so far.

  20. An evidence-informed review of the current myofascial pain literature--January 2015.

    Science.gov (United States)

    Dommerholt, Jan; Grieve, Rob; Layton, Michelle; Hooks, Todd

    2015-01-01

    This article provides an up-to-date review of the most recent publications about myofascial pain, trigger points (TrPs) and other related topics. We have added some commentaries where indicated with supporting references. In the Basic Research section, we reviewed the work by Danish researchers about the influence of latent TrPs and a second study of the presence and distribution of both active and latent TrPs in whiplash-associated disorders. The section on Soft Tissue Approaches considered multiple studies and case reports of the efficacy of myofascial release (MFR), classic and deep muscle massage, fascial techniques, and connective tissue massage. Dry needling (DN) is becoming a common approach and we included multiple studies, reviews, and case reports, while the section on Injection Techniques features an article on TrP injections following mastectomy and several articles about the utilization of botulinum toxin. Lastly, we review several articles on modalities and other clinical approaches.

  1. Characteristics of referred muscle pain to the head from active trigger points in women with myofascial temporomandibular pain and fibromyalgia syndrome.

    Science.gov (United States)

    Alonso-Blanco, Cristina; Fernández-de-Las-Peñas, César; de-la-Llave-Rincón, Ana Isabel; Zarco-Moreno, Pedro; Galán-Del-Río, Fernando; Svensson, Peter

    2012-11-01

    Our aim was to compare the differences in the prevalence and the anatomical localization of referred pain areas of active trigger points (TrPs) between women with myofascial temporomandibular disorder (TMD) or fibromyalgia (FMS). Twenty women (age 46 ± 8 years) with TMD and 20 (age 48 ± 6 years) with FMS were recruited from specialized clinic. Bilateral temporalis, masseter, sternocleidomastoid, upper trapezius, and suboccipital muscles were examined for TrPs. TrPs were identified by palpation and considered active when the pain reproduced familiar pain symptom experienced by the patient. The referred pain areas were drawn on anatomical maps, digitalized and also measured. A new analysis technique based on a center of gravity (COG) method was used to quantitative estimate of the localization of the TrP referred pain areas. Women with FMS exhibited larger areas of usual pain symptoms than women with myofascial TMD (P pain on the frontal and posterior pain maps were located more superior in TMD than in FMS. The number of active TrPs was significantly higher in TMD (mean ± SD 6 ± 1) than in FMS (4 ± 1) (P = 0.002). Women with TMD exhibited more active TrPs in the temporalis and masseter muscles than FMS (P pain areas than those with TMD for sternocleidomastoid and suboccipital muscles (P pain areas were found in TMD, the referred pain was more pronounced in the orofacial region, whereas the referred pain in FMS was more pronounced in the cervical spine. This study showed that the referred pain elicited from active TrPs shared similar patterns as usual pain symptoms in women with TMD or FMS, but that distinct differences in TrP prevalence and location of the referred pain areas could be observed. Differences in location of referred pain areas may help clinicians to determine the most relevant TrPs for each pain syndrome in spite of overlaps in pain areas.

  2. PENURUNAN NYERI DAN DISABILITAS DENGAN INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUES (INIT DAN MASSAGE EFFLEURAGE PADA MYOFASCIAL TRIGGER POINT SYNDROME OTOT TRAPESIUS BAGIAN ATAS

    Directory of Open Access Journals (Sweden)

    Veni Fatmawati

    2013-07-01

    Full Text Available Myofascia Trigger Point Syndrome (MTrPs is trigger point muscle happens in musculoskeletal. Factors which strengthen and trigger the emerge of MTrPs are the muscle contraction which happens continuously, poor body position, wrong body position or movement, poor occupation activity and unsuitable workplace arrangement that affect the unergonomic work behavior. The objective of this reseacrh is to reveal the effectivity of  integrated neuromuscular  inhibition techniques (init and massage efflurage in decreasing pain and disability in myofasial trigger point of upper trapesius muscle. The subjects this research are 34 people which are taken randomly in Puskesmas 2 Kartosuro, Surakarta with 17 samples of each group. Group 1 is integrated neuromuscular inhibition techniques (init and group 2 is massage efflurage. The data used in this research is NDI scale taken before and after therapy. The data collected is processed by using differential test through computer base of SPSS 15.0 version. The data analysis by using paired sample t-test, in group 1 the data resulted before therapy is 48,35±6,68 and the data resulted after therapy is 25,94±5,87 with p = 0,000 (p < 0,05. Whereas in group 2, the  resulted before therapy is 47,53±5,17 and the data resulted before therapy is 28,00±8,91 with p = 0,000 (p < 0,05. To conclude, based on the data resulted in this research, integrated neuromuscular  inhibition techniques (init and massage effleurage are there is no difference decrease pain and disability in myofascial trigger point of upper trapezius muscle.

  3. Modificaciones del umbral de dolor en un punto gatillo miofascial tras técnica de energía muscular Changes in pain threshold in myofascial trigger point after muscle energy technique

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    J.C. Zuil Escobar

    2010-10-01

    écnica de energía muscular en el punto gatillo miofascial latente 1 del trapecio superior ha mostrado un aumento inmediato en el umbral de dolor, quien no se mantuvo a las 24horas. Son necesarias investigaciones con una muestra mayor y con sujetos sintomáticos.Aims: Evaluate the changes in pressure pain threshold in latent myofascial trigger points 1 of the upper trapezius after a muscle energy technique application and evaluate intra-tester reliability of an analogue algometer on this point. Material y methods: A total of 35 asymptomatic subjects with latent upper trapezius myofascial trigger point 1 were randomized in two groups: one group was treated with a muscle energy technique (group 1 and the other one (control, group 2 was not treated. Demographic variables, such as gender, age, height and weight, and pressure pain threshold was evaluated. Pressure pain threshold was evaluated using an analogue algometer three times: before the intervention, five minutes post-intervention and 24h post-intervention. For quantitative variables statistical analysis, means, ranges and standard deviations wer used; and for qualitative variables, percentages and frequencies. For inter-tester reliability intra-class correlation coefficient was used. A two-way analysis of variance for repeated measurements was used for pressure pain threshold differences. The statistical analysis was performed using a 95% confidence level. Results: Intra-class correlation coefficient showed values ranging from 0.82-0.92. No significant differences were observed for baseline values. Analysis of variance showed significant effects for time and interaction between time and group. Group 1 showed a significant increase in pressure pain threshold after five minutes intervention, but this disappeared at 24h post intervention. Group 2 showed no significant differences. Conclusions: Inter-tested reliabilty of pressure pain threshold was good. Muscle energy technique in latent upper trapezius trigger point 1 has

  4. A Comparative Study of Trigger Point Therapy with Local Anaesthetic (0.5 % Bupivacaine) Versus Combined Trigger Point Injection Therapy and Levosulpiride in the Management of Myofascial Pain Syndrome in the Orofacial Region.

    Science.gov (United States)

    Gupta, Pranav; Singh, Virendra; Sethi, Sujata; Kumar, Arun

    2016-09-01

    To compare the efficacy of combined local anesthetic injection with 0.5 % bupivacaine and levosulpiride versus local anesthetic injection alone on outcome measures including levels of pain intensity and depression in the management of myofascial pain syndrome in orofacial region. This was a prospective, randomized, controlled and open-label comparative clinical study. Seventy-four patients diagnosed to have myofascial pain syndrome and fulfilling the inclusion criteria were enrolled for the study. Patients were randomly assigned into 2 groups. Group A received local anesthetic injection (0.5 % bupivacaine) on trigger points and Group B received combined trigger point injection therapy and 50 mg of tablet Levosulpiride orally B.I.D. They were assessed for pain intensity and depression at baseline and at follow-up of 1, 4, 6 and 12 week intervals. The mean age of patients was 44.54 + 15.977 years in group A and 39.97 + 14.107 years in group B (P value = 0.2). Group A comprised of 25 females (67.567 %) and 12 males (32.432 %) while group B had 27 females (75 %) and 9 males (25 %). 70.27 % were diagnosed with moderate depression in group A and 75 % in group B. 18.91 % in group A and 19.44 % in group B were diagnosed with severe depression. When the VAS score and BDI score was compared at the follow-up intervals with the baseline scores in both treatment groups, the mean difference was highly significant at all the follow-up intervals. However when the relative efficacies of two interventions were compared between the two groups, improvement in pain was significant at all the follow-up intervals except the 1st week follow-up whereas the improvement in depression was non-significant at 1st and 4th week interval while it was highly significant at 6th and 12th week intervals. The combined therapy with trigger point injection and levosulpiride as antidepressant significantly reduces pain and depression in the study subjects suffering from chronic

  5. The effectiveness of myofascial deep dry needling versus superficial dry needling in the treatment of Trapezius Myofascial Pain Syndrome

    OpenAIRE

    2012-01-01

    M.Tech. Purpose: The purpose of this study is to investigate whether needling active trigger points in the upper fibres of the trapezius muscle, using myofascial deep dry needling versus superficial dry needling is effective in the treatment of Trapezius Myofascial Pain Syndrome. Method: Forty participants underwent a general screening to determine whether they have active myofascial trigger points in the upper fibres of the Trapezius muscle. The general screening was done by using a pince...

  6. Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Pavlos Bobos

    2016-01-01

    Full Text Available Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs. Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67 completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05. However, no differences were found within and between the therapeutic groups (p<0.05 in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

  7. Efficacy of myofascial trigger point dry needling in the prevention of pain after total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial.

    Science.gov (United States)

    Mayoral, Orlando; Salvat, Isabel; Martín, María Teresa; Martín, Stella; Santiago, Jesús; Cotarelo, José; Rodríguez, Constantino

    2013-01-01

    The aim of this study was to determine whether the dry needling of myofascial trigger points (MTrPs) is superior to placebo in the prevention of pain after total knee arthroplasty. Forty subjects were randomised to a true dry needling group (T) or to a sham group (S). All were examined for MTrPs by an experienced physical therapist 4-5 hours before surgery. Immediately following anesthesiology and before surgery started, subjects in the T group were dry needled in all previously diagnosed MTrPs, while the S group received no treatment in their MTrPs. Subjects were blinded to group allocation as well as the examiner in presurgical and follow-up examinations performed 1, 3, and 6 months after arthroplasty. Subjects in the T group had less pain after intervention, with statistically significant differences in the variation rate of the visual analogue scale (VAS) measurements 1 month after intervention and in the need for immediate postsurgery analgesics. Differences were not significant at 3- and 6-month follow-up examinations. In conclusion, a single dry needling treatment of MTrP under anaesthesia reduced pain in the first month after knee arthroplasty, when pain was the most severe. Results show a superiority of dry needling versus placebo. An interesting novel placebo methodology for dry needling, with a real blinding procedure, is presented.

  8. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility.

    Science.gov (United States)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders H; Hartvigsen, Jan

    2011-04-01

    A diagnosis of Myofascial Pain Syndrome (MPS) requires palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies currently exist from which to draw firm conclusions regarding the robustness of TP examination. An inter-observer agreement study was conducted using two experienced and two inexperienced clinicians. All performed standardized palpation of the upper Trapezius musculature, judging the clinical relevance of TP(s) using clinician global assessment (GA). A random case mix of 81 female participants was examined, 14 asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor skills training and video feedback analysis to improve protocol standardization. Kappa co-efficient calculations indicated good agreement between the experienced pairing (κ = 0.63), moderate agreement between the mixed pairings (κ = 0.35 and 0.47) and poor agreement between the inexperienced pairing (κ = 0.22). Inter-observer agreement was not stable with the experienced pairing exhibiting a sharp decline in agreement during the latter portion of the study. Identification of clinically relevant TPs of the upper Trapezius musculature is reproducible when performed by two experienced clinicians, however, a mixed observer pairing can yield acceptable agreement. A protracted period of data collection may be detrimental to inter-observer agreement; more investigation is needed in this regard.

  9. The effect of dry needling on pain, pressure pain threshold and disability in patients with a myofascial trigger point in the upper trapezius muscle.

    Science.gov (United States)

    Ziaeifar, Maryam; Arab, Amir Massoud; Karimi, Noureddin; Nourbakhsh, Mohammad Reza

    2014-04-01

    Dry needling (DN) has been used recently by physical therapists as a therapy of choice for patients with myofascial trigger points (TrP). The purpose of this randomized controlled trial was to investigate the effect of DN in the treatment of TrPs in the upper trapezius (UT) muscle. A sample of convenience of 33 patients with TrP in the UT muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 16). The treatment protocol for the standard group consisted of trigger point compression technique (TCT) on MTP, while the patients in the experimental group received DN. Pain intensity and pressure pain thresholds were assessed for both groups before and after the treatment sessions. In addition, the Disability of Arm, Hand, and Shoulder (DASH) was administered. Statistical analysis (paired t-test) revealed a significant improvement in pain, PPT and DASH scores after treatment in the experimental (DN) and standard (TCT) group compared with before treatment (P < 0.05). The ANCOVA revealed significant differences between the DN and TCT groups on the post-measurement VAS score (P = 0.01). There was, however, no significant difference between the two groups on the post-measurement score of the PPT (P = 0.08) and DASH (P = 0.34). DN produces an improvement in pain intensity, PPT and DASH and may be prescribed for subjects with TrP in UT muscles especially when pain relief is the goal of the treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Liu, Lin; Huang, Qiang-Min; Liu, Qing-Guang; Thitham, Nguyen; Li, Li-Hui; Ma, Yan-Tao; Zhao, Jia-Min

    2017-07-08

    To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP). PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017. Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included. Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up. A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], -1.06; 95% confidence interval [CI], -1.77 to -0.36; P=.003) and functional disability (SMD, -0.76; 95% CI, -1.46 to -0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55-1.11; Pdry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Deep dry needling of trigger points located in the lateral pterygoid muscle: Efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction.

    Science.gov (United States)

    Gonzalez-Perez, Luis-Miguel; Infante-Cossio, Pedro; Granados-Nunez, Mercedes; Urresti-Lopez, Francisco-Javier; Lopez-Martos, Ricardo; Ruiz-Canela-Mendez, Pablo

    2015-05-01

    To determine whether deep dry needling (DDN) of trigger points (TPs) in the lateral pterygoid muscle (LPM) would significantly reduce pain and improve function, compared with methocarbamol/paracetamol medication. Forty-eight patients with chronic myofascial pain located in the LPM were selected and randomly assigned to one of two groups (DDN test group, n=24; drug-treated control group, n=24). The test group received three applications of needling of the LPM once per week for three weeks, while control group patients were given two tablets of a methocarbamol/paracetamol combination every six hours for three weeks. Assessments were carried out pre-treatment, 2 and 8 weeks after finishing the treatment. A statistically significant difference (p<0.05) was detected for both groups with respect to pain reduction at rest and with mastication, but the DDN test group had significantly better levels of pain reduction. Moreover, statistically significant differences (p<0.05) up to day 70 in the test group were seen with respect to maximum mouth opening, laterality and protrusion movements compared with pre-treatment values. Pain reduction in the test group was greater as a function of pain intensity at baseline. The evaluation of efficacy as assessed both by patients/investigators was better for the test group. 41% of the patients receiving the combination drug treatment described unpleasant side effects (mostly drowsiness). DDN of TPs in the LPM showed better efficacy in reducing pain and improving maximum mouth opening, laterality, and protrusion movements compared with methocarbamol/paracetamol treatment. No adverse events were observed with respect to DDN.

  12. [Cervical myofascial pain syndrome. Narrative review of physiotherapeutic treatment].

    Science.gov (United States)

    Capó-Juan, M A

    2015-01-01

    Pain is a complex and multifactorial phenomenon that depends on the interaction of biopsychosocial factors. Between 15-25% of adults suffer from chronic pain at some point in their lives. Cervical chronic pain is considered a public health problem affecting 9.6% men and 21.9% women, according to the latest National Health Survey 2011-12. A high percentage of medical consultations due to muscle pain turn out to be myofascial pain syndrome (MPS). Its existence implies the presence of myofascial trigger points which can be latent or active throughout the whole population. The aim of this review is to update knowledge in the various therapies applied by the physiotherapist in the treatment of this syndrome at cervical level. From the review it appears that some of the most used techniques that may be useful in the short or medium term are: ischemic compression and/or trigger point pressure release and dry needling. Furthermore, various combinations of treatment modalities are used to treat this syndrome, taking other aspects into account, such as education.

  13. Myofascial pain syndromes and their evaluation.

    Science.gov (United States)

    Giamberardino, Maria Adele; Affaitati, Giannapia; Fabrizio, Alessandra; Costantini, Raffaele

    2011-04-01

    This article reviews the available published knowledge about the diagnosis, pathophysiology and treatment of myofascial pain syndromes from trigger points. Furthermore, epidemiologic data and clinical characteristics of these syndromes are described, including a detailed account of sensory changes that occur at both painful and nonpainful sites and their utility for diagnosis and differential diagnosis; the identification/diagnostic criteria available so far are critically reviewed. The key role played by myofascial trigger points as activating factors of pain symptoms in other algogenic conditions--headache, fibromyalgia and visceral disease--is also addressed. Current hypotheses on the pathophysiology of myofascial pain syndromes are presented, including mechanisms of formation and persistence of primary and secondary trigger points as well as mechanisms beyond referred pain and hyperalgesia from trigger points. Conventional and most recent therapeutic options for these syndromes are described, and their validity is discussed on the basis of results from clinical controlled studies.

  14. A Multimodal Approach for Myofascial Pain Syndrome: A Prospective Study.

    Science.gov (United States)

    Segura-Pérez, María; Hernández-Criado, M Teresa; Calvo-Lobo, César; Vega-Piris, Lorena; Fernández-Martín, Raquel; Rodríguez-Sanz, David

    The purpose of this study was to analyze pain intensity in patients with myofascial pain syndrome (MPS) following a multimodal rehabilitation protocol. A prospective study was carried out following the Template for Intervention Description and Replication criteria. Patients were recruited from the rehabilitation unit of a university hospital in Spain between 2009 and 2013. Patients were included if they had a medical diagnosis of MPS in any of the following regions: cervicobrachial (n = 102), lumbosacral (n = 30), elbow (n = 14), ankle and foot (n = 10), and temporomandibular jaw (n = 1). The multimodal rehabilitation protocol included myofascial trigger point dry needling, spray and stretching, Kinesio taping, eccentric exercise, and patient education. The protocol was applied for 4 weeks (5 sessions) for the active and/or latent myofascial trigger points in each body region. Pain intensity was measured by using the visual analog scale (VAS) immediately before beginning of the study and 1 week after completion of the protocol. The study sample comprised 150 patients (mean ± standard deviation age, 51.5 ± 1.19 years). Statistically significant differences were obtained for reduction in pain intensity (4 ± 2.03; P = .002). Clinically relevant reductions (VAS ≥30 mm; P < .001) were obtained in 78.7% of the interventions. Four treatment sessions reduced the VAS score by 10 mm in 83.55% of the sample. There were no statistically significant differences (P = .064) for reduction in pain intensity in the different body regions. A multimodal rehabilitation protocol showed clinically relevant differences in the reduction in pain intensity in different body regions in patients with MPS. Copyright © 2017. Published by Elsevier Inc.

  15. Referred pain from myofascial trigger points in head, neck, shoulder, and arm muscles reproduces pain symptoms in blue-collar (manual) and white-collar (office) workers.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Gröbli, Christian; Ortega-Santiago, Ricardo; Fischer, Christine Stebler; Boesch, Daniel; Froidevaux, Philippe; Stocker, Lilian; Weissmann, Richard; González-Iglesias, Javier

    2012-07-01

    To describe the prevalence and referred pain area of trigger points (TrPs) in blue-collar (manual) and white-collar (office) workers, and to analyze if the referred pain pattern elicited from TrPs completely reproduces the overall spontaneous pain pattern. Sixteen (62% women) blue-collar and 19 (75% women) white-collar workers were included in this study. TrPs in the temporalis, masseter, upper trapezius, sternocleidomastoid, splenius capitis, oblique capitis inferior, levator scapulae, scalene, pectoralis major, deltoid, infraspinatus, extensor carpi radialis brevis and longus, extensor digitorum communis, and supinator muscles were examined bilaterally (hyper-sensible tender spot within a palpable taut band, local twitch response with snapping palpation, and elicited referred pain pattern with palpation) by experienced assessors blinded to the participants' condition. TrPs were considered active when the local and referred pain reproduced any symptom and the patient recognized the pain as familiar. The referred pain areas were drawn on anatomic maps, digitized, and measured. Blue-collar workers had a mean of 6 (SD: 3) active and 10 (SD: 5) latent TrPs, whereas white-collar workers had a mean of 6 (SD: 4) active and 11 (SD: 6) latent TrPs (P>0.548). No significant differences in the distribution of active and latent TrPs in the analyzed muscles between groups were found. Active TrPs in the upper trapezius, infraspinatus, levator scapulae, and extensor carpi radialis brevis muscles were the most prevalent in both groups. Significant differences in referred pain areas between muscles (Pmuscles showed the largest referred pain areas (Pmuscles showed the smallest (Pmuscle TrPs in blue-collar and white-collar workers.

  16. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice.

    Science.gov (United States)

    Njoo, K H; Van der Does, E

    1994-09-01

    The presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger point symptoms. Using the symptoms and signs as described by Simons' 1990 definition and two other former sets of criteria, 61 non-specific low back pain patients and 63 controls were examined in general practice by 5 observers, working in pairs. From the two major criteria of Simons' 1990 definition only 'localized tenderness' has good discriminative ability and inter-rater reliability (kappa > 0.5). This study does not find proof for the clinical usefulness of 'referred pain', which has neither of these two abilities. The criteria 'jump sign' and 'recognition', on the condition that localized tenderness is present, also have good discriminative ability and inter-rater reliability. Trigger points defined by the criteria found eligible in this study allow significant distinction between non-specific low back pain patients and controls. This is not the case with trigger points defined by Simons' 1990 criteria. Concerning reliability there is also a significant difference between the two different criteria sets. This study suggests that the clinical usefulness of trigger points is increased when localized tenderness and the presence of either jump sign or patient's recognition of his pain complaint are used as criteria for the presence of trigger points in the M. quadratus lumborum and the M. gluteus medius.

  17. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Lin; Huang, Qiang-Min; Liu, Qing-Guang; Ye, Gang; Bo, Cheng-Zhi; Chen, Meng-Jin; Li, Ping

    2015-05-01

    To evaluate current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with neck and shoulder pain. PubMed, EBSCO, Physiotherapy Evidence Database, ScienceDirect, The Cochrane Library, ClinicalKey, Wanfang Data Chinese database, China Knowledge Resource Integrated Database, Chinese Chongqing VIP Information, and SpringerLink databases were searched from database inception to January 2014. Randomized controlled trials were performed to determine whether dry needling was used as the main treatment and whether pain intensity was included as an outcome. Participants were diagnosed with MTrPs associated with neck and shoulder pain. Two reviewers independently screened the articles, scored methodological quality, and extracted data. The results of the study of pain intensity were extracted in the form of mean and SD data. Twenty randomized controlled trials involving 839 patients were identified for meta-analysis. Meta-analyses were performed using RevMan version 5.2 and Stata version 12.0. The results suggested that compared with control/sham, dry needling of MTrPs was effective in the short term (immediately to 3 days) (standardized mean difference [SMD]=-1.91; 95% confidence interval [CI], -3.10 to -.73; P=.002) and medium term (SMD=-1.07; 95% CI, -1.87 to -.27; P=.009); however, wet needling (including lidocaine) was superior to dry needling in relieving MTrP pain in the medium term (SMD=1.69; 95% CI, .40-2.98; P=.01). Other therapies (including physiotherapy) were more effective than dry needling in treating MTrP pain in the medium term (9-28d) (SMD=.62; 95% CI, .02-1.21; P=.04). Dry needling can be recommended for relieving MTrP pain in neck and shoulders in the short and medium term, but wet needling is found to be more effective than dry needling in relieving MTrP pain in neck and shoulders in the medium term. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Myofascial low back pain: a review.

    Science.gov (United States)

    Malanga, Gerard A; Cruz Colon, Eduardo J

    2010-11-01

    Myofascial pain syndrome is a common nonarticular local musculoskeletal pain syndrome caused by myofascial trigger points located at muscle, fascia, or tendinous insertions, affecting up to 95% of people with chronic pain disorders. Clinically, myofascial pain syndrome can present as painful restricted range of motion, stiffness, referred pain patterns, and autonomic dysfunction. The underlying cause is often related to muscular imbalances, and following a thorough physical examination the condition should be treated with a comprehensive rehabilitation program. Additional treatment options include pharmacologic, needling with or without anesthetic agents or nerve stimulation, and alternative medicine treatments such as massage or herbal medicines. Repeated trigger point injections should be avoided, and corticosteroids should not be injected into trigger points. Copyright © 2010 Elsevier Inc. All rights reserved.

  19. Effect of Trigger Point of Myofascial Pain for Treatment of Low Back Myofascial Pain Syndrome%肌筋膜疼痛触发点治疗技术治疗腰背肌筋膜疼痛综合征疗效分析

    Institute of Scientific and Technical Information of China (English)

    龙佳佳; 庄小强; 谭树生

    2011-01-01

    Objective:To evaluate the superiority effect of trigger point of myofascial pain for treatment of low back myofas-cial pain syndrome. Methods: All 500 patients met the diagnostic criteria were randomly divided into treatment group and control group, with 250 cases in each group. The patients of treatment group were treated with trigger point of myofascial pain technology (acupuncture and massage therapy), while the control group were treated with tizanidine, all the patients were treated every other day, for 7 days was a course of treatment. The two groups were compared each other before and 8 courses after treatment. Results: The index of pain, functional status, and induration cords were decreased after treatment in both groups (P<0. 05). There were 100 cases cured (accounting for 40. 00%), 78 cases effective (accounting for 31. 20%), 61 cases improved (accounting for 24. 40%), and 11 cases ineffective (accounting for 4. 40%), with the total efficiency of 95. 60% in the treatment group. While, there were 80 cases cured (accounting for 32. 00%), 92 cases effective (accounting for 36. 80%), 41 cases improved (accounting for 16. 40%), and 37 cases ineffective (accounting for 14. 80%), with the total efficiency of 85. 20% in the control group. The therapeutic effects was significant difference between two groups (P<0. 05). Conclusion: It is effective for using trigger point of myofascial pain for treatment of low back myofascial pain syndrome, and which is superior to tizanidine therapeutic, so it is worthy for further research and extension.%目的:评价利用肌筋膜疼痛触发点治疗腰背肌筋膜疼痛综合征临床疗效的优越性.方法:将500例符合诊断标准的患者随机分为治疗组和对照组,每组250例,治疗组采用肌筋膜疼痛触发点治疗技术(针刺和推拿疗法)进行治疗,对照组采用替扎尼定进行治疗;2组治疗均隔日1次,7d为1个疗程;治疗8个疗程后,进行2组自身治疗前后对照,以及2

  20. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction.

    Science.gov (United States)

    Aredo, Jacqueline V; Heyrana, Katrina J; Karp, Barbara I; Shah, Jay P; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections.

  1. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction

    Science.gov (United States)

    Aredo, Jacqueline V.; Heyrana, Katrina J.; Karp, Barbara I.; Shah, Jay P.; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections. PMID:28049214

  2. Progress of research on acupuncture at trigger point for myofascial pain syndrome%针刺激痛点治疗肌筋膜疼痛综合征研究进展

    Institute of Scientific and Technical Information of China (English)

    马尧; 布赫; 贾纪荣; 张雪

    2012-01-01

    To review the literature of acupuncture at trigger point for myofascial pain syndrome from the main selected points (trigger point), the mechanism of Chinese medicine and modern research and its clinical application. The results show that acupuncture at trigger point has significant effect on the myofascial pain syndrome, which could be influenced by the type of needle, manipulation, insertion angle and depth of the needles. However, the involved studies at present are still far from enough and lack of systematic study with multivariate analysis, it is needed to be improved that some problems about the clinical diagnosis and basic research.%从针刺治疗肌筋膜疼痛综合征的主要选穴(激痛点)、针刺激痛点治疗本痛的中医和现代研究机制及治疗该病时针刺激痛点的临床应用几个方面,对针刺激痛点治疗肌筋膜疼痛综合征的相关文献进行综述.结果表明针刺激痛点在治疗肌筋膜疼痛综合征中具有十分显著的疗效,且针刺激痛点时选择的针具、针刺的手法、角度、深度等各项参数对治疗肌筋膜疼痛综合征临床疗效有重要影响,但目前对此研究非常薄弱,缺乏多因素分析的系统性研究,且在临床诊断及基础性研究等方面有待改进.

  3. Comparing Trigger Point Dry Needling and Manual Pressure Technique for the Management of Myofascial Neck/Shoulder Pain: A Randomized Clinical Trial.

    Science.gov (United States)

    De Meulemeester, Kayleigh E; Castelein, Birgit; Coppieters, Iris; Barbe, Tom; Cools, Ann; Cagnie, Barbara

    2017-01-01

    The aim of this study was to investigate short-term and long-term treatment effects of dry needling (DN) and manual pressure (MP) technique with the primary goal of determining if DN has better effects on disability, pain, and muscle characteristics in treating myofascial neck/shoulder pain in women. In this randomized clinical trial, 42 female office workers with myofascial neck/shoulder pain were randomly allocated to either a DN or MP group and received 4 treatments. They were evaluated with the Neck Disability Index, general numeric rating scale, pressure pain threshold, and muscle characteristics before and after treatment. For each outcome parameter, a linear mixed-model analysis was applied to reveal group-by-time interaction effects or main effects for the factor "time." No significant differences were found between DN and MP. In both groups, significant improvement in the Neck Disability Index was observed after 4 treatments and 3 months (P Dry needling was found to be no more effective than MP in the treatment of myofascial neck/shoulder pain. Copyright © 2016. Published by Elsevier Inc.

  4. Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain.

    Science.gov (United States)

    Pastore, Elizabeth A; Katzman, Wendy B

    2012-01-01

    Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by health care providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, biofeedback, and electrical stimulation. An interdisciplinary team is essential for identifying and successfully treating MFPP.

  5. Occurrence of myofascial pain in patients with possible carpal tunnel syndrome - a single-blinded study

    DEFF Research Database (Denmark)

    Qerama, Erisela; Kasch, Helge; Fuglsang-Frederiksen, Anders

    2009-01-01

    There exits some similarity between symptoms of carpal tunnel syndrome (CTS) and myofascial pain related to trigger points (TPs) in the infraspinatus muscle.......There exits some similarity between symptoms of carpal tunnel syndrome (CTS) and myofascial pain related to trigger points (TPs) in the infraspinatus muscle....

  6. Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study.

    Science.gov (United States)

    Müller, Cristina Emöke Erika; Aranha, Maria Fernanda Montans; Gavião, Maria Beatriz Duarte

    2015-04-01

    Chronic pain has been often associated with myofascial pain syndrome (MPS), which is determined by myofascial trigger points (MTrP). New features have been tested for MTrP diagnosis. The aim of this study was to evaluate two-dimensional ultrasonography (2D US) and ultrasound elastography (UE) images and elastograms of upper trapezius MTrP during electroacupuncture (EA) and acupuncture (AC) treatment. 24 women participated, aged between 20 and 40 years (M ± SD = 27.33 ± 5.05) with a body mass index ranging from 18.03 to 27.59 kg/m2 (22.59 ± 3.11), a regular menstrual cycle, at least one active MTrP at both right (RTPz) and left trapezius (LTPz) and local or referred pain for up to six months. Subjects were randomized into EA and AC treatment groups and the control sham AC (SHAM) group. Intensity of pain was assessed by visual analogue scale; MTrP mean area and strain ratio (SR) by 2D US and UE. A significant decrease of intensity in general, RTPz, and LTPz pain was observed in the EA group (p = 0.027; p < 0.001; p = 0.005, respectively) and in general pain in the AC group (p < 0.001). Decreased MTrP area in RTPz and LTPz were observed in AC (p < 0.001) and EA groups (RTPz, p = 0.003; LTPz, p = 0.005). Post-treatment SR in RTPz and LTPz was lower than pre-treatment in both treatment groups. 2D US and UE effectively characterized MTrP and surrounding tissue, pointing to the possibility of objective confirmation of subjective EA and AC treatment effects. © The Author(s) 2014.

  7. Treatment experience of pulsed radiofrequency under ultrasound guided to the trapezius muscle at myofascial pain syndrome -a case report-.

    Science.gov (United States)

    Park, Chung Hoon; Lee, Yoon Woo; Kim, Yong Chan; Moon, Joo Hwa; Choi, Jong Bum

    2012-01-01

    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.

  8. Trigger pointy v širších souvislostech

    OpenAIRE

    Sobotková, Petra

    2010-01-01

    Title: Terminology problems in myofascial trigger points concept Objectives: The main aim of this work is to organize information in the field of myofascial pain syndrome and myofascial trigger points, and to show unclearness in using terminology. Another aim is to describe trigger points from the view of the etiology, the diagnosis and the therapy. Subsidiary aim is to evaluate the relation among trigger points, tender points and acupuncture points. Methods: Design review was used in this th...

  9. Paraspinal stimulation combined with trigger point needling and needle rotation for the treatment of myofascial pain: a randomized sham-controlled clinical trial.

    Science.gov (United States)

    Couto, Cláudio; de Souza, Izabel Cristina C; Torres, Iraci L S; Fregni, Felipe; Caumo, Wolnei

    2014-03-01

    There are different types and parameters of dry needling (DN) that can affect its efficacy in the treatment of pain that have not been assessed properly. To test the hypothesis that either multiple deep intramuscular stimulation therapy multiple deep intramuscular stimulation therapy (MDIMST) or TrP lidocaine injection (LTrP-I) is more effective than a placebo-sham for the treatment of myofascial pain syndrome (MPS) and that MDIMST is more effective than LTrP-I for improving pain relief, sleep quality, and the physical and mental state of the patient. Seventy-eight females aged 20 to 40 who were limited in their ability to perform active and routine activities due to MPS in the previous 3 months were recruited. The participants were randomized into 1 of the 3 groups as follows: placebo-sham, LTrP-I, or MDIMST. The treatments were provided twice weekly over 4 weeks using standardized MDIMST and LTrP-I protocols. There was a significant interaction (time vs. group) for the main outcomes. Compared with the sham-treated group, MDIMST and LTrP-I administration improved pain scores based on a visual analog scale, the pain pressure threshold (Pphysical and mental health scores. This study highlighted the greater efficacy of MDIMST over the placebo-sham and LTrP-I and indicated that both active treatments are more effective than placebo-sham for MPS associated with limitations in active and routine activities.

  10. 平刺和直刺肌筋膜触发点治疗颈型颈椎病疗效比较%Comparison of the Efficacies of Transverse Needling Versus Perpendicular Needling at Myofascial Trigger Points in Treating Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    王翀敏; 王延武; 楚佳梅; 朱敏

    2016-01-01

    Objective To compare the efficacies of transverse needling versus perpendicular needling at myofascial trigger points in treating cervical spondylosis and sift out a needling direction for a better improving effect on myofascial pain syndrome such as cervical spondylosis. Method One hundred and six patients with cervical spondylosis were randomly allocated to two groups. The transverse needling group received transverse needling at myofascial trigger points and the perpendicular needling group, perpendicular needling at myofascial trigger points. The symptoms and signs of cervical spondylosis were scored and the VAS score was recorded in the two groups before and after treatment. Result In the two groups, the VAS score had a statistically significant pre-/post-treatment difference (P0.05). In the two groups, the cervical spondylotic symptom and sign score had a statistically significant pre-/post-treatment difference (P<0.05) and decreased after treatment. The cervical spondylotic symptom and sign score was significantly lower in the transverse needling group than in the perpendicular needling group after treatment; there was a statistically significant difference between the two groups (P<0.05). The total efficacy rate was 94.0% in the transverse needling group, which was higher than 79.6% in the perpendicular needling group; there was a statistically significant difference between the two groups (P<0.05). Conclusion Both transverse needling and perpendicular needling can remove myofascial trigger points and treat cervical spondylosis, but transverse needling at myofascial trigger points is superior to perpendicular needling at myofascial trigger points.%目的:比较平刺和直刺肌筋膜触发点治疗颈型颈椎病的疗效差异;并筛选出改善颈型颈椎病等肌筋膜疼痛综合征的更高效的针刺方向。方法将106例颈型颈椎病患者随机分为两组,平刺组采用平刺肌筋膜触发点进行治疗,直刺组采用直刺肌

  11. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The hardware of the trigger components has been mostly finished. The ECAL Endcap Trigger Concentrator Cards (TCC) are in production while Barrel TCC firmware has been upgraded, and the Trigger Primitives can now be stored by the Data Concentrator Card for readout by the DAQ. The Regional Calorimeter Trigger (RCT) system is complete, and the timing is being finalized. All 502 HCAL trigger links to RCT run without error. The HCAL muon trigger timing has been equalized with DT, RPC, CSC and ECAL. The hardware and firmware for the Global Calorimeter Trigger (GCT) jet triggers are being commissioned and data from these triggers is available for readout. The GCT energy sums from rings of trigger towers around the beam pipe beam have been changed to include two rings from both sides. The firmware for Drift Tube Track Finder, Barrel Sorter and Wedge Sorter has been upgraded, and the synchronization of the DT trigger is satisfactory. The CSC local trigger has operated flawlessly u...

  12. TRIGGER

    CERN Multimedia

    Roberta Arcidiacono

    2013-01-01

    Trigger Studies Group (TSG) The Trigger Studies Group has just concluded its third 2013 workshop, where all POGs presented the improvements to the physics object reconstruction, and all PAGs have shown their plans for Trigger development aimed at the 2015 High Level Trigger (HLT) menu. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger menu development, path timing, Trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – this last task in collaboration with PdmV (Physics Data and Monte Carlo Validation group). In the last months the group has delivered several HLT rate estimates and comparisons, using the available data and Monte Carlo samples. The studies were presented at the Trigger workshops in September and December, and STEAM has contacted POGs and PAGs to understand the origin of the discrepancies observed between 8 TeV data and Monte Carlo simulations. The most recent results show what the...

  13. Range of motion and cervical myofascial pain.

    Science.gov (United States)

    Wilke, J; Niederer, D; Fleckenstein, J; Vogt, L; Banzer, W

    2016-01-01

    Several studies investigating myofascial pain syndrome include assessments of range of motion (ROM) as a diagnostic criterion. However, the value of ROM in this context has not yet been evaluated in controlled clinical studies. We aimed to examine whether patients with myofascial pain syndrome display alterations of ROM when compared to healthy subjects. Twenty-two individuals (13 females, 9 males; aged 33.4 ± 13.9 yrs) afflicted with active myofascial trigger points in the upper trapezius muscle as well as 22 age and sex matched healthy controls were included. All subjects underwent an examination of maximal active cervical ROM in flexion/extension assessed by means of a 3D ultrasonic movement analysis system (30 Hz; Zebris CMS 70). In the patients group, pressure pain threshold (PPT) of the trigger points was determined using a pressure algometer. Maximum range of motion in the sagittal plane did not differ between individuals with MTrP (125.9 ± 23.2°, 95% CI: 116.2-135.6°) and asymptomatic subjects (128.2 ± 20.4°, 95% CI: 119.7-136.7°; p > .05). In patients, PPT (1.7 ± .6, 95% CI: 1.5-1.9) was not correlated with cervical mobility (r = -.13; p > .05). Based on these pilot data, range of motion in flexion/extension is not a valid criterion for the detection of myofascial trigger points. Additional research incorporating movement amplitudes in other anatomical planes and additional afflicted muscles should be conducted in order to further delineate the relative impact of MTrP on range of motion.

  14. Incidence of myofascial pain syndrome in breast cancer surgery: a prospective study.

    Science.gov (United States)

    Torres Lacomba, María; Mayoral del Moral, Orlando; Coperias Zazo, José Luís; Gerwin, Robert D; Goñí, Alvaro Zapico

    2010-05-01

    Pain after breast cancer therapy is a recognized complication found to have an adverse impact on patient's quality of life, increasing psychosocial distress. In recent years, case reports about myofascial pain syndrome are emerging in thoracic surgery as a cause of postsurgery pain. Myofascial pain syndrome is a regional pain syndrome characterized by myofascial trigger points in palpable taut bands of skeletal muscle that refers pain a distance, and that can cause distant motor and autonomic effects. The objective of this study was to assess the incidence of myofascial pain syndrome prospectively 12 months after breast cancer surgery. Each participant was assessed preoperatively, postoperatively between day 3 and day 5, and at 1, 3, 6, and 12 months after surgery. A physical therapist, expert in the diagnosis of myofascial pain syndrome, performed follow-up assessments. Pain descriptions by the patients and pain pattern drawings in body forms guided the physical examination. The patients were not given any information concerning myofascial pain or other muscle pain syndromes. One year follow-up was completed by 116 women. Of these, 52 women developed myofascial pain syndrome (44.8%, 95% confidence interval: 35.6, 54.3). Myofascial pain syndrome is a common source of pain in women undergoing breast cancer surgery that includes axillary lymph node dissection at least during the first year after surgery. Myofascial pain syndrome is one potential cause of chronic pain in breast cancer survivors who have undergone this kind of surgery.

  15. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.

    Science.gov (United States)

    Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J

    2016-06-01

    Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.

  16. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The trigger synchronization procedures for running with cosmic muons and operating with the LHC were reviewed during the May electronics week. Firmware maintenance issues were also reviewed. Link tests between the new ECAL endcap trigger concentrator cards (TCC48) and the Regional Calorimeter Trigger have been performed. Firmware for the energy sum triggers and an upgraded tau trigger of the Global Calorimeter Triggers has been developed and is under test. The optical fiber receiver boards for the Track-Finder trigger theta links of the DT chambers are now all installed. The RPC trigger is being made more robust by additional chamber and cable shielding and also by firmware upgrades. For the CSC’s the front-end and trigger motherboard firmware have been updated. New RPC patterns and DT/CSC lookup tables taking into account phi asymmetries in the magnetic field configuration are under study. The motherboard for the new pipeline synchronizer of the Global Trigg...

  17. TRIGGER

    CERN Multimedia

    W. Smith

    2012-01-01

      Level-1 Trigger The Level-1 Trigger group is ready to deploy improvements to the L1 Trigger algorithms for 2012. These include new high-PT patterns for the RPC endcap, an improved CSC PT assignment, a new PT-matching algorithm for the Global Muon Trigger, and new calibrations for ECAL, HCAL, and the Regional Calorimeter Trigger. These should improve the efficiency, rate, and stability of the L1 Trigger. The L1 Trigger group also is migrating the online systems to SLC5. To make the data transfer from the Global Calorimeter Trigger to the Global Trigger more reliable and also to allow checking the data integrity online, a new optical link system has been developed by the GCT and GT groups and successfully tested at the CMS electronics integration facility in building 904. This new system is now undergoing further tests at Point 5 before being deployed for data-taking this year. New L1 trigger menus have recently been studied and proposed by Emmanuelle Perez and the L1 Detector Performance Group...

  18. TRIGGER

    CERN Multimedia

    W. Smith

    At the March meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, the program of trigger pattern tests and vertical slice tests and planning for the Global Runs starting this summer. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and integration testing is in full swing. A program of orderly connection and checkout with subsystems and central systems has been developed. This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored. After full checkout, trigger subsystems will be then operated in the CMS Global Runs. Continuous...

  19. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The production of the trigger hardware is now basically finished, and in time for the turn-on of the LHC. The last boards produced are the Trigger Concentrator Cards for the ECAL Endcaps (TCC-EE). After the recent installation of the four EE Dees, the TCC-EE prototypes were used for their commissioning. Production boards are arriving and are being tested continuously, with the last ones expected in November. The Regional Calorimeter Trigger hardware is fully integrated after installation of the last EE cables. Pattern tests from the HCAL up to the GCT have been performed successfully. The HCAL triggers are fully operational, including the connection of the HCAL-outer and forward-HCAL (HO/HF) technical triggers to the Global Trigger. The HCAL Trigger and Readout (HTR) board firmware has been updated to permit recording of the tower “feature bit” in the data. The Global Calorimeter Trigger hardware is installed, but some firmware developments are still n...

  20. TRIGGER

    CERN Multimedia

    by Wesley Smith

    2010-01-01

    Level-1 Trigger Hardware and Software The overall status of the L1 trigger has been excellent and the running efficiency has been high during physics fills. The timing is good to about 1%. The fine-tuning of the time synchronization of muon triggers is ongoing and will be completed after more than 10 nb-1 of data have been recorded. The CSC trigger primitive and RPC trigger timing have been refined. A new configuration for the CSC Track Finder featured modified beam halo cuts and improved ghost cancellation logic. More direct control was provided for the DT opto-receivers. New RPC Cosmic Trigger (RBC/TTU) trigger algorithms were enabled for collision runs. There is further work planned during the next technical stop to investigate a few of the links from the ECAL to the Regional Calorimeter Trigger (RCT). New firmware and a new configuration to handle trigger rate spikes in the ECAL barrel are also being tested. A board newly developed by the tracker group (ReTRI) has been installed and activated to block re...

  1. Myofascial pelvic pain.

    Science.gov (United States)

    Kotarinos, Rhonda

    2012-10-01

    Myofascial pelvic pain is fraught with many unknowns. Is it the organs of the pelvis, is it the muscles of the pelvis, or is the origin of the pelvic pain from an extrapelvic muscle? Is there a single source or multiple? In this state of confusion what is the best way to manage the many symptoms that can be associated with myofascial pelvic pain. This article reviews current studies that attempt to answer some of these questions. More questions seem to develop as each study presents its findings.

  2. Effect of acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm%针刺肌筋膜触发点治疗缺血性脑卒中痉挛的效果

    Institute of Scientific and Technical Information of China (English)

    龙佳佳; 庄小强; 谭树生; 言丽燕

    2013-01-01

    Objective To study the clinical curative effect of acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm.Methods 75 patients with cerebral arterial thrombosis spasm in Department of Rehabilitation Medicine,the National Hospital of Guangxi Zhuang Autonomous Region from February 2010 to December 2012 were divided into acupuncture myofascial trigger points group (treatment group,38 cases) and traditional acupuncture group (control group,37 cases) according to random number table with single-blind method.The FuglMeyer motor function score,Barthel index of daily life ability,degree of hemiplegic limb spasm,overall evaluation of spasticity comprehensive efficacy evaluation and clinical nerve function defect score of two groups before treatment and after 1,2 courses of treatment were evaluated.The dates were statistically analyzed by SPSS 17.0 statistics software.Results The Fugl-Meyer motor function score,Barthel index of daily life ability,modified Ashworth scale,clinic spasticity index and nerve function defect score of two groups could be improved obviously.The Fugl-Meyer motor function score,Barthel index of daily life ability,modified Ashworth scale,clinic spasticity index and nerve function defect score after 2 courses of treatment in the treatment group were better than those before treatment,after 1 course of treatment in the treatment group and after 2 courses of treatment in the control group (all P < 0.05).The total effective rate of treatment group (92.11%) was better than that of control group (75.68%) (P < 0.05).Conclusion Acupuncture myofascial trigger points in the treatment of cerebral arterial thrombosis spasm has good clinical curative effect,less side effects and it is worthy of clinical application.%目的 探讨针刺肌筋膜触发点治疗缺血性脑卒中痉挛的临床疗效.方法 选取2010年2月~2012年12月来广西壮族自治区民族医院康复医学科就诊

  3. Efficacy Observation on Acupuncture on Trigger Point of Myofascial Pain Combined with Massage Treating Lumbar Disc Herniation%针刺肌筋膜疼痛触发点联合推拿治疗腰椎间盘突出症疗效观察

    Institute of Scientific and Technical Information of China (English)

    雷迈; 李乾扬

    2014-01-01

    目的:观察针刺肌筋膜疼痛触发点联合推拿治疗腰椎间盘突出症(LDH)的疗效。方法:将60例LDH患者随机分为治疗组(30例)和对照组(30例),治疗组采用针刺肌筋膜疼痛触发点联合推拿治疗,对照组给予常规药物及理疗,比较两组患者JOA、VAS评分改善情况及临床疗效。结果:治疗组总有效率、JOA评分均高于对照组(P<0.01),VAS评分低于对照组(P<0.01)。结论:针刺肌筋膜疼痛触发点联合推拿治疗LDH疗效显著。%Objective:To observe the effects of acupuncture on trigger point of myofascial pain combined with massage treating lumbar disc hernia-tion (LDH). Methods:60 cases of LDH were randomly divided into treatment group (30 cases) and control group (30 cases), treatment group was treated with acupuncture on trigger point of myofascial pain combined with massage, control group with routine medicine and physiotherapy, im-provement of JOA and VAS score and clinical efficacy were compared between the two groups. Results:The total effective rate and JOA score of treatment group were higher than those of control group (P<0.01), VAS score was lower than that of control group (P<0.01). Conclusion:Acupunc-ture on trigger point of myofascial pain combined with massage treating lumbar disc herniation is of distinct efficacy.

  4. 针刺配合干针刺肌筋膜触发点治疗腰椎间盘突出症疗效观察%Efficacy Observation on Acupuncture Combined with Dry Needling Myofascial Trigger Points for Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    植剑龙

    2013-01-01

    Objective:To investigate the efficacy of acupuncture combined with dry needling myofascial trigger points for lumbar disc herniation. Methods:136 cases of patients were randomly divided into observation group and control group, the observation group used conventional acupunc-ture combined with dry needling myofascial trigger points, the control group only used conventional acupuncture. Results:The total effective rate of observation group was 92.65%, which was higher than 73.53 that of control group (P<0.01). Conclusion:Conventional acupuncture combined with dry needling myofascial trigger points has significant curative effect on lumbar disc herniation.%目的:探讨针刺配合干针刺肌筋膜触发点治疗腰椎间盘突出症的疗效。方法:将136例患者随机分为观察组和对照组,观察组采用常规针刺配合干针刺肌筋膜触发点治疗,对照组单纯采用常规针刺治疗。结果:观察组总有效率为92.65%,高于对照组的73.53%(P<0.01)。结论:常规针刺配合干针刺肌筋膜触发点治疗腰椎间盘突出症疗效显著。

  5. TRIGGER

    CERN Multimedia

    W. Smith

    2010-01-01

    Level-1 Trigger Hardware and Software The Level-1 Trigger hardware has performed well during both the recent proton-proton and heavy ion running. Efforts were made to improve the visibility and handling of alarms and warnings. The tracker ReTRI boards that prevent fixed frequencies of Level-1 Triggers are now configured through the Trigger Supervisor. The Global Calorimeter Trigger (GCT) team has introduced a buffer cleanup procedure at stops and a reset of the QPLL during configuring to ensure recalibration in case of a switch from the LHC clock to the local clock. A device to test the cables between the Regional Calorimeter Trigger and the GCT has been manufactured. A wrong charge bit was fixed in the CSC Trigger. The ECAL group is improving crystal masking and spike suppression in the trigger primitives. New firmware for the Drift Tube Track Finder (DTTF) sorters was developed to improve fake track tagging and sorting. Zero suppression was implemented in the DT Sector Collector readout. The track finder b...

  6. TRIGGER

    CERN Multimedia

    Wesley Smith

    Trigger Hardware The status of the trigger components was presented during the September CMS Week and Annual Review and at the monthly trigger meetings in October and November. Procedures for cold and warm starts (e.g. refreshing of trigger parameters stored in registers) of the trigger subsystems have been studied. Reviews of parts of the Global Calorimeter Trigger (GCT) and the Global Trigger (GT) have taken place in October and November. The CERN group summarized the status of the Trigger Timing and Control (TTC) system. All TTC crates and boards are installed in the underground counting room, USC55. The central clock system will be upgraded in December (after the Global Run at the end of November GREN) to the new RF2TTC LHC machine interface timing module. Migration of subsystem's TTC PCs to SLC4/ XDAQ 3.12 is being prepared. Work is on going to unify the access to Local Timing Control (LTC) and TTC CMS interface module (TTCci) via SOAP (Simple Object Access Protocol, a lightweight XML-based messaging ...

  7. TRIGGER

    CERN Multimedia

    W. Smith from contributions of C. Leonidopoulos

    2010-01-01

    Level-1 Trigger Hardware and Software Since nearly all of the Level-1 (L1) Trigger hardware at Point 5 has been commissioned, activities during the past months focused on the fine-tuning of synchronization, particularly for the ECAL and the CSC systems, on firmware upgrades and on improving trigger operation and monitoring. Periodic resynchronizations or hard resets and a shortened luminosity section interval of 23 seconds were implemented. For the DT sector collectors, an automatic power-off was installed in case of high temperatures, and the monitoring capabilities of the opto-receivers and the mini-crates were enhanced. The DTTF and the CSCTF now have improved memory lookup tables. The HCAL trigger primitive logic implemented a new algorithm providing better stability of the energy measurement in the presence of any phase misalignment. For the Global Calorimeter Trigger, additional Source Cards have been manufactured and tested. Testing of the new tau, missing ET and missing HT algorithms is underw...

  8. TRIGGER

    CERN Multimedia

    R. Carlin with contributions from D. Acosta

    2012-01-01

    Level-1 Trigger Data-taking continues at cruising speed, with high availability of all components of the Level-1 trigger. We have operated the trigger up to a luminosity of 7.6E33, where we approached 100 kHz using the 7E33 prescale column.  Recently, the pause without triggers in case of an automatic "RESYNC" signal (the "settle" and "recover" time) was reduced in order to minimise the overall dead-time. This may become very important when the LHC comes back with higher energy and luminosity after LS1. We are also preparing for data-taking in the proton-lead run in early 2013. The CASTOR detector will make its comeback into CMS and triggering capabilities are being prepared for this. Steps to be taken include improved cooperation with the TOTEM trigger system and using the LHC clock during the injection and ramp phases of LHC. Studies are being finalised that will have a bearing on the Trigger Technical Design Report (TDR), which is to be rea...

  9. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The final parts of the Level-1 trigger hardware are now being put in place. For the ECAL endcaps, more than half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are now available at CERN, such that one complete endcap can be covered. The Global Trigger now correctly handles ECAL calibration sequences, without being influenced by backpressure. The Regional Calorimeter Trigger (RCT) hardware is complete and working in USC55. Intra-crate tests of all 18 RCT crates and the Global Calorimeter Trigger (GCT) are regularly taking place. Pattern tests have successfully captured data from HCAL through RCT to the GCT Source Cards. HB/HE trigger data are being compared with emulator results to track down the very few remaining hardware problems. The treatment of hot and dead cells, including their recording in the database, has been defined. For the GCT, excellent agreement between the emulator and data has been achieved for jets and HF ET sums. There is still som...

  10. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware and Software The trigger system has been constantly in use in cosmic and commissioning data taking periods. During CRAFT running it delivered 300 million muon and calorimeter triggers to CMS. It has performed stably and reliably. During the abort gaps it has also provided laser and other calibration triggers. Timing issues, namely synchronization and latency issues, have been solved. About half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are installed, and the firmware is being worked on. The production of the other half has started. The HCAL Trigger and Readout (HTR) card firmware has been updated, and new features such as fast parallel zero-suppression have been included. Repairs of drift tube (DT) trigger mini-crates, optical links and receivers of sector collectors are under way and have been completed on YB0. New firmware for the optical receivers of the theta links to the drift tube track finder is being installed. In parallel, tests with new eta track finde...

  11. Elite swimmers with and without unilateral shoulder pain: mechanical hyperalgesia and active/latent muscle trigger points in neck-shoulder muscles.

    Science.gov (United States)

    Hidalgo-Lozano, A; Fernández-de-las-Peñas, C; Calderón-Soto, C; Domingo-Camara, A; Madeleine, P; Arroyo-Morales, M

    2013-02-01

    Our aim was to investigate the presence of mechanical hypersensitivity and active trigger points (TrPs) in the neck-shoulder muscles in elite swimmers with/without unilateral shoulder pain. Seventeen elite swimmers with shoulder pain; 18 swimmers without shoulder pain; and 15 elite athletes matched controls were recruited. Pressure pain thresholds (PPT) were assessed over the levator scapulae, sternocleidomastoid, upper trapezius, infraspinatus, scalene, subscapularis and tibialis anterior muscles. TrPs in the levator scapulae, upper trapezius, infraspinatus, scalene, sternocleidomastoid and subscapularis muscles were also explored. Swimmers with shoulder pain showed significant lower PPT in all muscles compared with controls (Ppain, underlining widespread mechanical hypersensitivity. The mean number of TrPs for elite swimmer with and without shoulder pain was, respectively, 4.7 ± 1 (2.1 ± 1.5 active; 2.6 ± 1.4 latent) and 4.7 ± 1.3 (1.3 ± 1.3 active; 3.4 ± 1.5 latent), whereas healthy athletes only showed latent TrPs (2.4 ± 1.2). Elite swimmers with shoulder pain showed higher number of active TrPs than swimmers without pain, whereas it was the opposite for the number of latent muscle TrP (Pmechanical hypersensitivity suggests that active TrPs play a role in the development of shoulder pain in elite swimmers.

  12. New trends in the treatment and management of myofascial pain syndrome.

    Science.gov (United States)

    Srbely, John Z

    2010-10-01

    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.

  13. TRIGGER

    CERN Multimedia

    W. Smith

    At the December meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, and results from the Magnet Test and Cosmic Challenge (MTCC) phase II. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and moving towards integration testing. A program of orderly connection and checkout with subsystems and central systems has been developed. This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored. This is combined with operations and testing without beam that will continue until startup. The plans for start-up, pilot and early running tri...

  14. TRIGGER

    CERN Multimedia

    W. Smith from contributions of C. Leonidopoulos, I. Mikulec, J. Varela and C. Wulz.

    Level-1 Trigger Hardware and Software Over the past few months, the Level-1 trigger has successfully recorded data with cosmic rays over long continuous stretches as well as LHC splash events, beam halo, and collision events. The L1 trigger hardware, firmware, synchronization, performance and readiness for beam operation were reviewed in October. All L1 trigger hardware is now installed at Point 5, and most of it is completely commissioned. While the barrel ECAL Trigger Concentrator Cards are fully operational, the recently delivered endcap ECAL TCC system is still being commissioned. For most systems there is a sufficient number of spares available, but for a few systems additional reserve modules are needed. It was decided to increase the overall L1 latency by three bunch crossings to increase the safety margin for trigger timing adjustments. In order for CMS to continue data taking during LHC frequency ramps, the clock distribution tree needs to be reset. The procedures for this have been tested. A repl...

  15. TRIGGER

    CERN Multimedia

    R. Arcidiacono

    2013-01-01

      In 2013 the Trigger Studies Group (TSG) has been restructured in three sub-groups: STEAM, for the development of new HLT menus and monitoring their performance; STORM, for the development of HLT tools, code and actual configurations; and FOG, responsible for the online operations of the High Level Trigger. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger Menu development, path timing, trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – in collaboration and with the technical support of the PdmV group. Since the end of proton-proton data taking, the group has started preparing for 2015 data taking, with collisions at 13 TeV and 25 ns bunch spacing. The reliability of the extrapolation to higher energy is being evaluated comparing the trigger rates on 7 and 8 TeV Monte Carlo samples with the data taken in the past two years. The effect of 25 ns bunch spacing is being studied on the d...

  16. TRIGGER

    CERN Multimedia

    W. Smith, from contributions of D. Acosta

    2012-01-01

      The L1 Trigger group deployed several major improvements this year. Compared to 2011, the single-muon trigger rate has been reduced by a factor of 2 and the η coverage has been restored to 2.4, with high efficiency. During the current technical stop, a higher jet seed threshold will be applied in the Global Calorimeter Trigger in order to significantly reduce the strong pile-up dependence of the HT and multi-jet triggers. The currently deployed L1 menu, with the “6E33” prescales, has a total rate of less than 100 kHz and operates with detector readout dead time of less than 3% for luminosities up to 6.5 × 1033 cm–2s–1. Further prescale sets have been created for 7 and 8 × 1033 cm–2s–1 luminosities. The L1 DPG is evaluating the performance of the Trigger for upcoming conferences and publication. Progress on the Trigger upgrade was reviewed during the May Upgrade Week. We are investigating scenarios for stagin...

  17. TRIGGER

    CERN Multimedia

    Wesley Smith

    2011-01-01

    Level-1 Trigger Hardware and Software New Forward Scintillating Counters (FSC) for rapidity gap measurements have been installed and integrated into the Trigger recently. For the Global Muon Trigger, tuning of quality criteria has led to improvements in muon trigger efficiencies. Several subsystems have started campaigns to increase spares by recovering boards or producing new ones. The barrel muon sector collector test system has been reactivated, new η track finder boards are in production, and φ track finder boards are under revision. In the CSC track finder, an η asymmetry problem has been corrected. New pT look-up tables have also improved efficiency. RPC patterns were changed from four out of six coincident layers to three out of six in the barrel, which led to a significant increase in efficiency. A new PAC firmware to trigger on heavy stable charged particles allows looking for chamber hit coincidences in two consecutive bunch-crossings. The redesign of the L1 Trigger Emulator...

  18. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware and Software The road map for the final commissioning of the level-1 trigger system has been set. The software for the trigger subsystems is being upgraded to run under CERN Scientific Linux 4 (SLC4). There is also a new release for the Trigger Supervisor (TS 1.4), which implies upgrade work by the subsystems. As reported by the CERN group, a campaign to tidy the Trigger Timing and Control (TTC) racks has begun. The machine interface was upgraded by installing the new RF2TTC module, which receives RF signals from LHC Point 4. Two Beam Synchronous Timing (BST) signals, one for each beam, can now be received in CMS. The machine group will define the exact format of the information content shortly. The margin on the locking range of the CMS QPLL is planned for study for different subsystems in the next Global Runs, using a function generator. The TTC software has been successfully tested on SLC4. Some TTC subsystems have already been upgraded to SLC4. The TTCci Trigger Supervisor ...

  19. Prevalence of myofascial pain in general internal medicine practice.

    OpenAIRE

    Skootsky, S A; Jaeger, B; Oye, R K

    1989-01-01

    Myofascial pain is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. We examined a series of 172 patients presenting to a university primary care general internal medicine practice. Of 54 patients whose reason for a visit included pain, 16 (30%) satisfied criteria for a clinical diagnosis of myofascial pain. These patients were similar in age and sex to other patients with pain, and the frequency of pain as a ...

  20. Myofascial low back pain treatment.

    Science.gov (United States)

    Sharan, Deepak; Rajkumar, Joshua Samuel; Mohandoss, Mathankumar; Ranganathan, Rameshkumar

    2014-09-01

    Myofascial pain is a common musculoskeletal problem, with the low back being one of the commonest affected regions. Several treatments have been used for myofascial low back pain through physical therapies, pharmacologic agents, injections, and other such therapies. This review will provide an update based on recently published literature in the field of myofascial low back pain along with a brief description of a sequenced, multidisciplinary treatment protocol called Skilled Hands-on Approach for the Release of myofascia, Articular, Neural and Soft tissue mobilization (SHARANS) protocol. A comprehensive multidisciplinary approach is recommended for the successful management of individuals with myofascial low back pain.

  1. TRIGGER

    CERN Multimedia

    W. Smith

    2011-01-01

    Level-1 Trigger Hardware and Software Overall the L1 trigger hardware has been running very smoothly during the last months of proton running. Modifications for the heavy-ion run have been made where necessary. The maximal design rate of 100 kHz can be sustained without problems. All L1 latencies have been rechecked. The recently installed Forward Scintillating Counters (FSC) are being used in the heavy ion run. The ZDC scintillators have been dismantled, but the calorimeter itself remains. We now send the L1 accept signal and other control signals to TOTEM. Trigger cables from TOTEM to CMS will be installed during the Christmas shutdown, so that the TOTEM data can be fully integrated within the CMS readout. New beam gas triggers have been developed, since the BSC-based trigger is no longer usable at high luminosities. In particular, a special BPTX signal is used after a quiet period with no collisions. There is an ongoing campaign to provide enough spare modules for the different subsystems. For example...

  2. TRIGGER

    CERN Multimedia

    J. Alimena

    2013-01-01

    Trigger Strategy Group The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for the development of future High-Level Trigger menus, as well as of its DQM and validation, in collaboration and with the technical support of the PdmV group. Taking into account the beam energy and luminosity expected in 2015, a rough estimate of the trigger rates indicates a factor four increase with respect to 2012 conditions. Assuming that a factor two can be tolerated thanks to the increase in offline storage and processing capabilities, a toy menu has been developed using the new OpenHLT workflow to estimate the transverse energy/momentum thresholds that would halve the current trigger rates. The CPU time needed to run the HLT has been compared between data taken with 25 ns and 50 ns bunch spacing, for equivalent pile-up: no significant difference was observed on the global time per event distribution at the only available data point, corresponding to a pile-up of about 10 interactions. Using th...

  3. TRIGGER

    CERN Multimedia

    by Wesley Smith

    2011-01-01

    Level-1 Trigger Hardware and Software After the winter shutdown minor hardware problems in several subsystems appeared and were corrected. A reassessment of the overall latency has been made. In the TTC system shorter cables between TTCci and TTCex have been installed, which saved one bunch crossing, but which may have required an adjustment of the RPC timing. In order to tackle Pixel out-of-syncs without influencing other subsystems, a special hardware/firmware re-sync protocol has been introduced in the Global Trigger. The link between the Global Calorimeter Trigger and the Global Trigger with the new optical Global Trigger Interface and optical receiver daughterboards has been successfully tested in the Electronics Integration Centre in building 904. New firmware in the GCT now allows a setting to remove the HF towers from energy sums. The HF sleeves have been replaced, which should lead to reduced rates of anomalous signals, which may allow their inclusion after this is validated. For ECAL, improvements i...

  4. Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

    2011-02-01

    Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

  5. Myofacial trigger points in advanced cancer patients

    Directory of Open Access Journals (Sweden)

    Hideaki Hasuo

    2016-01-01

    Full Text Available Myofascial pain syndrome is started to be recognized as one of important factors of pain in cancer patients. However, no reports on features of myofascial trigger points were found in terminally-ill cancer populations. This time, we encountered 5 patients with myofascial pain syndrome and terminal cancer in whom delirium developed due to increased doses of opioid without a diagnosis of myofascial pain syndrome on initial presentation. The delirium subsided with dose reductions of opioid and treatment of myofascial pain syndrome. The common reason for a delayed diagnosis among the patients included an incomplete palpation of the painful sites, which led to unsuccessful myofascial trigger points identification. The features of myofascial trigger points included single onset in the cancer pain management site with opioid and the contralateral abdominal side muscles of the non-common sites. Withdrawal reflexes associated with cancer pain in the supine position, which are increasingly seen in the terminal cancer patients, were considered to have contributed to this siuation.We consider that careful palpation of the painful site is important, in order to obtain greater knowledge and understanding of the features of myofascial trigger points.

  6. Treatment of temporomandibular myofascial pain with deep dry needling.

    Science.gov (United States)

    Gonzalez-Perez, Luis-Miguel; Infante-Cossio, Pedro; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco-Javier

    2012-09-01

    The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6.5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. We found a statistically significant relationship (p<0.01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle.

  7. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware The CERN group is working on the TTC system. Seven out of nine sub-detector TTC VME crates with all fibers cabled are installed in USC55. 17 Local Trigger Controller (LTC) boards have been received from production and are in the process of being tested. The RF2TTC module replacing the TTCmi machine interface has been delivered and will replace the TTCci module used to mimic the LHC clock. 11 out of 12 crates housing the barrel ECAL off-detector electronics have been installed in USC55 after commissioning at the Electronics Integration Centre in building 904. The cabling to the Regional Calorimeter Trigger (RCT) is terminated. The Lisbon group has completed the Synchronization and Link mezzanine board (SLB) production. The Palaiseau group has fully tested and installed 33 out of 40 Trigger Concentrator Cards (TCC). The seven remaining boards are being remade. The barrel TCC boards have been tested at the H4 test beam, and good agreement with emulator predictions were found. The cons...

  8. Multiple active myofascial trigger points and pressure pain sensitivity maps in the temporalis muscle are related in women with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Caminero, Ana B; Madeleine, Pascal; Guillem-Mesado, Amparo; Ge, Hong-You; Arendt-Nielsen, Lars; Pareja, Juan A

    2009-01-01

    To describe the common locations of active trigger points (TrPs) in the temporalis muscle and their referred pain patterns in chronic tension type headache (CTTH), and to determine if pressure sensitivity maps of this muscle can be used to describe the spatial distribution of active TrPs. Forty women with CTTH were included. An electronic pressure algometer was used to assess pressure pain thresholds (PPT) from 9 points over each temporalis muscle: 3 points in the anterior, medial and posterior part, respectively. Both muscles were examined for the presence of active TrPs over each of the 9 points. The referred pain pattern of each active TrP was assessed. Two-way analysis of variance detected significant differences in mean PPT levels between the measurement points (F=30.3; P<0.001), but not between sides (F=2.1; P=0.2). PPT scores decreased from the posterior to the anterior column (P<0.001). No differences were found in the number of active TrPs (F=0.3; P=0.9) between the dominant side the nondominant side. Significant differences were found in the distribution of the active TrPs (chi2=12.2; P<0.001): active TrPs were mostly found in the anterior column and in the middle of the muscle belly. The analysis of variance did not detect significant differences in the referred pain pattern between active TrPs (F=1.1, P=0.4). The topographical pressure pain sensitivity maps showed the distinct distribution of the TrPs indicated by locations with low PPTs. Multiple active TrPs in the temporalis muscle were found, particularly in the anterior column and in the middle of the muscle belly. Bilateral posterior to anterior decreased distribution of PPTs in the temporalis muscle in women with CTTH was found. The locations of active TrPs in the temporalis muscle corresponded well to the muscle areas with lower PPT, supporting the relationship between multiple active muscle TrPs and topographical pressure sensitivity maps in the temporalis muscle in women with CTTH.

  9. Spontaneous Myoelectric Phenomenon and Histopathology of Myofascial Trigger Points in Rats%大鼠肌筋膜疼痛触发点自发肌电现象和病理组织学研究

    Institute of Scientific and Technical Information of China (English)

    韩蓓; 黄强民; 谭树生; 庄小强

    2011-01-01

    Objective We attempted to observe the spontaneous myoelectric phenomenon and histopathology of myofascial trigger points. Methods Thirty two male mice were equally divided into control group (A) , and experimental groups B、 C and D. Medial vastus muscle of rat was stroked in combination with eccentric exercise once a week in groups B for 4 weeks, in group C for 8 weeks with 2 weeks rest, and in group D for 8 weeks with 4 weeks rest. The responsive taut band, spontaneous EMG, and local tic of rats were checked. Histology of the trigger points was observed as well. Results Comparing with group A: (1) the positive rate of responsive taut band was 0%, 100% (8/8, P<0.01) , and75% (6/8, P<0.01) ingroupsB, C, andD, respectively: (2) the positive rate of local tic was 37.5% (3/8, P<0.05) , 87.5% (7/8, P<0.01) , and75% (6/8, P<0.01)in groups B, C, and D, respectively: (3) the positive rate of spontaneous EMG was 12.5% (1/8,P>0.05) , 100% (8/8, P<0.01) , and 87.5% (7/8, P<0.01) ingroupsB, C, andD, respectively. The contracture of muscle fiber was found in group C and D, except in group B. Conclusion 1-week striking plus eccentric exercise can cause the development of mynfascial trigger point, but is not enough to induce the myofascial pain syndrome.%目的:观察局部损伤后肌筋膜疼痛触发点动物模型的自发肌电和触发点肌纤维的病理结构改变.方法:32只雄性SD大鼠(7周龄)随机分成4组,每组8只.A组对照组,不进行干预;B、C、D组为实验组,采取打击结合离心运动进行干预,每周1次,不同组采取的干预持续时间不同,B组干预4周,C组干预8周后饲养2周,D组干预8周后饲养4周.实验共12周.分别在不同时间检查大鼠受累肌的紧张带和局部抽搐反应,采用肌电仪观察自发肌电现象,然后解剖取材,检查触发点肌肉组织学改变,并与对照组进行比较.结果:A组各项检查均为阴性.其它3组与A组比较:(1)紧张带:B组

  10. Tufted angioma and myofascial pain syndrome.

    Science.gov (United States)

    Silva, Roberto Souto da; Bressan, Aline Lopes; Nascimento, Lívia Barbosa; Kac, Bernard Kawa; Azulay-Abulafia, Luna

    2011-01-01

    Tufted angioma is a rare acquired vascular tumor. It is characterized by painful purplish macules that may progress to plaques containing angiomatous papules. The condition is benign; however, it often affects extensive areas of the skin, leading to functional disability of the affected limb if painful. The present report describes a case of a tufted angioma associated with myofascial pain syndrome in which the predisposing element was the presence of this tumor since childhood. Pain at the site of the lesion affected muscle use and led to the onset of the associated syndrome. Complete relief from symptoms was achieved by blocking the trigger points of the affected limb with anesthesia.

  11. 美洛昔康痛点注射配合肌筋膜牵拉手法治疗肩关节周围炎%Clinical Observation on Trigger Point Injection with Meloxicam Combined with Myofascial Traction for treating Periarthritis of Shoulder

    Institute of Scientific and Technical Information of China (English)

    欧汉锋; 罗海燕; 魏秋实; 曾伟恒

    2013-01-01

    Objective:To observe the efficacy and safety of trigger point injection with meloxicam combined with myofascial traction for treating periarthritis of shoulder.Methods:All 106 outpatients were randomly divided into treatment group I (meloxicam combined with myofascial traction group),treatment group Ⅱ (myofascial traction group),and control group (routine massage group).Three groups were administrated with manipulation treatment and self-rehabilitation.The patients were performed with routine massage in control group and myofascial traction in treatment group,and plus trigger point injection once a weeks in treatment group Ⅰ.All groups were treated once a day,7 days for a treatment course,every 2 courses with 2 day's interval,and a total of four courses.The efficacy and safety were evaluated according to Constant-Murley score and complications.Results:The efficacy of treatment group Ⅰ (100%) and Ⅱ (93.7%) were higher than control group (70%,P<0.05),and treatment group Ⅰ was higher than treatment group Ⅱ (P<0.05).There was no complication in all groups.Conclusion:Trigger point injection with meloxicam combined with myofascial traction can effectively loosen adhesion of soft tissue in frozen shoulder,relieve pain,improve function of shoulder,and reduce labor intensity of operator.It is easy,safe,and effective for clinical application.%目的:观察美洛昔康痛点注射配合肌筋膜牵拉手法治疗肩关节周围炎的临床效果和安全性.方法:106个门诊病例应用随机分为美洛昔康+肌筋膜牵拉手法组(A组)、肌筋膜牵拉手法组(B组)和常规推拿手法组(C组),3组均进行手法治疗和自主康复训练,C组进行常规推拿手法,A、B组进行肌筋膜牵拉手法,A在手法结束后进行痛点注射;每日1次,7d为1个疗程,每2个疗程间休息2d,痛点注射每周1次,共4个疗程.根据Constant-Murley score来评价疗效,根据并发症来评价安全性.结果:疗效比较,A组(l00

  12. Therapeutic Observation of Acupuncture at Myofascial Trigger Points for Cervical Spondylosis of Vertebral Artery Type%针刺肌筋膜触发点治疗椎动脉型颈椎病疗效观察

    Institute of Scientific and Technical Information of China (English)

    王翀敏; 陈红薇; 王延武; 岳红; 朱敏

    2015-01-01

    目的:观察针刺肌筋膜触发点治疗椎动脉型颈椎病的临床疗效。方法将98例椎动脉型颈椎病患者随机分为治疗组51例和对照组47例。治疗组采用针刺肌筋膜触发点治疗,对照组采用注射消炎镇痛液治疗。比较两组治疗前后旋颈试验阳性率、眩晕评分及头项部疼痛VAS评分。结果两组治疗后VAS评分、旋颈试验阳性率及眩晕评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后VAS评分、旋颈试验阳性率及眩晕评分与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为96.1%,对照组为76.6%,两组比较差异具有统计学意义(P<0.05)。结论针刺肌筋膜触发点能改善椎动脉型颈椎病患者眩晕及头项部疼痛症状。%Objective To observe the therapeutic efficacy of acupuncture at myofascial trigger points (MTrPs) in treating cervical spondylosis of vertebral artery type. Methods Ninety-eight patients with cervical spondylosis of vertebral artery type were randomized into a treatment group of 51 cases and a control group of 47 cases. The treatment group was intervened by acupuncture at the MTrPs, while the control group was by injection of medical solution for anti-inflammation and analgesia. The positive rate of rotate-cervix test, dizziness score, and visual analogue scale (VAS) of the head and neck pain were compared before and after intervention. Results After intervention, the positive rate, dizziness score, and VAS score were significantly changed in both groups (P<0.05). There were significant differences in comparing the positive rate, dizziness score, and VAS score between the two groups after intervention (P<0.05). The total effective rate was 96.1%in the treatment group versus 76.6%in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupuncture at the MTrPs can improve the dizziness and head-neck pain in patients with

  13. Myofascial pain, fibromyalgia or fibrositis?

    Science.gov (United States)

    Pearce, J M S

    2004-01-01

    The terms myofascial pain, fibromyalgia and fibrositis are critically examined. They constitute diagnostic labels for non-specific musculoskeletal aches and pains. Analysis of the evidence shows that none of these labels is substantiated by hard physical signs or by laboratory evidence of consistent pathological or biochemical abnormality. What is the objective evidence for disorder(s) of muscle, fascia or fibrous tissues, so clearly indicated by these diagnostic names? Alternative terms such as 'regional pain syndrome' or 'chronic pain syndrome' merely redefine the clinical problem without providing a mechanism or basis for diagnosis. Despite different diagnostic criteria, these conditions, along with chronic fatigue syndrome, have many demographic and clinical similarities, most notably tender trigger points. Indeed, the terms are often used interchangeably. There are few differences in the symptoms, physical findings, laboratory tests, functional status, psychosocial features and psychiatric disorders. This paper seeks not to deny the existence of aches and pains, but to critically examine the utility of these terms. The only claimed physical sign is the presence of tender trigger points over muscles or muscle attachments. Research suggests that tender points are a measure of general distress related to pain complaints but separately associated with fatigue and depression. They are present in some normal subjects and are variable in occurrence in time in the same individual. They reflect no demonstrable pathology. It is therefore argued that none of these commonly used diagnoses represent distinct disease entities. A possible but unproven alternative hypothesis is that such symptoms relate to neural pain with both peripheral and central components, and in some instances psychological or wilful embellishment.

  14. A critical overview of the current myofascial pain literature - October 2015.

    Science.gov (United States)

    Dommerholt, Jan; Grieve, Rob; Hooks, Todd; Layton, Michelle

    2015-10-01

    The number of publications about myofascial pain and trigger points (TrP) seems to increase every year. In the current overview we include 27 articles published in past months. The Basic Review section includes articles about the presence and characteristics of TrPs in various neck and shoulder muscles, the correlation between referred pain from active TrPs and knee osteoarthritis, and an anatomical study exploring whether the location of TrPs may be related to the nerve innervation of muscles. Zuil-Escobar and colleagues from Spain considered the intra-rater reliability of the identification of latent TrPs in several leg muscles and the possible correlation of TrP and the presence of a lower medial longitudinal arch. In the section on manual approaches, contributing author Rob Grieve and colleagues continue their studies of TrPs in the lower extremity muscles, while Méndez-Rebolledo and colleagues studied the impact of cross taping and compression. Dry needling (DN) continues to be a topic of interest. We included twelve papers addressing a wide range of topics, such as the effectiveness and safety of DN, and the impact of DN on proprioception, spasticity, and fibromyalgia. Two papers investigated the utilization of repetitive transcranial magnetic stimulation and laser on TrPs, The final section on other clinical studies and reviews includes 8 papers. The studies originated in thirteen different countries with Spain leading the charts with 7 contributions to the literature, followed by Brazil with four. As we have mentioned in previous editions of this literature overview, many studies suffer from very small sample sizes, which makes it difficult to reach definitive conclusions. Nevertheless, myofascial pain continues to be a topic of interest to researchers and clinicians around the globe. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Current studies on myofascial pain syndrome.

    Science.gov (United States)

    Kuan, Ta-Shen

    2009-10-01

    Recent studies have clarified the nature of myofascial trigger points (MTrPs). In an MTrP region, multiple hyperirritable loci can be found. The sensory components of the MTrP locus are sensitized nociceptors that are responsible for pain, referred pain, and local twitch responses. The motor components are dysfunctional endplates that are responsible for taut band formation as a result of excessive acetylcholine (ACh) leakage. The concentrations of pain- and inflammation-related substances are increased in the MTrP region. It has been hypothesized that excessive ACh release, sarcomere shortening, and release of sensitizing substances are three essential features that relate to one another in a positive feedback cycle. This MTrP circuit is the connection among spinal sensory (dorsal horn) neurons responsible for the MTrP phenomena. Recent studies suggest that measurement of biochemicals associated with pain and inflammation in the MTrP region, the sonographic study of MTrPs, and the magnetic resonance elastography for taut band image are potential tools for the diagnosis of MTrPs. Many methods have been used to treat myofascial pain, including laser therapy, shockwave therapy, and botulinum toxin type A injection.

  16. [Features of autonomic dysfunction in myofascial pain syndromes cervicobrachial localization].

    Science.gov (United States)

    Морозова, О Г; Ярошевский, А А; Липинская, Я В

    2015-01-01

    The relevance of this study is due to the prevalence of autonomic disorders and musculoskeletal pain, especially among the young people of working age. In recent years, many authors in scientific works have been highlighted aspects of mutual development myofascial and autonomic dysfunction, which is caused by neurophysiological preconditions and anatomical and topographical relationships that need to be considered in the diagnostic and therapeutic approaches. To study the characteristics of the formation and flow of autonomic dysfunction syndrome with paroxysmal and permanent types of flow in patients with myofascial pain syndromes cervicobrachial localization. Using clinical neurological, vertebral neurological, neuropsychological methods of studying the severity of pain (visual analogue scale and Pain questionnaire of Mac Gill) examined 84 patients suffering from autonomic dysfunction on the background of myofascial pain syndromes cervicobrachial localization. To identify the features of vegetative regulation of patients were divided into two groups: group 1 (51 people) - with a permanent type of course; group 2 (33 patients) - a type of paroxysmal of course of autonomic dysfunction. It was found more pronounced disturbances in patients with paroxysmal type of course of autonomic dysfunction. The frequency and severity of autonomic paroxysms associated with the severity of musculo-tonic syndrome and location of active trigger points in the muscles of the neck and shoulder girdle, due to anatomic and topographic features of these muscles, namely the proximity of their location to the sympathetic formations neck. The formation and development of emotional and affective disorders in both groups played a significant role of pain and musculo-tonic syndrome. The syndrome of autonomic dysfunction, in particular its paroxysmal type of flow, on the one hand is a response to the development of myofascial pain syndromes cervicobrachial localization, with another - a factor

  17. The Kinesio Taping Method for Myofascial Pain Control.

    Science.gov (United States)

    Wu, Wei-Ting; Hong, Chang-Zern; Chou, Li-Wei

    2015-01-01

    Many people continue suffering from myofascial pain syndrome (MPS) defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. Muscle spasm and block of blood circulation can be noticed in the taut bands. In the MTrP region, nociceptors can be sensitized by the peripheral inflammatory factors and contracture of fascia can also be induced. Traditional treatments of MPS include stretching therapy, thermal treatment, electrical stimulation, massage, manipulation, trigger points injection, acupuncture, and medicine. However, the pain syndrome may not be relieved even under multiple therapies. Recently, the Kinesio Taping (KT) method is popularly used in sports injuries, postoperative complications, and various pain problems, but little research is focused on MPS with KT method. In this paper, we review the research studies on the application to KT in treating MPS and other related issues. It appears that the KT application can elevate the subcutaneous space and then increase the blood circulation and lymph fluid drainage to reduce the chemical factors around the MTrP region. Therefore, it is suggested that KT method can be used as a regular treatment or added to the previous treatment for myofascial pain.

  18. The Kinesio Taping Method for Myofascial Pain Control

    Directory of Open Access Journals (Sweden)

    Wei-Ting Wu

    2015-01-01

    Full Text Available Many people continue suffering from myofascial pain syndrome (MPS defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs clinically. Muscle spasm and block of blood circulation can be noticed in the taut bands. In the MTrP region, nociceptors can be sensitized by the peripheral inflammatory factors and contracture of fascia can also be induced. Traditional treatments of MPS include stretching therapy, thermal treatment, electrical stimulation, massage, manipulation, trigger points injection, acupuncture, and medicine. However, the pain syndrome may not be relieved even under multiple therapies. Recently, the Kinesio Taping (KT method is popularly used in sports injuries, postoperative complications, and various pain problems, but little research is focused on MPS with KT method. In this paper, we review the research studies on the application to KT in treating MPS and other related issues. It appears that the KT application can elevate the subcutaneous space and then increase the blood circulation and lymph fluid drainage to reduce the chemical factors around the MTrP region. Therefore, it is suggested that KT method can be used as a regular treatment or added to the previous treatment for myofascial pain.

  19. The Kinesio Taping Method for Myofascial Pain Control

    Science.gov (United States)

    Wu, Wei-Ting; Hong, Chang-Zern

    2015-01-01

    Many people continue suffering from myofascial pain syndrome (MPS) defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. Muscle spasm and block of blood circulation can be noticed in the taut bands. In the MTrP region, nociceptors can be sensitized by the peripheral inflammatory factors and contracture of fascia can also be induced. Traditional treatments of MPS include stretching therapy, thermal treatment, electrical stimulation, massage, manipulation, trigger points injection, acupuncture, and medicine. However, the pain syndrome may not be relieved even under multiple therapies. Recently, the Kinesio Taping (KT) method is popularly used in sports injuries, postoperative complications, and various pain problems, but little research is focused on MPS with KT method. In this paper, we review the research studies on the application to KT in treating MPS and other related issues. It appears that the KT application can elevate the subcutaneous space and then increase the blood circulation and lymph fluid drainage to reduce the chemical factors around the MTrP region. Therefore, it is suggested that KT method can be used as a regular treatment or added to the previous treatment for myofascial pain. PMID:26185522

  20. [Myofascial pain syndrome].

    Science.gov (United States)

    Novikova, L B; Akopyan, A P

    2015-01-01

    To analyze clinical characteristics of pain syndrome in patients with dorsalgia. Authors studied 43 patients (mean age 41.9±1.2 years), 34 women and 9 men, with acute and subacute chronic back pain. The study included neurological examination, MRI and/or CT of the spine, measurement of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), The Brief Pain Inventory (BPI) and the McGill Pain Inventory. Chronic myofascial pain syndrome (MFPS) was frequently associated with anxiety-depressive disorders found in patients with cervical and cervical/pectoral pain, fibromyalgia with minimal neurological symptoms and no signs of neural structure compression according to MRI and CT. The results of the study of chronic MFPS should be taken into account in the choice of tactics of treatment of MFPS patients. The use of amelotex in the combination with compligam B in patients with dorsopathy and MFPS is effective together with correction of emotional disorders and treatment with chondroprotectors.

  1. Efficacy of Trigger Point Biopsy Combined with Injection Therapy in the Upper Trapezius Muscle for Myofascial Pain Syndrome%斜方肌激痛点活检复合注射疗法治疗肌筋膜疼痛综合征的疗效

    Institute of Scientific and Technical Information of China (English)

    郭亚秋; 齐峰; 胡启雅; 王姿; 郭静旋; 黄海真; 丁超; 潘新; 张力

    2014-01-01

    The aim was to observe the efficacy of trigger point biopsy combined with injection therapy on the upper trapezius muscle for myofascial pain syndrome (MPS). Sixty patients of MPS were recruited and randomly divided equally into two groups. Group BI groupreceived myofascial trigger point (MTrP) biopsy plus injection therapy and group IT treated with MTrP injection therapy alone. The Visual Analogue Scale (VAS) was measured before the treatment, after the treatment immediately, and the day 7, 14, 21 and 28 after the treatment. The efficacy rate was evaluated up to three months after the treatment. Side effects were also observed during the treatment. The VAS in both groups decreased significantly after treatment (P<0. 05). The VAS in the group BI decreased significantly as compared to that in the group IT at day 14, 21, 28 after treatment (P< 0. 05). The effective rate was significantly higher than that in group IT three months after treatment (P<0. 05). Only one side effect appeared in group BI. Myofascial trigger point biopsy combined with analgesic injection therapy can provide an effective treatment for MPS than injection therapy alone.%观察斜方肌激痛点活检复合注射疗法治疗肌筋膜疼痛综合征(MPS)的疗效是否优于单纯注射治疗。选择MPS患者60例,随机分为激痛点活检复合镇痛液注射治疗组(BI组)和单纯镇痛液注射治疗组(IT组),每组30例。BI组患者行激痛点活检,并于活检处行镇痛液注射疗法;IT组患者仅于激痛点处行镇痛液注射治疗。评定患者治疗前和治疗后即刻、7天、14天、21天及28天疼痛视觉模拟评分(VAS),治疗后3个月的临床有效率以及和治疗有关的不良反应。结果两组治疗后VAS评分与治疗前相比均降低(P<0.05),从治疗后14天起BI组VAS评分低于IT组(P<0.05)。治疗3个月后BI组有效率高于IT组(P<0.05)。BI组出现1例不良反应患者。激痛点活

  2. 温和灸激痛点治疗肩背部肌筋膜疼痛综合征:随机对照研究%A Randomized Controlled Clinical Trial for Treatment of Shoulder-back Myofascial Pain Syn-drome with Mild Moxibustion at Trigger Points

    Institute of Scientific and Technical Information of China (English)

    王列; 马帅; 赵悦; 曹锐; 王颖; 马铁明

    2016-01-01

    Objective To compare the efficacy difference between the mild moxibustion and acupuncture stimulation at trigger points in the treatment of shoulder and back myofascial pain syndrome (MPS),so as to provide a reference for clinical treatment of MPS.Methods A total of 60 patients with shoulder and back MPS were equally and randomly divided into mild moxibustion group and acupuncture group.The myofascial trigger points in the shoulder and back regions were stimulated with mild moxibustion for 20- 1 00 min every time or punctured with filiform needles by retaining the needles for 30 min after twirling for a while.The treatment was conducted once daily for 1 0 days.The short-form McGill pain questionnaire (SF-MPQ)including the pain rating index [PRI consisting of 1 5 descriptors (1 1 sensory,4 affective)which are rated on an intensity scale as 0 = none,1 =mild,2=moderate and 3=severe],present pain intensity (PPI)index of the standard MPQ and a visual analogue scale (VAS) was used to assess the patient’s pain severity before and after the treatment.Results Following the treatment,of the two 30 cases of MPS patients in the acupuncture and mild moxibustion groups,1 and 7 were cured,1 1 and 1 7 experienced marked im-provement,1 4 and 5 were effective,4 and 1 was invalid,with the effective rates being 86.7% (26/30)and 96.7%(29/30),re-spectively.The cured plus markedly effective rate of the mild moxibustion group was significantly better than that of the acupunc-ture group(P 0.05).Conclusion Mild moxibustion stimulation of myofascial trigger point is effective in relieving shoulder-back MPS,being comparable to that of acupuncture therapy.%目的::比较温和灸与针刺激痛点治疗肩背部肌筋膜疼痛综合征(MPS)的疗效差异,为肩背部MPS 的治疗提供参考。方法:60例肩背部 MPS 患者随机分为温和灸组和针刺组,每组30例,两组均选取疼痛部位的激痛点进行治疗。温和灸组采用温和

  3. 肌筋膜疼痛触发点配合经络穴位治疗腰背肌筋膜疼痛综合征的临床研究%Clinical Research of Muscular Fasciae Trigger Point Combined with Meridian Point in the Treatment of Lumbar Back Myofascial Pain Syndrome

    Institute of Scientific and Technical Information of China (English)

    农洪升

    2013-01-01

    Objective:To study the clinical research of muscular fasciae trigger point combined with meridian point in the treatment of lumbar back Myofascial Pain Syndrome.Methods:200 cases with lumbar back myofascial pain syndrome were divided into control group and treatment group according to random number table method,100 cases in each group.The control group was treated with muscular fasciae trigger point.The treatment group was given additional meridian point treatment based on the control group.Both the two groups were given eight courses of treatment,each course 15 d.Compare the pain index,scleroma cords index,function index and efficient of two groups before and after the treatment.Results:The pain index,scleroma cords index,function index and efficient of two groups had greatly improved,the difference was statistically significant (P < 0.05).The effective rate was 96.0% in treatment group and 82.0% in control group.Compared the efficient of two groups,the difference was statistically significant (P < 0.05).Conclusion:Muscular fasciae trigger point combined with meridian point in the treatment of lumbar back Myofascial Pain Syndrome has obvious curative effect and high efficient.%目的:探讨肌筋膜疼痛触发点配合经络穴位治疗腰背肌筋膜疼痛综合征的临床疗效.方法:腰背肌筋膜疼痛综合征患者200例按随机数字表法分为对照组和治疗组,每组各100例.对照组采取肌筋膜疼痛触发点治疗技术进行治疗,治疗组在对照组的基础上配合经络穴位治疗.两组患者均治疗8个疗程,每个疗程15 d.治疗结束后,比较两组患者在治疗前后疼痛指数、硬结条索状物指数、功能状态指数及有效率.结果:两组患者各自在疼痛指数、功能状态指数以及硬结条索状物指数方面,治疗后都较治疗前有较大的改善,差异有统计学意义(P<0.05).治疗组有效率为96.0%,对照组有效率为82.0%,两组有效率比

  4. Influencia de la presión sobre la mucosa gingival en la medición algométrica de un punto gatillo miofascial del músculo masetero: Estudio aleatorio, cruzado, controlado The influence of pressure on the gingivae mucosa on the algometry measurement of the masseter´s myofascial trigger point: A Randomized Cross-Over Controlled Trial

    Directory of Open Access Journals (Sweden)

    R. La Touche

    2007-03-01

    Full Text Available Objetivo: Este trabajo valora mediante una aplicación algométrica si la presión sobre la mucosa gingival de la zona de los molares mandibulares influye sobre el umbral del dolor a la presión (UDP de uno de los puntos gatillo miofasciales (PGMs del músculo masetero. Material y métodos: Se estudiaron un total de 38 pacientes que presentaban dolor orofacial por PGMs a nivel del músculo masetero. Se valoro el UDP por medio de algometría y la percepción de la intensidad del dolor (PID post-medición por medio de la Escala Visual Analógica (EVA. Todos los sujetos del estudio se utilizaron como grupo experimental y control; al grupo experimental se la aplicó una medición donde se evitaba generar presión sobre la mucosa gingival y al control una medición directa sobre PGM. El orden de aplicación de las mediciones se realizó por medio de una distribución aleatoria sistemática. Resultados: Se observaron diferencias estadísticamente significativas entre el UDP obtenido en el grupo experimental con respecto al control (P 0,05 y tampoco se apreció una correlación entre el UDP y la PID postmedición para el grupo experimental (r = -0,11, P = 0,5 ni para el caso del grupo control. (r = 0,15, P = 0,36. Conclusiones: Los resultados obtenidos demuestran que el evitar la presión sobre la mucosa gingival si influye en el valor de la medición algométrica, ya que aumenta el UDP de el PGM valorado en el músculo masetero. Sin embargo, es necesario realizar más investigaciones que puedan determinar la sensibilidad y la fiabilidad de este protocolo de medición antes de ser extrapolado a la clínica.Objective: Our study sets out to determine if the pressure on the gingivae mucosa of the lower molars influences the pressure pain threshold of one of the masseter's myofascial trigger point. Material and methods: A total of 38 subjects who had orofacial pain were included in the study. The masseter's myofascial trigger point was studied. The

  5. Effect of Therapeutic Sequence of Hot Pack and Ultrasound on Physiological Response Over Trigger Point of Upper Trapezius

    Directory of Open Access Journals (Sweden)

    Benjaboonyanupap

    2015-09-01

    Full Text Available Background Musculoskeletal pain is a common problem among athletes. Apart from sport injuries, the myofascial pain syndrome is another important problem that affects performance of the athlete. Objectives The aim of this study was to evaluate the effects of therapeutic sequences of the hot pack in combination with ultrasound on the physiological responses over the latent myofascial trigger point (LMTrP of upper trapezius muscle. Materials and Methods Thirty subjects with a latent myofascial trigger point (LMTrP in both sides of the upper trapezius muscle participated in the study (age 27.33 ± 4.34 years, weight 58.11 ± 7.47 kg, height 161.50 ± 5.82 cm, pressure pain threshold 2.28 ± 0.24 kg/cm2, pain intensity 7.17 ± 2.25 VAS. All subjects received both treatments (hot pack followed by ultrasound: HP + US; and ultrasound followed by hot pack: US + HP by randomization with a 24 to 48-hour interval between sessions. Outcome measures, including the tissue blood flow (TBF, pressure pain threshold (PPT, supra-thermal threshold (STT and visual analog scale (VAS were evaluated at baseline, immediately, after 30 minutes and after 60 minutes. Results The TBF and PPT significantly increased from baseline in both treatment conditions (i.e. HP + US and US + HP, while the HP + US condition showed a trend toward significant difference in VAS and STT in 45°C. Conclusions The application of HP and US treatment induces physiological responses (especially, TBF and PPT on the LMTrP. This finding provides the direction toward the management of MTrPs condition.

  6. Myofascial pain: from Virchow's to our days

    Directory of Open Access Journals (Sweden)

    I. V. Egorov

    2014-01-01

    Full Text Available Myalgia is not a definite nosological entity and fixes the attention of neurologists, rheumatologists, and physicians in other specialties. This is first of all associated with the high incidence of chronic pain syndrome that leads to long-term disability mainly in young and middle-aged persons. One of the most common reasons for seeking advice from a therapist and neurologist is low back pain that may be due to the involvement of three key anatomical players: facet joints (arthrosis treatment should make an emphasis on  hondroprotectors, intervertebral disks (in case of discopathy, clinicians tend to favor nonsteroidal anti-inflammatory drugs – NSAIDs, and a muscular frame. In this case, two thirds of patients with pain syndromes in the trunk and limbs are found to have myofascial dysfunction that is defined as impaired function of one orother muscle, which occurs with its overload and manifests itself as muscle spasm and the presence of painful muscle infiltrations or local muscle hypertonus and trigger points in the tense muscles. Ignoring this fact gives rise to the irrational use of analgesic and anti-inflammatory drugs and further to the increase of their doses because the treatment is ineffective. Modern-day therapy for myofascial syndrome is multimodal and encompasses physiotherapic and manual procedures and the use of myorelaxants rather than NSAIDs. To prescribe myorelaxants, it is necessary to understand their mechanisms of action and the effects of different agents in this group.

  7. [Myofascial pain syndrome--fascial muscle pain].

    Science.gov (United States)

    Partanen, Juhani; Ojala, Tuula; Arokoski, Jari P A

    2010-01-01

    Symptoms of myofascial pain syndrome, i.e. fascial muscle pain may occur in several areas of the body, particularly in the neck-shoulder region. The muscle pain symptom in the neck-shoulder region is commonly termed tension neck pain or nonspecific neck pain, but myofascial pain syndrome can also be distinguished into its own diagnosis. This review deals with the clinical picture of myofascial pain syndrome along with pathophysiological hypotheses and treatment options.

  8. Expression of the endocannabinoid system in fibroblasts and myofascial tissues.

    Science.gov (United States)

    McPartland, John M

    2008-04-01

    The endocannabinoid (eCB) system, like the better-known endorphin system, consists of cell membrane receptors, endogenous ligands and ligand-metabolizing enzymes. Two cannabinoid receptors are known: CB(1) is principally located in the nervous system, whereas CB(2) is primarily associated with the immune system. Two eCB ligands, anandamide (AEA) and 2-arachidonoylglycerol (2-AG), are mimicked by cannabis plant compounds. The first purpose of this paper was to review the eCB system in detail, highlighting aspects of interest to bodyworkers, especially eCB modulation of pain and inflammation. Evidence suggests the eCB system may help resolve myofascial trigger points and relieve symptoms of fibromyalgia. However, expression of the eCB system in myofascial tissues has not been established. The second purpose of this paper was to investigate the eCB system in fibroblasts and other fascia-related cells. The investigation used a bioinformatics approach, obtaining microarray data via the GEO database (www.ncbi.nlm.nih.gov/geo/). GEO data mining revealed that fibroblasts, myofibroblasts, chondrocytes and synoviocytes expressed CB(1), CB(2) and eCB ligand-metabolizing enzymes. Fibroblast CB(1) levels nearly equalled levels expressed by adipocytes. CB(1) levels upregulated after exposure to inflammatory cytokines and equiaxial stretching of fibroblasts. The eCB system affects fibroblast remodeling through lipid rafts associated with focal adhesions and dampens cartilage destruction by decreasing fibroblast-secreted metalloproteinase enzymes. In conclusion, the eCB system helps shape biodynamic embryological development, diminishes nociception and pain, reduces inflammation in myofascial tissues and plays a role in fascial reorganization. Practitioners wield several tools that upregulate eCB activity, including myofascial manipulation, diet and lifestyle modifications, and pharmaceutical approaches.

  9. Myofascial pain syndrome and its suggested role in the pathogenesis and treatment of fibromyalgia syndrome.

    Science.gov (United States)

    Meyer, Helgard P

    2002-08-01

    Myofascial pain syndrome is a chronic muscle pain disorder in one or more muscles or groups of muscles accompanied by local and referred pain, decreased range of motion, weakness, and often autonomic phenomena. Patients are readily recognized by their history of muscle pain and the presence of myofascial trigger points, which are specific areas of hyperirritability in a muscle that cause local and referred pain on palpation. Failure to recognize MPS often leads to over-investigation, unnecessary medical intervention, and iatrogenic harm with serious cost implications. The purpose of this review is to present clinically relevant data regarding myofascial pain syndrome and to discuss its possible role in the pathophysiology and optimal treatment of fibromyalgia syndrome.

  10. Update on the efficacy of extracorporeal shockwave treatment for myofascial pain syndrome and fibromyalgia.

    Science.gov (United States)

    Ramon, Silvia; Gleitz, Markus; Hernandez, Leonor; Romero, Luis David

    2015-12-01

    Chronic muscle pain syndrome is one of the main causes of musculoskeletal pathologies requiring treatment. Many terms have been used in the past to describe painful muscular syndromes in the absence of evident local nociception such as myogelosis, muscle hardening, myalgia, muscular rheumatism, fibrositis or myofascial trigger point with or without referred pain. If it persists over six months or more, it often becomes therapy resistant and frequently results in chronic generalized pain, characterized by a high degree of subjective suffering. Myofascial pain syndrome (MPS) is defined as a series of sensory, motor, and autonomic symptoms caused by a stiffness of the muscle, caused by hyperirritable nodules in musculoskeletal fibers, known as myofascial trigger points (MTP), and fascial constrictions. Fibromyalgia (FM) is a chronic condition that involves both central and peripheral sensitization and for which no curative treatment is available at the present time. Fibromyalgia shares some of the features of MPS, such as hyperirritability. Many treatments options have been described for muscle pain syndrome, with differing evidence of efficacy. Extracorporeal Shockwave Treatment (ESWT) offers a new and promising treatment for muscular disorders. We will review the existing bibliography on the evidence of the efficacy of ESWT for MPS, paying particular attention to MTP (Myofascial Trigger Point) and Fibromyalgia (FM).

  11. Modificaciones del umbral de dolor en un punto gatillo miofascial tras técnica de energía muscular Changes in pain threshold in myofascial trigger point after muscle energy technique

    OpenAIRE

    J.C. Zuil Escobar; M. García del Pozo; M. González Propin

    2010-01-01

    Objetivos: Valorar los cambios en el umbral del dolor a la presión del punto gatillo 1 latente del trapecio superior tras la aplicación de una técnica de energía muscular y valorar la fiabilidad intraobservador de la algometría analógica sobre dicho punto. Material y métodos: Treinta y cinco sujetos asintomáticos con el punto gatillo miofascial 1 (PGM1) del trapecio superior latente fueron aleatorizados en dos grupos: un grupo recibió como tratamiento la aplicación de una técnica de energía m...

  12. Myofascial pain syndrome: an overview.

    Science.gov (United States)

    Saxena, Anudeep; Chansoria, Mayank; Tomar, Gaurav; Kumar, Abhyuday

    2015-03-01

    Over the last few decades, advances have been made in the understanding of myofascial pain syndromes (MPSs). In spite of its high prevalence in the society, it is not a commonly established diagnosis. MPS is said to be the great imitator. This article puts some light on the various clinical presentations of the syndrome, on the various tools to reach to a diagnosis for commencing the treatment and on the treatment modalities that have been used so far.

  13. Myofascial Pain Dysfunction Syndrome (MPDS)

    OpenAIRE

    2010-01-01

    Introduction: Myofascial Pain Dysfunction Syndrome (MPDS) is one of the most important causes of the orofacial pain. The main purpose of this study was to evaluate 40 related variables in this regard. Materials and Methods: Thirty nine patients with MPDS were evaluated in this study. Different factors including age, gender, occupation, marital status, sensitivity of masticatory muscles, maximum opening of the mouth, deviation, deflection, involvement of temporomandibular joint, habit, parafun...

  14. Short-Term Effects of Kinesio Taping and Cross Taping Application in the Treatment of Latent Upper Trapezius Trigger Points: A Prospective, Single-Blind, Randomized, Sham-Controlled Trial

    Science.gov (United States)

    Halski, Tomasz; Ptaszkowski, Kuba; Słupska, Lucyna; Paprocka-Borowicz, Małgorzata; Dymarek, Robert; Taradaj, Jakub; Bidzińska, Gabriela; Marczyński, Daniel; Cynarska, Aleksandra; Rosińczuk, Joanna

    2015-01-01

    Kinesio taping (KT) may be a new treatment in patients with myofascial trigger points (MTrPs). A new method available for taping practitioners is cross taping (CT). The main objective was to determine how CT, KT, and medical adhesive tape (sham group) affect the subjective assessment of resting bioelectrical activity and pain of the upper trapezius muscle (UT) in patients with MTrPs. 105 volunteers were recruited to participate. The primary outcome was resting bioelectrical activity of UT muscle as assessed by surface electromyography (sEMG) in each group and pain intensity on a visual analog scale (VAS). Assessments were collected before and after intervention and after the 24-hours follow-up. No significant differences were observed in bioelectrical activity of UT between pre-, post-, and follow-up results. In three groups patients had significantly lower pain VAS score after the intervention (CT—p tapes does not influence the resting bioelectrical activity of UT muscle and may not lead to a reduction in muscle tone in the case of MTrPs. PMID:26491458

  15. Short-Term Effects of Kinesio Taping and Cross Taping Application in the Treatment of Latent Upper Trapezius Trigger Points: A Prospective, Single-Blind, Randomized, Sham-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Tomasz Halski

    2015-01-01

    Full Text Available Kinesio taping (KT may be a new treatment in patients with myofascial trigger points (MTrPs. A new method available for taping practitioners is cross taping (CT. The main objective was to determine how CT, KT, and medical adhesive tape (sham group affect the subjective assessment of resting bioelectrical activity and pain of the upper trapezius muscle (UT in patients with MTrPs. 105 volunteers were recruited to participate. The primary outcome was resting bioelectrical activity of UT muscle as assessed by surface electromyography (sEMG in each group and pain intensity on a visual analog scale (VAS. Assessments were collected before and after intervention and after the 24-hours follow-up. No significant differences were observed in bioelectrical activity of UT between pre-, post-, and follow-up results. In three groups patients had significantly lower pain VAS score after the intervention (CT—p<0.001, KT—p<0.001, and sham—p<0.01. The Kruskal-Wallis ANOVA showed no significant differences in almost all measurements between groups. The application of all three types of tapes does not influence the resting bioelectrical activity of UT muscle and may not lead to a reduction in muscle tone in the case of MTrPs.

  16. [Myofascial pain syndrome--frequent occurrence and often misdiagnosed].

    Science.gov (United States)

    Pongratz, D E; Späth, M

    1998-09-30

    Myofascial pain syndrome (MPS) is a very common localized--sometimes also polytopic--painful musculoskeletal condition associated with trigger points, for which, however, diagnostic criteria established in well-designed studies are still lacking. These two facts form the basis for differentiating between MPS and the fibromyalgia syndrome. The difference between trigger points (MPS) and tender points (fibromyalgia) is of central importance--not merely in a linguistic sense. A knowledge of the signs and symptoms typically associated with a trigger point often obviates the need for time-consuming and expensive technical diagnostic measures. The assumption that many cases of unspecific complaints affecting the musculoskeletal system may be ascribed to MPS makes clear the scope for the saving of costs.

  17. Dry needling for myofascial pain: prognostic factors.

    Science.gov (United States)

    Huang, Yuan-Ting; Lin, Shun-Yuan; Neoh, Choo-Aun; Wang, Kuo-Yang; Jean, Yen-Hsuan; Shi, Hon-Yi

    2011-08-01

    The study objectives were to evaluate outcomes in patients who have received dry needling treatments and to identify predictors of pain and disability. The study was a prospective cohort follow-up design. The study was conducted at the Pain Clinic at Pingtung Christian Hospital, Taiwan. Ninety-two (92) patients sick-listed for 3 months or longer for myofascial pain syndrome. From February to October 2008, participants were treated at the pain clinic with dry needling of trigger points and muscle stretches of the involved muscles. Data were collected by self-administered questionnaires to assess changes in pain intensity and pain interference. Data collection was performed at baseline and after 2, 4, and 8 weeks. Sociodemographic variables, symptom characteristics, and baseline outcome measures were analyzed using generalized estimating equation methodology. The proposed dry-needling protocol reduced pain intensity and pain interference. Long duration of pain symptoms, high pain intensity, poor quality of sleep, and repetitive stress were associated with poor outcomes. Dry needling is an effective treatment for reducing pain and pain interference. However, long pain duration, high pain intensity, poor quality of sleep, and repetitive stress are associated with poor outcomes. Treatment outcome depends not only on the dry needling protocol, but also on disease characteristics and patient demographic profile.

  18. Myofascial Pain: Mechanisms to Management.

    Science.gov (United States)

    Fricton, James

    2016-08-01

    More than 100 million adults in the United States have chronic pain conditions, costing more than $500 billion annually in medical care and lost productivity. They are the most common reason for seeking health care, for disability and addiction, and the highest driver of health care costs. Myofascial pain is the most common condition causing chronic pain and can be diagnosed through identifying clinical characteristics and muscle palpation. Management is focused on integrating patient training in changing lifestyle risk factors with evidence-based treatment. Understanding the cause, diagnosis, and management of myopain conditions will help prevent the impact of chronic pain.

  19. Ultrasound imaging of embedded shrapnel facilitates diagnosis and management of myofascial pain syndrome.

    Science.gov (United States)

    Shankar, Hariharan; Cummings, Craig

    2013-06-01

    Trigger points can result from a variety of inciting events including muscle overuse, trauma, mechanical overload, and psychological stress. When the myofascial trigger points occur in cervical musculature, they have been known to cause headaches. Ultrasound imaging is being increasingly used for the diagnosis and interventional management of various painful conditions. A veteran was referred to the pain clinic for management of his severe headache following a gunshot wound to the neck with shrapnel embedded in the neck muscles a few years prior to presentation. He had no other comorbid conditions. Physical examination revealed a taut band in the neck. An ultrasound imaging of the neck over the taut band revealed the deformed shrapnel located within the levator scapulae muscle along with an associated trigger point in the same muscle. Ultrasound guided trigger point injection, followed by physical therapy resolved his symptoms. This is a unique report of embedded shrapnel and coexisting myofascial pain syndrome revealed by ultrasound imaging. The association between shrapnel and myofascial pain syndrome requires further investigation.

  20. The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders Holsgaard

    A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter...

  1. Prevalence of Myofascial Pain Syndrome in Chronic Non-Specific Neck Pain: A Population-Based Cross-Sectional Descriptive Study.

    Science.gov (United States)

    Cerezo-Téllez, Ester; Torres-Lacomba, María; Mayoral-Del Moral, Orlando; Sánchez-Sánchez, Beatriz; Dommerholt, Jan; Gutiérrez-Ortega, Carlos

    2016-12-01

    Chronic non-specific neck pain is a frequent complaint. It is a recognized medical and socioeconomic problem and a frequent cause of job absenteeism. In recent years, case reports about myofascial pain syndrome (MPS) are emerging among patients suffering from pain. MPS is a regional pain syndrome characterized by myofascial trigger points (MTrP) in palpable taut bands of skeletal muscle that refer pain to a distance, and that can cause distant motor and autonomic effects. To assess the prevalence of active and latent MTrPs in subjects suffering from chronic non-specific neck pain. A population-based cross-sectional descriptive study was carried out from January 2012 to December 2014. Three primary healthcare centers in Alcalá de Henares, Madrid (Spain). Two hundred and twenty-four participants diagnosed by their family doctor with chronic non-specific neck pain. Participants were examined by a physical therapist to determine the presence of MPS. Pain descriptions from the subjects and pain body diagrams guided the physical examination. The subjects were not given any information concerning MPS or other muscle pain syndromes. All participants presented with MPS. MTrPs of the trapezius muscles were the most prevalent, in 93.75% of the participants. The most prevalent active MTrPs were located right (82.1%) and left (79%) in the nearly-horizontal fibers of the upper trapezius muscle. Furthermore, active MTrPs in the levator scapulae, multifidi, and splenius cervicis muscles reached a prevalence of 82.14%, 77.68%, and 62.5%, respectively. MPS is a common source of pain in subjects presenting chronic non-specific neck pain. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Basic principles of renewal of sportsmen with myofascial by a pain syndrome taking into account the psychological aspect of their rehabilitation

    Directory of Open Access Journals (Sweden)

    Kharchenko G.D.

    2014-05-01

    Full Text Available Purpose: to examine and learn the fundamentals of the recovery of athletes with myofascial pain syndrome, taking into account the psychological aspect of their rehabilitation. Material: the data analyzed and summarized the scientific and methodological literature; sites on the internet. Results: the analysis of specialized literature on development features myofascial pain syndrome in athletes. Myofascial pain syndrome is widespread in sports practice. It is characterized by muscle spasms and trigger points, palpation of which there is a growing pain. The basic principles of the recovery of athletes with myofascial pain syndrome. The questions of the effectiveness of rehabilitation measures, taking into account the influence of psychological factors on the recovery of athletes. Conclusions: the presented strategy is comprehensive physical rehabilitation. Recommended keeping the basic principles of the recovery of athletes and the psychological aspect of their rehabilitation.

  3. Low 25-Hydroxyvitamin D and Myofascial Pain: Association of Cancer, Colon Polyps, and Tendon Rupture.

    Science.gov (United States)

    Hightower, Jane M; Dalessandri, Kathie M; Pope, Karl; Hernández, Germán T

    2017-08-01

    Myofascial pain that has been associated with cancer and increased risk of morbidity and mortality in cancer patients is intrinsically associated with low magnesium and low 25-hydroxyvitamin D (25(OH)D). Therefore, this physical finding was used as a clinical diagnostic proxy. The objective of this study was to assess the association and prevalence of disease in individuals with myofascial pain and low 25(OH)D in a county with low magnesium in the drinking water. This is a retrospective cross-sectional study of a chart review of 269 subjects to assess subjects presenting with myofascial pain (assessed by tender trigger points) and 25(OH)D concentrations below 30 ng/mL or a history of 25(OH)D deficiency compared to those without these exposures. The association between the exposure of low 25(OH)D levels and myofascial pain was compared to all cancers, colon polyps, and tendon ruptures. The odds of having cancer with the combined exposures was 10.14 times the odds of not having either exposure (95% confidence interval [CI], 5.08, 20.25, p D less than 30 ng/mL, 74 were tested for red blood cell (RBC) magnesium. Half of those subjects had RBC magnesium concentrations D deficiency showed a significant association with cancer, adenomatous colon polyps, and tendon rupture. Further studies to verify these results are needed, especially in areas where there is low magnesium in the drinking water.

  4. Probable Mechanisms of Needling Therapies for Myofascial Pain Control

    Directory of Open Access Journals (Sweden)

    Li-Wei Chou

    2012-01-01

    Full Text Available Myofascial pain syndrome (MPS has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed.

  5. Myofascial Pain Syndrome in Chronic Back Pain Patients

    Science.gov (United States)

    Nizar, Abd Jalil

    2011-01-01

    Background Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS (χ2 = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P < 0.001) in Visual Analogue Score (VAS) and Modified Oswestry Disability Score (MODS) with standard management during three consecutive visits at six-month intervals. Conclusions MPS prevalence among chronic back pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome. PMID:21716607

  6. Probable Mechanisms of Needling Therapies for Myofascial Pain Control

    Science.gov (United States)

    Chou, Li-Wei; Kao, Mu-Jung; Lin, Jaung-Geng

    2012-01-01

    Myofascial pain syndrome (MPS) has been defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs) clinically. MTrP is defined as the hyperirritable spot in a palpable taut band of skeletal muscle fibers. Appropriate treatment to MTrPs can effectively relieve the clinical pain of MPS. Needling therapies, such as MTrP injection, dry needling, or acupuncture (AcP) can effectively eliminate pain immediately. AcP is probably the first reported technique in treating MPS patients with dry needling based on the Traditional Chinese Medicine (TCM) theory. The possible mechanism of AcP analgesia were studied and published in recent decades. The analgesic effect of AcP is hypothesized to be related to immune, hormonal, and nervous systems. Compared to slow-acting hormonal system, nervous system acts in a faster manner. Given these complexities, AcP analgesia cannot be explained by any single mechanism. There are several principles for selection of acupoints based on the TCM principles: “Ah-Shi” point, proximal or remote acupoints on the meridian, and extra-meridian acupoints. Correlations between acupoints and MTrPs are discussed. Some clinical and animal studies of remote AcP for MTrPs and the possible mechanisms of remote effectiveness are reviewed and discussed. PMID:23346211

  7. A review of treatment approaches of Myofascial Pain Dysfunction Syndrome

    Directory of Open Access Journals (Sweden)

    Arash Mansuorian

    2017-03-01

    Full Text Available Masticatory muscle pain is the second most frequent cause of orofacial pain after dental pain. Myofascial pain dysfunction syndrome (MPDS is the most common form of temporomandibular joint dysfunction. MPDS is a pain that triggers from [sensitive] points in the muscles and fascia and is followed by spasm, tenderness to palpation, restricted movement, fatigue, and sometimes dysfunction. The researchers intended to collect comprehensive information about therapeutic interventions for myofascial pain through the conduction of a critical study based on evidence in the literature. In this review, 51 English articles, published between 1981 and 2013, were extracted from PubMed, Medline, Ovid, and Google Scholar. These articles were then reviewed in detail in two categories, namely pharmaceutical and non-pharmaceutical treatments. MPDS treatment should be first focused on the identification and correction of underlying causes. Thiocolchicoside (TCC, non-steroidal anti-inflammatory drugs (NSAIDs, and Cox-2 inhibitors are among promising pharmaceutical methods. On the other hand, ultrasound and laser therapy are among promising non-pharmaceutical methods. The complex mechanism of MPDS, along with its underlying peripheral and central nervous mechanisms may make MPDS, difficult to treat, especially in its chronic form.

  8. A role for the body burden of aluminium in vaccine-associated macrophagic myofasciitis and chronic fatigue syndrome.

    Science.gov (United States)

    Exley, Christopher; Swarbrick, Louise; Gherardi, Rhomain K; Authier, Francois-Jérôme

    2009-02-01

    Macrophagic myofasciitis and chronic fatigue syndrome are severely disabling conditions which may be caused by adverse reactions to aluminium-containing adjuvants in vaccines. While a little is known of disease aetiology both conditions are characterised by an aberrant immune response, have a number of prominent symptoms in common and are coincident in many individuals. Herein, we have described a case of vaccine-associated chronic fatigue syndrome and macrophagic myofasciitis in an individual demonstrating aluminium overload. This is the first report linking the latter with either of these two conditions and the possibility is considered that the coincident aluminium overload contributed significantly to the severity of these conditions in this individual. This case has highlighted potential dangers associated with aluminium-containing adjuvants and we have elucidated a possible mechanism whereby vaccination involving aluminium-containing adjuvants could trigger the cascade of immunological events which are associated with autoimmune conditions including chronic fatigue syndrome and macrophagic myofasciitis.

  9. Demographics features, clinical findings and functional status in a group of subjects with cervical myofascial pain syndrome.

    Science.gov (United States)

    Sahin, Nilay; Karataş, Omer; Ozkaya, Murat; Cakmak, Ayşegül; Berker, Ender

    2008-07-01

    Subjects with myofascial pain of muscles of the neck region may present with various clinical symptoms. The aim of this study was to explore the demographics features, clinical findings and functional status in a group of patients presenting with myofascial pain of the cervical muscles. 94 cervical myofascial pain syndrome patients were recruited from the out-patient clinic. Evaluated of patient short form health survey (SF-36), pain, depression, patient demographics and physical examinations. Outcome measures; SF-36 Health Survey, visual analog scale, Beck Depression Inventory, history, physical examination. A total of 82 patients with a diagnosis of cervical myofascial syndrome were included in the study. All patients were in the young age group 37.4+/-9, and 87.8% were females. 53.1% had trigger points in the trapezius muscle with high percentage of autonomic phenomena like skin reddening, lacrimation, tinnitus and vertigo. 58.5% of the series had suffered from former cervical trauma and 40.2% also had fibromyalgia syndrome and 18.5% had benign Joint hypermobility syndrome. Younger female patients presenting with autonomic phenomena and early onset cervical injury should be examined for cervical myofascial pain syndrome and also for fibromyalgia syndrome since this study demonstrated a high percentage of fibromyalgia syndrome in these patients.

  10. Usefulness of diagnostic ultrasound for detecting myofascial change of the hamstring muscles due to lmmobilization: Experimental study with caged rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yoon Kyoo; Kim, Joo Hyun; Lee, Chang Hyung; Kim, Jung Ryul; Kim, Han Kyum [Korea University College of Medicine, Seoul (Korea, Republic of)

    2002-03-15

    To evaluate the usefulness of diagnostic ultrasound in the localization of soft tissue changes in the region of clinically suspected myofascial pain syndrome and to investigate the ultrasonographic and pathologic differences of the hamstring muscles between caged and freely mobile rabbits. A total of eight caged rabbits were used in this study. Four rabbits (age; two were 3-4 months, and the other two were 8-9 months) were raised in a small cage (40 X 50 X 30 cm), and the other four rabbits (age; two were 3-4 months while the other two 8-9 months) raised in a yard where they were free to move around. First, clinically identified myofascial trigger point-taut band or nodule was identified followed by diagnostic ultrasound examination of the hamstring and gluteus muscles and injection of Indian ink of the band or nodule. Biopsies were performed to include the hyperechoic regions as well as clinically identified myofascial trigger points, and the obtained specimens were stained with hematoxylin-eosin and masson-trichrome. The analysis of the results of the ultrasound study and pathologic study found correlation between the pathologic identification of myofascial trigger point and diagnostic ultrasound, where palpable nodules of caged animal, older more than younger one should greater extent of increment of echogenicity and degenerative pathologic changes such as fatty changes and appearance of hyaline fibers. Diagnostic ultrasound could be applied to identify or observe soft tissue changes in the regions of clinically identified myofascial trigger points. A pattern has emerged where soft tissue changes were ore likely to be observed in the caged animal where their movements were restricted and prone to fixed position. Further study to investigate the reversibility of pathologic changes of caged animal should be carried out.

  11. 针刺腹肌肌筋膜触发点治疗原发性痛经的疗效%Efficacy of acupuncture at abdominal myofascial trigger points for the treatment of patients with primary dysmenorrhea

    Institute of Scientific and Technical Information of China (English)

    刘琳; 黄强民; 刘庆广; 马彦韬; 赵佳敏

    2016-01-01

    Objective To retrospectively observe the efficacy of acupuncture at myofacial trigger points (MTrPs) in abdominal muscles for the treatment of patients with primary dysmenorrhea.Methods Sixtyfive patients with moderate or severe primary dysmenorrhea were treated with acupuncture therapy.The MTrPs in abdominal region were localized and repeatedly acupunctured and injected with 1% lidocaine,combined with auto-stretching exercise of abdominal muscles,0.5-1.0 min/time,3-5 times/d.VAS and effects were evaluated at the menstrual period after every acupuncture,and one year after last acupuncture.Results The effective rate was 63% (41/65 cases),100% (65/65 cases) and 100% (65/65 cases) after the acupuncture 1,2 times and 1 year after the treatment respectively.Conclusion Acupuncture at MTrPs in abdominal region combined with stretching exercise is effective for the treatment of primary dysmenorrhea.%目的 回顾性分析针刺腹肌肌筋膜触发点(MTrPs)治疗原发性痛经的效果.方法 选择中、重度原发性痛经患者65例,在腹肌肌筋膜定位MTrPs,并在月经中期对MTrPs进行针刺并注射1%利多卡因治疗,针刺时需引出腹肌局部跳动,反复针刺直至跳动消失.每次针刺结束后指导患者行腹肌牵张锻炼,保持0.5~1.0 min/次·3~5次/d.于每次治疗后的下一次月经期及最后一次治疗的1年后,评估VAS及疗效.当VAS≤3时,结束针刺治疗.结果 第1、2次治疗后及1年后随访有效率分别为63%(41/65例),100%(65/65例)和100%(65/65例).结论 针刺腹肌MTrPs结合腹肌牵张锻炼可有效缓解原发性痛经.

  12. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey

    Directory of Open Access Journals (Sweden)

    Freiberg Florentina

    2010-02-01

    Full Text Available Abstract Background Myofascial pain is a common dysfunction with a lifetime prevalence affecting up to 85% of the general population. Current guidelines for the management of myofascial pain are not available. In this study we investigated how physicians on the basis of prescription behaviour evaluate the effectiveness of treatment options in their management of myofascial pain. Methods We conducted a cross-sectional, nationwide survey with a standardized questionnaire among 332 physicians (79.8% male, 25.6% female, 47.5 ± 9.6 years experienced in treating patients with myofascial pain. Recruitment of physicians took place at three German meetings of pain therapists, rheumatologists and orthopaedists, respectively. Physicians estimated the prevalence of myofascial pain amongst patients in their practices, stated what treatments they used routinely and then rated the perceived treatment effectiveness on a six-point scale (with 1 being excellent. Data are expressed as mean ± standard deviation. Results The estimated overall prevalence of active myofascial trigger points is 46.1 ± 27.4%. Frequently prescribed treatments are analgesics, mainly metamizol/paracetamol (91.6%, non-steroidal anti-inflammatory drugs/coxibs (87.0% or weak opioids (81.8%, and physical therapies, mainly manual therapy (81.1%, TENS (72.9% or acupuncture (60.2%. Overall effectiveness ratings for analgesics (2.9 ± 0.7 and physical therapies were moderate (2.5 ± 0.8. Effectiveness ratings of the various treatment options between specialities were widely variant. 54.3% of all physicians characterized the available treatment options as insufficient. Conclusions Myofascial pain was estimated a prevalent condition. Despite a variety of commonly prescribed treatments, the moderate effectiveness ratings and the frequent characterizations of the available treatments as insufficient suggest an urgent need for clinical research to establish evidence-based guidelines for the

  13. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey

    Science.gov (United States)

    2010-01-01

    Background Myofascial pain is a common dysfunction with a lifetime prevalence affecting up to 85% of the general population. Current guidelines for the management of myofascial pain are not available. In this study we investigated how physicians on the basis of prescription behaviour evaluate the effectiveness of treatment options in their management of myofascial pain. Methods We conducted a cross-sectional, nationwide survey with a standardized questionnaire among 332 physicians (79.8% male, 25.6% female, 47.5 ± 9.6 years) experienced in treating patients with myofascial pain. Recruitment of physicians took place at three German meetings of pain therapists, rheumatologists and orthopaedists, respectively. Physicians estimated the prevalence of myofascial pain amongst patients in their practices, stated what treatments they used routinely and then rated the perceived treatment effectiveness on a six-point scale (with 1 being excellent). Data are expressed as mean ± standard deviation. Results The estimated overall prevalence of active myofascial trigger points is 46.1 ± 27.4%. Frequently prescribed treatments are analgesics, mainly metamizol/paracetamol (91.6%), non-steroidal anti-inflammatory drugs/coxibs (87.0%) or weak opioids (81.8%), and physical therapies, mainly manual therapy (81.1%), TENS (72.9%) or acupuncture (60.2%). Overall effectiveness ratings for analgesics (2.9 ± 0.7) and physical therapies were moderate (2.5 ± 0.8). Effectiveness ratings of the various treatment options between specialities were widely variant. 54.3% of all physicians characterized the available treatment options as insufficient. Conclusions Myofascial pain was estimated a prevalent condition. Despite a variety of commonly prescribed treatments, the moderate effectiveness ratings and the frequent characterizations of the available treatments as insufficient suggest an urgent need for clinical research to establish evidence-based guidelines for the treatment of myofascial

  14. Effect of yoga on the Myofascial Pain Syndrome of neck

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    D Sharan

    2014-01-01

    Full Text Available Myofascial Pain Syndrome (MPS refers to pain attributed to muscle and its surrounding fascia, which is associated with ′′myofascial trigger points′′ (MTrPs. MTrPs in the trapezius has been proposed as the main cause of temporal and cervicogenic headache and neck pain. Literature shows that the prevalence of various musculoskeletal disorders (MSD among physiotherapists is high. Yoga has traditionally been used to treat MSDs in various populations. But there is scarcity of literature which explains the effects of yoga on reducing MPS of the neck in terms of various physical parameters and subjective responses. Therefore, a pilot study was done among eight physiotherapists with minimum six months of experience. A structured yoga protocol was designed and implemented for five days in a week for four weeks. The outcome variables were Disability of Arm, Shoulder and Hands (DASH score, Neck Disability Index (NDI, Visual Analogue Scale (VAS, Pressure Pain Threshold (PPT for Trigger Points, Cervical Range of Motion (CROM - active & passive, grip and pinch strengths. The variables were compared before and after the intervention. Finally, the result revealed that all the variables (DASH: P<0.00, NDI: P<0.00, VAS: P<0.00, PPT: Left: P<0.00, PPT: Right: P<0.00, Grip strength: left: P<0.00, Grip strength: right: P<0.01, Key pinch: left: P<0.01, Key pinch: right: P<0.01, Palmar pinch: left: P<0.01, Palmar pinch: right: P<0.00, Tip pinch: left: P<0.01, Tip pinch: Right: P<0.01 improved significantly after intervention.

  15. Effect of yoga on the Myofascial Pain Syndrome of neck.

    Science.gov (United States)

    Sharan, D; Manjula, M; Urmi, D; Ajeesh, Ps

    2014-01-01

    Myofascial Pain Syndrome (MPS) refers to pain attributed to muscle and its surrounding fascia, which is associated with "myofascial trigger points" (MTrPs). MTrPs in the trapezius has been proposed as the main cause of temporal and cervicogenic headache and neck pain. Literature shows that the prevalence of various musculoskeletal disorders (MSD) among physiotherapists is high. Yoga has traditionally been used to treat MSDs in various populations. But there is scarcity of literature which explains the effects of yoga on reducing MPS of the neck in terms of various physical parameters and subjective responses. Therefore, a pilot study was done among eight physiotherapists with minimum six months of experience. A structured yoga protocol was designed and implemented for five days in a week for four weeks. The outcome variables were Disability of Arm, Shoulder and Hands (DASH) score, Neck Disability Index (NDI), Visual Analogue Scale (VAS), Pressure Pain Threshold (PPT) for Trigger Points, Cervical Range of Motion (CROM) - active & passive, grip and pinch strengths. The variables were compared before and after the intervention. Finally, the result revealed that all the variables (DASH: P<0.00, NDI: P<0.00, VAS: P<0.00, PPT: Left: P<0.00, PPT: Right: P<0.00, Grip strength: left: P<0.00, Grip strength: right: P<0.01, Key pinch: left: P<0.01, Key pinch: right: P<0.01, Palmar pinch: left: P<0.01, Palmar pinch: right: P<0.00, Tip pinch: left: P<0.01, Tip pinch: Right: P<0.01) improved significantly after intervention.

  16. Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

    Directory of Open Access Journals (Sweden)

    José M. Climent

    2013-01-01

    Full Text Available Introduction. Botulinum toxin inhibits acetylcholine (ACh release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

  17. Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

    Science.gov (United States)

    Climent, José M.; Fenollosa, Pedro; Martin-del-Rosario, Francisco

    2013-01-01

    Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies. PMID:23533477

  18. Botulinum toxin for the treatment of myofascial pain syndromes involving the neck and back: a review from a clinical perspective.

    Science.gov (United States)

    Climent, José M; Kuan, Ta-Shen; Fenollosa, Pedro; Martin-Del-Rosario, Francisco

    2013-01-01

    Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

  19. Comparison of dry needling and physiotherapy in treatment of myofascial pain syndrome.

    Science.gov (United States)

    Rayegani, Seyed Mansoor; Bayat, Masume; Bahrami, Mohammad Hasan; Raeissadat, Seyed Ahmad; Kargozar, Elham

    2014-06-01

    To compare the effects of dry needling and physiotherapy in treatment of myofascial pain syndrome, a randomized controlled trial was performed on 28 patients with myofascial pain syndrome (MPS) of upper trapezius muscle in the Physical Medicine and Rehabilitation Center of Shohadaye Tajrish Hospital from April 2009 to April 2010. After matching the age, sex, duration of symptoms, pain severity, and quality of life measures, subjects were randomly assigned into two subgroups of case (dry needling) and control (physiotherapy). One week and 1 month after receiving standard therapeutic modalities, outcomes and intragroup and intergroup changes in pain severity, pressure pain of trigger point (TP), and quality of life measures were evaluated and compared. After 1 month, both the physiotherapy and dry needling groups had decreased resting, night, and activity pain levels (pmyofascial pain of the upper trapezius muscle.

  20. Ultrasonic tissue characterization of the upper trapezius muscle in patients with myofascial pain syndrome.

    Science.gov (United States)

    Turo, Diego; Otto, Paul; Shah, Jay P; Heimur, Juliana; Gebreab, Tadesse; Armstrong, Katherine; Gerber, Lynn H; Sikdar, Siddhartha

    2012-01-01

    Myofascial trigger points (MTrPs) are palpable, tender nodules in skeletal muscle that produce symptomatic referred pain when palpated. MTrPs are characteristic findings in myofascial pain syndrome (MPS). The role of MTrPs in the pathophysiology of MPS is unknown. Objective characterization and quantitative measurement of the properties of MTrPs can improve their localization and diagnosis, as well as lead to clinical outcome measures. MTrPs associated with soft tissue neck pain are often found in the upper trapezius muscle. We have previously demonstrated that MTrPs can be visualized using ultrasound imaging. The goal of this study was to evaluate whether texture-based image analysis can differentiate structural heterogeneity of symptomatic MTrPs and normal muscle.

  1. Myofascial Pelvic Pain and Related Disorders.

    Science.gov (United States)

    Bonder, Jaclyn H; Chi, Michelle; Rispoli, Leia

    2017-08-01

    Myofascial pelvic pain refers to pain in the pelvic floor muscles, the pelvic floor connective tissue, and the surrounding fascia. The cause is often multifactorial and requires treatment that encompasses multiple modalities. This type of pain is often associated with other abdominopelvic disorders, so providers in these specialties need to be aware of these connections. A comprehensive musculoskeletal examination, including evaluation of the pelvic floor muscles, and history are key to diagnosing myofascial pelvic pain. Treatments include physical therapy, muscle relaxers, oral neuromodulators, cognitive-behavioral therapy, and pelvic floor muscle injections. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Myofascial release of carpal tunnel syndrome.

    Science.gov (United States)

    Sucher, B M

    1993-01-01

    Current treatment for carpal tunnel syndrome may be ineffective or associated with complications or recurrence. In the case reported here, a myofascial release by the physician combined with the patient's self-stretch reduced pain and numbness and improved electromyographic results. The manipulative approach releases the transverse carpal ligament,-and "opens" or dilates the canal. The patient stretches the wrist, digits, and thumb, including myofascial components. An aggressive, conservative approach lessens the need for surgery in mild to moderate cases. Studies with magnetic resonance imaging may be helpful to document canal size before and after treatment.

  3. A Comparative Study Between Acupuncture and Lidocaine Block Treatment for Back of the Neck Myofascial Trigger Point%针刺与利多卡因阻滞治疗颈背部肌筋膜扳机点比较研究

    Institute of Scientific and Technical Information of China (English)

    尹凤华

    2014-01-01

    目的:比较运用针刺与利多卡因阻滞治疗颈背部肌筋膜扳机点的临床疗效。方法收集菏泽市第二人民医院2013年5-12月MPS患者100例,通过PEMS3.1软件按照1:1的比例获取随机数字,随机将患者分为针刺组和对照组,每组50例。结果针刺组与对照组在治疗前VAS比较差异无统计学意义(P>0.05),两组治疗后1次以及治疗后3次均较治疗前降低(P0.05)。针刺组与对照组在治疗前NDI比较差异无统计学意义(P>0.05),两组治疗后1次以及治疗后3次均较治疗前降低(P0.05)。针刺组与对照组在治疗前PPDT与PPTO比较差异无统计学意义(P>0.05),两组治疗1次后以及治疗3次后PPDT与PPTO均较治疗前降低(P0.05)。结论针刺扳机点可降低VAS和NDI,提高患者的压痛阈和耐痛阈,临床效果明显,且无明显的不良反应,是治疗颈背部MPS的一种有效的可供选择的方法。%Objective To compare the clinical efficacy between acupuncture and lidocaine block for the treatment of back of the neck myofascial trigger point. Methods 100 cases of patients with MPS admitted in Heze Second People's Hospital from May, 2013 to December, 2013 were selected. A random number was obtained by PEMS3.1 software in accordance with the ratio of 1:1, and the patients were randomly divided into acupuncture group and control group with 50 cases in each. Results The difference in pre-treatment VAS between the acupuncture group and the control group was statistically significant (P>0.05), and after 1 time, 3 times of treatment, VAS of both groups were lower than before treatment(P0.05). Before treatment, the difference in NDI between the acupuncture group and the control group was statistically significant(P>0.05), after 1 time and 3 times of treatment, the NDI of both groups were lower than those before treatment (P0.05). Before treatment, the difference in PPDT and PPTO between the acupuncture group and the

  4. Myofascial Pain Dysfunction Syndrome (MPDS

    Directory of Open Access Journals (Sweden)

    Hamed Mortazavi

    2010-10-01

    Full Text Available Introduction: Myofascial Pain Dysfunction Syndrome (MPDS is one of the most important causes of the orofacial pain. The main purpose of this study was to evaluate 40 related variables in this regard. Materials and Methods: Thirty nine patients with MPDS were evaluated in this study. Different factors including age, gender, occupation, marital status, sensitivity of masticatory muscles, maximum opening of the mouth, deviation, deflection, involvement of temporomandibular joint, habit, parafunction, malocclusion, neck pain, headache, earache and history of jaw involvement, etc were analyzed in this  evaluation. Results: In our study, 39 patients (32 females and 7 males, 20-40 years old, with the average age of 35 ± 13.32 years were studied. 51% were housewives and 74.4% were married. The most common involvements were Clicking (74.4%, pain in temporomandibular joint (54%, headache (46.2%, earache (41%, neck-pain (35.9%, trouble in the mouth opening (71.8%, malocclusion Class I (74.4%, cross bite and deep bite (25%, clenching (64.1% and involvement of masseter and lateral pterygoid muscle (84%. Conclusion: Since MPDS consists of variable symptoms, it might be very difficult to provide any definite diagnosis and treatment. Therefore the more the specialists extend their knowledge and information about this disorder, the more they will make the best decision in this regard.

  5. Quantitative Ultrasound Assessment of Myofascial Pain Syndrome Affecting the Trapezius: A Reliability Study.

    Science.gov (United States)

    Kumbhare, Dinesh; Shaw, Saurabh; Grosman-Rimon, Liza; Noseworthy, Michael D

    2017-07-03

    Myofascial pain syndrome is one of the most common causes of chronic pain and is highlighted by the presence of myofascial trigger points. The current practice of diagnosing myofascial pain syndrome among clinicians involves manual detection of myofascial trigger points, which can be inconsistent. However, the detection process can be strengthened with the assistance of ultrasound (US). Therefore, this study aimed to characterize the upper trapezius by using quantitative techniques in healthy asymptomatic individuals with neck pain. Study participants were recruited on the basis of the inclusion and exclusion criteria established, and US images of the trapezius, along the axial and longitudinal orientations, were obtained. Each set was obtained by 2 investigators: experienced and inexperienced personnel. Fifteen participants were recruited. The mean gray scale US echo intensity distribution obtained was 41.9. A paired t test of the global mean echo intensity value obtained for each image from the US operators did not show any significant difference (P = .77). A t test was performed, comparing the echo intensity of the group of patients with neck pain and healthy control participants, and the difference was found to be significant (P = .052). The median blob area was 2.71. The quartile range for the blob area was 1.72 for the 25th percentile to 4.90 for the 75th percentile. This study demonstrated that quantitative analysis of the echo intensity of US images can provide important information. However, further research is necessary to explore the relationships among sex, age, blob area, count, body mass index, regional anatomy, and extent of training or exercise of the particular muscle. © 2017 by the American Institute of Ultrasound in Medicine.

  6. Effect of self-myofascial release on myofascial pain, muscle flexibility, and strength: A narrative review.

    Science.gov (United States)

    Kalichman, Leonid; Ben David, Chen

    2017-04-01

    Numerous techniques have been employed to treat myofascial pain syndrome. Self-myofascial release (SMFR) is a relatively new technique of soft tissue mobilization. The simplicity and portability of the SMFR tools allow it to be easily implemented in any type of fitness or rehabilitation program. It is an active method and can be used by anyone at home or at the workplace. To review the current methods of SMFR, their mechanisms, and efficacy in treating myofascial pain, improving muscle flexibility and strength. PubMed, Google Scholar, and PEDro databases were searched without search limitations from inception until July 2016 for terms relating to SMFR. During the past decade, therapists and fitness professionals have implemented SMFR mainly via foam rolling as a recovery or maintenance tool. Researchers observed a significant increase in the joint range of motion after using the SMFR technique and no decrease in muscle force or changes in performance after treatment with SMFR. SMFR has been widely used by health-care professionals in treating myofascial pain. However, we found no clinical trials which evaluated the influence of SMFR on myofascial pain. There is an acute need for these trials to evaluate the efficacy and effectiveness of SMFR in the treatment of the myofascial syndrome. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Comparison of the Effectiveness of Transcutaneous Electrical Nerve Stimulation and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome: A Randomized Controlled Study.

    Science.gov (United States)

    Dissanayaka, Thusharika Dilrukshi; Pallegama, Ranjith Wasantha; Suraweera, Hilari Justus; Johnson, Mark I; Kariyawasam, Anula Padma

    2016-09-01

    The aim of this study was to compare the effectiveness of transcutaneous electrical nerve stimulation and interferential therapy (IFT) both in combination with hot pack, myofascial release, active range of motion exercise, and a home exercise program on myofascial pain syndrome patients with upper trapezius myofascial trigger point. A total of 105 patients with an upper trapezius myofascial trigger point were recruited to this single-blind randomized controlled trial. Following random allocation of patients to three groups, three therapeutic regimens-control-standard care (hot pack, active range of motion exercises, myofascial release, and a home exercise program with postural advice), transcutaneous electrical nerve stimulation-standard care and IFT-standard care-were administered eight times during 4 wks at regular intervals. Pain intensity and cervical range of motions (cervical extension, lateral flexion to the contralateral side, and rotation to the ipsilateral side) were measured at baseline, immediately after the first treatment, before the eighth treatment, and 1 wk after the eighth treatment. Immediate and short-term improvements were marked in the transcutaneous electrical nerve stimulation group (n = 35) compared with the IFT group (n = 35) and the control group (n = 35) with respect to pain intensity and cervical range of motions (P < 0.05). The IFT group showed significant improvement on these outcome measurements than the control group did (P < 0.05). Transcutaneous electrical nerve stimulation with standard care facilitates recovery better than IFT does in the same combination.

  8. Characteristics of Myofascial Pain Syndrome of the Infraspinatus Muscle.

    Science.gov (United States)

    Kwon, Junbeom; Kim, Hyoung Seop; Chang, Won Hyuk; Park, Chunung; Lee, Sang Chul

    2017-08-01

    To report the characteristics of myofascial trigger points (MTrPs) in the infraspinatus muscle and evaluate the therapeutic effect of trigger-point injections. Medical records of 297 patients (221 women; age, 53.9±11.3 years) with MTrPs in the infraspinatus muscle were reviewed retrospectively. Because there were 83 patients with MTrPs in both infraspinatus muscles, the characteristics of total 380 infraspinatus muscles with MTrPs (214 one side, 83 both sides) were investigated. Specific characteristics collected included chief complaint area, referred pain pattern, the number of local twitch responses, and distribution of MTrPs in the muscle. For statistical analysis, the paired t-test was used to compare a visual analogue scale (VAS) before and 2 weeks after the first injection. The most common chief complaint area of MTrPs in the infraspinatus muscle was the scapular area. The most common pattern of referred pain was the anterolateral aspect of the arm (above the elbow). Active MTrPs were multiple rather than single in the infraspinatus muscle. MTrPs were frequently in the center of the muscle. Trigger-point injection of the infraspinatus muscle significantly decreased the pain intensity. Mean VAS score decreased significantly after the first injection compared to the baseline (7.11 vs. 3.74; pmyofascial pain syndrome of the infraspinatus muscle.

  9. Sleep bruxism and myofascial temporomandibular disorders

    Science.gov (United States)

    Raphael, Karen G.; Sirois, David A.; Janal, Malvin N.; Wigren, Pia E.; Dubrovsky, Boris; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2015-01-01

    Background Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients’ self-reports rather than on direct observation. Methods The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants. Results The results of independent sample t tests and χ2 analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent). Conclusions Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned. Clinical Implications Although other reasons to consider treating SB may exist, misplaced concern about SB’s sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment. PMID:23115152

  10. The therapeutic effect of collateral meridian therapy is comparable to acupoint pressure therapy in treating myofascial pain syndrome.

    Science.gov (United States)

    Lee, Si-Huei; Lu, Wan-An; Lee, Chang-Shun; Wang, Jia-Chi; Lin, Tsung-Ching; Yang, Jen-Lin; Chan, Rai-Chi; Ko, Shan-Chi; Kuo, Cheng-Deng

    2014-11-01

    This study compared the therapeutic effects of collateral meridian therapy (CMT) with traditional acupoint pressure therapy (APT) in patients with unilateral upper back pain. Forty-nine patients with active myofascial trigger points in upper trapezius muscle were randomly allocated to the control (CTL), APT, or CMT group. Each subject in the CMT and APT groups received 2 sessions of treatment per week over 1 month. Patients in the APT and CMT groups showed significant improvements 1 month after treatment in visual analogue scale, range of motion, pain pressure threshold, regional superficial blood flow, and physical health, as compared to the CTL group. No significant differences in outcome measures were found between APT and CMT groups 1 month after treatment. Both APT and CMT have comparable therapeutic efficacy in the treatment of unilateral upper back pain with active myofascial trigger points in the upper trapezius muscle. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Microstructural Abnormalities Were Found in Brain Gray Matter from Patients with Chronic Myofascial Pain

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    Peng Xie

    2016-12-01

    Full Text Available Myofascial pain, presented as myofascial trigger points (MTrPs-related pain, is a common, chronic disease involving skeletal muscle, but its underlying mechanisms have been poorly understood. Previous studies have revealed that chronic pain can induce microstructural abnormalities in the cerebral gray matter. However, it remains unclear whether the brain gray matter of patients with chronic MTrPs-related pain undergo alteration. In this study, we employed the Diffusion Kurtosis Imaging (DKI technique, which is particularly sensitive to brain microstructural perturbation, to monitor the MTrPs-related microstructural alterations in brain gray matter of patients with chronic pain. Our results revealed that, in comparison with the healthy controls, patients with chronic myofascial pain exhibited microstructural abnormalities in the cerebral gray matter and these lesions were mainly distributed in the limbic system and the brain areas involved in the pain matrix. In addition, we showed that microstructural abnormalities in the right anterior cingulate cortex (ACC and medial prefrontal cortex (mPFC had a significant negative correlation with the course of disease and pain intensity. The results of this study demonstrated for the first time that there are microstructural abnormalities in the brain gray matter of patients with MTrPs-related chronic pain. Our findings may provide new insights into the future development of appropriate therapeutic strategies to this disease.

  12. Value of transcutaneous electric nerve stimulation in the treatment of myofascial pain dysfunction syndrome

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    Hina Handa

    2017-01-01

    Full Text Available Pain in facial region originating from both temporomandibular joint (TMJ and jaw muscles is a common clinical problem and is a diagnostic dilemma till today. There are many synonyms for this condition including myofascial pain dysfunction syndrome, mandibular dysfunction syndrome, and the TMJ dysfunction syndrome. With change in time, advances and new diagnostic criteria have been made in the diagnosis of myofascial pain syndrome, its epidemiology, clinical characteristics, and etiopathogenesis, but many unknowns remain. An integrated hypothesis has provided a greater understanding of the physiopathology of trigger points, which may allow the development of new diagnostic criteria and treatment of this chronic disease and combined pharmacological as well as physical therapy for the management of the disease. The purpose of this paper is to describe the multidisciplinary approach highlighting the effect of transcutaneous electric nerve stimulation (TENS for the treatment of a 60-year-old female who suffered from myofascial pain and 5-day TENS therapy for management of pain.

  13. A critical overview of the current myofascial pain literature - March 2016.

    Science.gov (United States)

    Dommerholt, Jan; Hooks, Todd; Finnegan, Michelle; Grieve, Rob

    2016-04-01

    The worldwide interest in myofascial pain syndrome (MPS) and trigger points (TrPs) is reflected in the increasing number of publications. In this overview of the literature, we included 26 studies, case reports and review articles by authors from 18 different countries. Several research groups are exploring the characteristic of TrPs such as Chen and colleagues, who continued their work on the quantification of the taut bands. Meng and colleagues studied the relationships between TrPs and central sensitization, while Yu and colleagues examined the electrophysiological characteristics that occur as a result of active TrPs. Several researchers used objective measurements to determine clinical outcomes, such as Koppenhaver and colleagues who measured objective changes in the function and nociceptive sensitivity of lumbar multifidus muscle subjects with low back pain. Turo and colleagues quantified muscle tissue changes after dry needling in chronic myofascial pain using elastography. Multiple studies explored various treatment options for TrPs, such as dry needling, injections with lidocaine or granisetron, traditional Thai massage, self-myofascial release, kinesiotaping, and monochromatic infrared photo energy, among others.

  14. A critical overview of the current myofascial pain literature - January 2016.

    Science.gov (United States)

    Dommerholt, Jan; Finnegan, Michelle; Grieve, Rob; Hooks, Todd

    2016-01-01

    Reflecting on the past year, the number of publications on myofascial pain continues to increase in a steady rate. The current review includes 30 basic and clinical studies, case reports, reviews, and reports from fifteen different countries about trigger points (TrP), myofascial pain (MP), dry needling (DN) and other related interventions. We are pleased that during 2015 this article made the top 15 of most downloaded articles as many as three times! In general, the quality of published papers is improving as well. Nevertheless, several papers included in this overview, mention the application of "ischemic compression", which is a questionable concept in the context of TrP inactivation. As we have outlined previously, in the current thinking about myofascial pain, TrPs feature significant hypoxia and a lowered pH (Ballyns et al., 2011; Shah and Gilliams, 2008), and attempts to induce more ischemia would be counterproductive. Already in 1999, Simons, Travell and Simons changed the terminology from ischemic compression to TrP compression (Simons et al., 1999) and we recommend that contemporary researchers and clinicians adopt the new terminology and stop using the term "ischemic compression."

  15. Chronic refractory myofascial pain and denervation supersensitivity as global public health disease.

    Science.gov (United States)

    Chu, J; Bruyninckx, F; Neuhauser, D V

    2016-01-13

    Chronic pain with a 30.3% global prevalence significantly impacts universal health. Low back pain has a 9.4% prevalence worldwide causing the most widespread disability. Neck pain ranks 4th highest regarding years lived with disability with a 4.9% prevalence worldwide. The principal cause of pain in 85% of patients visiting a tertiary pain clinic has a myofascial origin. The root cause is multifocal neuromuscular ischaemia at myofascial trigger points from muscle tightening and shortening following spondylotic radiculopathy induced partial denervation. Chronic refractory myofascial pain (CRMP) is a neuromusculoskeletal disease needing management innovations. Using electrical twitch-obtaining intramuscular stimulation (eToims), we provide objective evidence of denervation supersensitivity in multiple myotomes as cause, aggravation and maintenance of CRMP. This study underscores our previous findings that eToims is safe and efficacious for long-term use in CRMP. eToims aids potential prevention (pre-rehabilitation), simultaneous diagnosis, treatment (rehabilitation) and prognosis in real time for acute and CRMP management.

  16. Two- and three-dimensional ultrasound imaging to facilitate detection and targeting of taut bands in myofascial pain syndrome.

    Science.gov (United States)

    Shankar, Hariharan; Reddy, Sapna

    2012-07-01

    Ultrasound imaging has gained acceptance in pain management interventions. Features of myofascial pain syndrome have been explored using ultrasound imaging and elastography. There is a paucity of reports showing the benefit clinically. This report provides three-dimensional features of taut bands and highlights the advantages of using two-dimensional ultrasound imaging to improve targeting of taut bands in deeper locations. Fifty-eight-year-old man with pain and decreased range of motion of the right shoulder was referred for further management of pain above the scapula after having failed conservative management for myofascial pain syndrome. Three-dimensional ultrasound images provided evidence of aberrancy in the architecture of the muscle fascicles around the taut bands compared to the adjacent normal muscle tissue during serial sectioning of the accrued image. On two-dimensional ultrasound imaging over the palpated taut band, areas of hyperechogenicity were visualized in the trapezius and supraspinatus muscles. Subsequently, the patient received ultrasound-guided real-time lidocaine injections to the trigger points with successful resolution of symptoms. This is a successful demonstration of utility of ultrasound imaging of taut bands in the management of myofascial pain syndrome. Utility of this imaging modality in myofascial pain syndrome requires further clinical validation. Wiley Periodicals, Inc.

  17. DRY NEEDLING AS A PAIN MODULATING MODALITY IN MYOFASCIAL PAIN SYNDROME

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    Ravinder Kumar

    2016-06-01

    Full Text Available BACKGROUND Myofascial Pain Syndrome (MPS is a significant health problem affecting as much as 85% of the general population, sometime in their lifetime, while the estimated overall prevalence is 46%. Low back pain is the most common MPS affecting all age groups with no gender discrimination. It can be acute or chronic. It can cause localised, diffuse, radicular or referred type of pains. Dry Needling or intramuscular stimulation is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular and connective tissues for the management of neuromusculoskeletal pain and movement impairments in Myofascial Pain Syndrome (MPS. MATERIALS AND METHODS 90 patients (57 male and 33 female who attended the Department of Physio-Occupation Therapy, which is a part of the Department of Orthopaedics, Osmania General Hospital, were randomly chosen after clearance from the Ethical Committee. The study period extended from June 2015 to Jan 2016. They were divided into groups according to their position in Visual Analogue Scale (VAS and their respective scores were noted. Their scores were once again noted after they received the Dry Needling treatment of about 6 sittings. RESULTS Out of the 90 cases, 65 cases showed excellent results (VAS 0-1 after treatment, 18 cases showed good results (VAS 2-3 after treatment, 6 cases showed fair results (VAS 4-5 after treatment, 2 cases showed VAS-6 after treatment. CONCLUSION Dry Needling is a relatively new treatment modality with specific subjective pain modulation efficacy in myofascial pain syndrome, which can help us in alleviating the pain in chronic conditions and acts adjuvant to the specific treatment.

  18. Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion.

    Science.gov (United States)

    Gerber, Lynn H; Sikdar, Siddhartha; Aredo, Jacqueline V; Armstrong, Katee; Rosenberger, William F; Shao, Hui; Shah, Jay P

    2017-02-01

    Dry needling is an effective treatment for reducing pain associated with active myofascial trigger points (a-MTrPs) in the short term. The duration of the benefits of this treatment have not been fully assessed. To determine whether the benefits of dry needling (DN) of a-MTrPs are sustained 6 weeks posttreatment. Follow-up of a prospective study. University. A total of 45 patients (13 male and 32 female) with cervical pain >3 months and a-MTrPs in the upper trapezius who completed 3 DN treatments and who were evaluated 6 weeks posttreatment. None. Primary outcomes were changes from baseline to follow-up in scores for the verbal analogue scale (VAS), Brief Pain Inventory (BPI), and MTrP status. MTrPs were rated as active (spontaneously painful), latent (painful only on compression), and nonpalpable nodule. Responders were patients whose MTrP status changed from active to latent or nonpalpable nodule (resolved). Secondary outcomes were pain pressure threshold (PPT), Profile of Mood States, Oswestry Disability Index (ODI), MOS 36-Item Short-Form Health Survey (SF-36), and cervical range of motion. Pain measures remained significantly improved 6 weeks posttreatment (P < .003), as did the SF-36 physical functioning score (0.01) and ODI (P = .002). Side bending and PPT for subjects with unilateral MTrPs had sustained improvement (P = .002). The number of subjects with sustained MTrP response at 6 weeks was significant (P < .001). Comparing responders to nonresponders, the changes in VAS and BPI were statistically significant (P = .006, P = .03) but the change in PPT was not. Patients with higher baseline VAS scores had a higher risk of not responding to DN; those with a greater drop in VAS score from baseline had a higher probability of sustained response. A 1-unit decrease in VAS at baseline resulted in a 6.3-fold increase in the odds of being a responder versus a nonresponder (P = .008). In this study, there was sustained reduction of pain scores after completion of DN

  19. Increased Risk of Myofascial Pain Syndrome Among Patients with Insomnia.

    Science.gov (United States)

    Lin, Wei-Chen; Shen, Cheng-Che; Tsai, Shih-Jen; Yang, Albert C

    2017-08-01

    The aim of this study is to evaluate the risk of developing myofascial pain syndrome among patients diagnosed with insomnia. We conducted a population-based longitudinal study of a matched cohort with 7,895 participants (1,579 patients with insomnia and 6,316 controls) who were selected from the Taiwan National Health Insurance Research Database. The patients were observed for a maximum of 10 years to determine the incidence of newly diagnosed myofascial pain syndrome. A Cox regression analysis was performed to identify the risk factors associated with myofascial pain syndrome in patients with insomnia. During the 10-year follow-up period, 182 insomnia patients (14.9 per 1,000 person-years) and 379 controls (7.5 per 1,000 person-years) were diagnosed with myofascial pain syndrome. The incidence risk ratio of myofascial pain syndrome between the insomnia and control patients was 2.00 (95% confidence interval [CI] = 1.67-2.38, P  myofascial pain syndrome (95% CI = 1.62-2.31, P  myofascial pain syndrome in patients with insomnia. Patients with insomnia had a higher risk of developing myofascial pain syndrome than controls. This study adds to the understanding of the complex relationship between sleep disturbance and pain.

  20. The Comparison of the Effects of Trigger Points Pressure Release and Kinesio Taping on Pain and Hip Abductor Muscles Strength in Patients with Patellofemoral Pain Syndrome

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    Vahid Mazloum

    2016-10-01

    Full Text Available Background & objectives: Hip muscles insufficiency plays a significant role in deterioration of patellofemoral pain syndrome (PFPS, which can be manifested as myofascial trigger point (MTrPs in hip muscles. Then, our purpose was to determine the prevalence of MTrPs in the gluteus medius (GMe and quadratus lumborum (QL muscles and to investigate the effect of a therapeutic intervention on pain intensity and hip abductor muscles isometric strength in patients with PFPS. Methods: Forty volunteer subjects (20 patients and 20 healthy participated in the study. Latent MTrPs in GMe and QL were evaluated and a handheld dynamometer was used to measure peak isometric strength test (PIST for hip abductors. Patients with PFPS having MTrPs in GMe were randomly divided into either a treatment group (Mean age±SD: 23.2±4.3 years or control (Mean age±SD: 24.4±4.6 years. The therapeutic intervention included trigger point pressure release (TrPPR and Kinesio Taping® (KT. Pain intensity and PIST for hip abductors were assessed at baseline and after intervention in both groups. Results: There is more significant patients with PFPS having latent MTrPs in GMe and QL than the healthy counterparts (p0.05. Conclusion: Concomitant using of TrPPR therapy and KT method can decrease pain intensity in individuals with PFPS. Further studies are required to understand the underlying mechanisms.

  1. Effectiveness of dry needling for the treatment of temporomandibular myofascial pain: a double-blind, randomized, placebo controlled study.

    Science.gov (United States)

    Dıraçoğlu, Demirhan; Vural, Meltem; Karan, Ayşe; Aksoy, Cihan

    2012-01-01

    To test the hypothesis that dry needling is more effective than sham dry needling in relieving myofascial pain of the temporomandibular muscles. Fifty-two subjects with established myofascial trigger points were randomized into two groups; study group (N: 26) and placebo group (N: 26). Dry needling was applied using acupuncture needles. Sham dry needling was applied to the placebo group. Pain pressure threshold was measured with pressure algometry, pain intensity was rated using a 10-cm visual analog scale (VAS) and the unassisted jaw opening without pain measurement was performed. Evaluations were done by a physician blinded to the data. Of 52 patients assigned, 50 completed the study. Mean algometric values were significantly higher in the study group when compared to the placebo group (p values being less than 0.05). There were no differences between the two groups in terms of VAS and unassisted jaw-opening without pain values. Dry needling appears to be an effective treatment method in relieving the pain and tenderness of myofascial trigger points.

  2. [Comparative study on effect of acupuncture and lidocaine block for lumbar myofascial pain syndrome].

    Science.gov (United States)

    Jiang, Gui-Mei; Lin, Mou-De; Wang, Lu-Ying

    2013-03-01

    To observe the clinical efficacy of acupuncture at Jiaji (EX-B 2) points mainly for lumbar myofascial pain syndrome (MPS). Sixty-six cases of MPS were randomized into an acupuncture group and a lidocaine group, 33 cases in each group. The acupuncture group was treated with acupuncture at Jiaji (EX-B 2) points combined with needling local myofascial trigger points (MTrP), and the lidocaine group was treated with local block at trigger points with lidocaine injection. The treatment was given once every 2 days. After three and five times of the treatment, the simplified McGill scale, Oswestry disability index (ODI) and pressure-pain threshold were assessed to compare the therapeutic effects between the two groups. After treatment, the scores of simplified McGill and ODI of two groups were obviously reduced while the score of pressure-pain threshold was obviously increased (all P 0.05). Acupuncture at Jiaji (EX-B 2) points combined with needling MTrP is an effective and safe therapy for lumbar MPS, the therapeutic effect is equal to lidocaine block.

  3. Lipid profile in patients with fibromyalgia and myofascial pain syndromes.

    Science.gov (United States)

    Ozgocmen, S; Ardicoglu, O

    2000-10-01

    In this study serum lipid profile of patients with fibromyalgia syndrome (FMS) and myofascial pain syndrome (MPS) were investigated and compared with healthy controls. Thirty women who had FMS and 32 women who had MPS with the characteristic trigger points (TrP), especially on the periscapular region were included in this study. Thirty one age matched healthy women were assigned as a control group. All of the subjects were sedentary healthy housewives. Total cholesterol, triglyceride and high-density lipoprotein cholesterol (HDL-c) levels were not significantly different between the FMS and control groups. On the other hand the MPS group had total cholesterol (198.7 vs 172.9 mg/dL, p=0.003), triglyceride (124.7 vs 87.6 mg/dL, p=0.01), low-density lipoprotein cholesterol (LDL-c) (127.5 vs 108.4 mg/dL, p=0.02) and very low-density lipoprotein cholesterol (VLDL-c) (24.9 vs 17.3 mg/dL, p=0.008) levels, which were significantly higher than the controls. There was no significant difference between the lipid profiles in the FMS and MPS groups. Tissue compliance, which was measured from trigger points in the MPS group, correlated significantly with total cholesterol and LDL-c levels. In conclusion, a significant difference was found between the lipid levels of patients with MPS and the controls. More extensive investigation of lipid and lipoprotein levels is required to determine whether high lipid levels are the cause or result of MPS.

  4. The Expression of Human Cytomegalovirus MicroRNA MiR-UL148D during Latent Infection in Primary Myeloid Cells Inhibits Activin A-triggered Secretion of IL-6.

    Science.gov (United States)

    Lau, Betty; Poole, Emma; Krishna, Benjamin; Sellart, Immaculada; Wills, Mark R; Murphy, Eain; Sinclair, John

    2016-08-05

    The successful establishment and maintenance of human cytomegalovirus (HCMV) latency is dependent on the expression of a subset of viral genes. Whilst the exact spectrum and functions of these genes are far from clear, inroads have been made for protein-coding genes. In contrast, little is known about the expression of non-coding RNAs. Here we show that HCMV encoded miRNAs are expressed de novo during latent infection of primary myeloid cells. Furthermore, we demonstrate that miR-UL148D, one of the most highly expressed viral miRNAs during latent infection, directly targets the cellular receptor ACVR1B of the activin signalling axis. Consistent with this, we observed upregulation of ACVR1B expression during latent infection with a miR-UL148D deletion virus (ΔmiR-UL148D). Importantly, we observed that monocytes latently infected with ΔmiR-UL148D are more responsive to activin A stimulation, as demonstrated by their increased secretion of IL-6. Collectively, our data indicates miR-UL148D inhibits ACVR1B expression in latently infected cells to limit proinflammatory cytokine secretion, perhaps as an immune evasion strategy or to postpone cytokine-induced reactivation until conditions are more favourable. This is the first demonstration of an HCMV miRNA function during latency in primary myeloid cells, implicating that small RNA species may contribute significantly to latent infection.

  5. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain.

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    León-Hernández, Jose V; Martín-Pintado-Zugasti, Aitor; Frutos, Laura G; Alguacil-Diego, Isabel M; de la Llave-Rincón, Ana I; Fernandez-Carnero, Josue

    2016-07-11

    Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.

  6. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

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    Jose V. León-Hernández

    Full Text Available ABSTRACT Background Dry needling (DN and percutaneous electrical nerve stimulation (PENS are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group and 31 received DN and PENS (DN+PENS group. The primary outcomes were neck disability index (NDI and visual analog scale for pain for both post-needling soreness (PNS and neck pain intensity (NPI. Pressure pain threshold (PPT and cervical range of motion (CROM were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain.

  7. Epimuscular myofascial force transmission between antagonistic and synergistic muscles can explain movement limitation in spastic paresis

    NARCIS (Netherlands)

    Huijing, Peter A.

    2007-01-01

    Details and concepts of intramuscular, extramuscular and intermuscular myofascial force transmission are reviewed. Some new experimental data are added regarding myofascial force transmission between antagonistic muscles across the interosseal membrane of the lower hind limb of the rat. Combined wit

  8. Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update.

    Science.gov (United States)

    Khan, Mohammad; Nishi, Shamima Easmin; Hassan, Siti Nazihahasma; Islam, Md Asiful; Gan, Siew Hua

    2017-01-01

    Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.

  9. Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

    Directory of Open Access Journals (Sweden)

    Mohammad Khan

    2017-01-01

    Full Text Available Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.

  10. The use of dry needling and myofascial meridians in a case of plantar fasciitis.

    Science.gov (United States)

    Akhbari, Behnam; Salavati, Mahyar; Ezzati, Kamran; Mohammadi Rad, Shahrzad

    2014-03-01

    The purpose of this case report is to describe the use of dry needling based on myofascial meridians for management of plantar fasciitis. A 53-year-old man presented with bilateral chronic foot pain for more than 2 years. After 2 months of conventional treatment (ultrasound, plantar fascia and Achilles tendon stretching, and intrinsic foot strengthening), symptoms eventually improved; however, symptoms returned after prolonged standing or walking. Almost all previous treatment methods were localized in the site of pain that targeted only the plantar fascia. Initial examination of this individual revealed that multiple tender points were found along the insertion of Achilles tendon, medial gastrocnemius, biceps femoris, semimembranosus, and ischial tuberosity. Dry needling of the trigger points was applied. After 4 treatments over 2 weeks, the patient felt a 60% to 70% reduction in pain. His pressure pain threshold was increased, and pain was alleviated. The patient returned to full daily activities. The rapid relief of this patient's pain after 2 weeks of dry needling to additional locations along the superficial back line suggests that a more global view on management was beneficial to this patient. Dry needling based on myofascial meridians improved the symptoms for a patient with recurrent plantar fasciitis.

  11. A review of myofascial pain and fibromyalgia--factors that promote their persistence.

    Science.gov (United States)

    Gerwin, Robert D

    2005-09-01

    Chronic muscle pain (myalgia) is a common problem throughout the world. Seemingly simple, it is actually a difficult problem for the clinician interested in determining the aetiology of the pain, as well as in managing the pain. The two common muscle pain conditions are fibromyalgia and myofascial pain syndrome. Fibromyalgia is a chronic, widespread muscle tenderness syndrome, associated with central sensitisation. It is often accompanied by chronic sleep disturbance and fatigue, visceral pain syndromes like irritable bowel syndrome and interstitial cystitis. Myofascial pain syndrome is an overuse or muscle stress syndrome characterised by the presence of trigger points in muscle. The problem these syndromes pose lies not in making the diagnosis of muscle pain. Rather, it is the need to identify the underlying cause(s) of persistent or chronic muscle pain in order to develop a specific treatment plan. Chronic myalgia may not improve until the underlying precipitating or perpetuating factor(s) are themselves managed. Precipitating or perpetuating causes of chronic myalgia include structural or mechanical causes like scoliosis, localised joint hypomobility, or generalised or local joint laxity; and metabolic factors like depleted tissue iron stores, hypothyroidism or Vitamin D deficiency. Sometimes, correction of an underlying cause of myalgia is all that is needed to resolve the condition.

  12. The effect of cetylated fatty esters and physical therapy on myofascial pain syndrome of the neck.

    Science.gov (United States)

    Sharan, Deepak; Jacob, Biju Nirmal; Ajeesh, P S; Bookout, Jack B; Barathur, Raj R

    2011-07-01

    Participants with Myofascial Pain Syndrome (MPS) of the neck were randomly assigned into 2 groups of the double-blinded study: topical cetylated fatty ester complex (CFEC) cream application plus physical therapy (CF-PT; n=37), and placebo cream application plus physical therapy (PL-PT; n=35). There were 3 visits during 4 weeks of treatment. Physical Therapy (PT), given twice/week, included Ischaemic Compression, Deep Pressure Trigger Point Massage and Myofascial Releases. Topical cream [CFEC cream (5.6%) and 1.5% menthol] or placebo cream [1.5% menthol, in a cream base] was applied twice/day. CF-PT provided the fastest and most effective study treatment modality. The addition of CFEC cream to PT resulted in statistically significant improvements, compared to PL-PT, for reduction of pain, neck disability and life quality indicators. Our results indicate that cetylated derivatives of fatty acids can effectively reduce pain and symptoms associated with neck MPS, when combined with physical therapy.

  13. Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

    Science.gov (United States)

    Nishi, Shamima Easmin; Hassan, Siti Nazihahasma

    2017-01-01

    Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome. PMID:28827979

  14. Efficacy and safety of a single botulinum type A toxin complex treatment (Dysport) for the relief of upper back myofascial pain syndrome: results from a randomized double-blind placebo-controlled multicentre study.

    Science.gov (United States)

    Göbel, Hartmut; Heinze, Axel; Reichel, Gerhard; Hefter, Harald; Benecke, Reiner

    2006-11-01

    Botulinum type A toxin (BoNT-A) has antinociceptive and muscle-relaxant properties and may help relieve the symptoms of myofascial pain syndrome. In this study we evaluated the efficacy and tolerability of BoNT-A (Dysport) in patients with myofascial pain syndrome of the upper back. We conducted a prospective, randomized, double-blind, placebo-controlled, 12-week, multicentre study. Patients with moderate-to-severe myofascial pain syndrome affecting cervical and/or shoulder muscles (10 trigger points, disease duration 6-24 months) were randomized to Dysport or saline. Injections were made into the 10 most tender trigger points (40 units per site). The primary outcome was the proportion of patients with mild or no pain at week 5. Secondary outcomes included changes in pain intensity and the number of pain-free days per week. Tolerability and safety were also assessed. At week 5, significantly more patients in the Dysport group reported mild or no pain (51%), compared with the patients in the placebo group (26%; p=0.002). Compared with placebo, Dysport resulted in a significantly greater change from baseline in pain intensity during weeks 5-8 (ppain between weeks 5 and 12 (p=0.036). Treatment was well tolerated, with most side effects resolving within 8 weeks. In conclusion, in patients with upper back myofascial pain syndrome, injections of 400 Ipsen units of Dysport at 10 individualised trigger points significantly improved pain levels 4-6 weeks after treatment. Injections were well tolerated.

  15. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis.

    Science.gov (United States)

    Kietrys, David M; Palombaro, Kerstin M; Azzaretto, Erica; Hubler, Richard; Schaller, Bret; Schlussel, J Mathew; Tucker, Mary

    2013-09-01

    Systematic review and meta-analysis. Myofascial pain syndrome (MPS) is associated with hyperalgesic zones in muscle called myofascial trigger points. When palpated, active myofascial trigger points cause local or referred symptoms, including pain. Dry needling involves inserting an acupuncture-like needle into a myofascial trigger point, with the goal of reducing pain and restoring range of motion. To explore the evidence regarding the effectiveness of dry needling to reduce pain in patients with MPS of the upper quarter. An electronic literature search was performed using the key word dry needling. Articles identified with the search were screened for the following inclusion criteria: human subjects, randomized controlled trial (RCT), dry needling intervention group, and MPS involving the upper quarter. The RCTs that met these criteria were assessed and scored for internal validity using the MacDermid Quality Checklist. Four separate meta-analyses were performed: (1) dry needling compared to sham or control immediately after treatment, (2) dry needling compared to sham or control at 4 weeks, (3) dry needling compared to other treatments immediately after treatment, and (4) dry needling compared to other treatments at 4 weeks. The initial search yielded 246 articles. Twelve RCTs were ultimately selected. The methodological quality scores ranged from 23 to 40 points, with a mean of 34 points (scale range, 0-48; best possible score, 48). The findings of 3 studies that compared dry needling to sham or placebo treatment provided evidence that dry needling can immediately decrease pain in patients with upper-quarter MPS, with an overall effect favoring dry needling. The findings of 2 studies that compared dry needling to sham or placebo treatment provided evidence that dry needling can decrease pain after 4 weeks in patients with upper-quarter MPS, although a wide confidence interval for the overall effect limits the impact of the effect. Findings of studies that

  16. A critical appraisal of the evidence for botulinum toxin type A in the treatment for cervico-thoracic myofascial pain syndrome.

    Science.gov (United States)

    Desai, Mehul J; Shkolnikova, Tatyana; Nava, Andrew; Inwald, Danielle

    2014-02-01

    Myofascial pain syndrome (MPS) is a musculoskeletal condition characterized by regional pain and muscle tenderness associated with the presence of myofascial trigger points (MTrPs). The last decade has seen an exponential increase in the use of botulinum toxin (BTX) to treat MPS. To understand the medical evidence substantiating the role of therapeutic BTX injections and to provide useful information for the medical practitioner, we applied the principles of evidence-based medicine to the treatment for cervico-thoracic MPS. A search was conducted through MEDLINE (PubMed, OVID, MDConsult), EMBASE, SCOPUS and the Cochrane database for the period 1966 to 2012 using the following keywords: myofascial pain, muscle pain, botulinum toxin, trigger points, and injections. A total of 7 trials satisfied our inclusion criteria and were evaluated in this review. Although the majority of studies found negative results, our analysis identified Gobel et al.'s as the highest quality study among these prospectively randomized investigations. This was due to appropriate identification of diagnostic criteria, excellent study design and objective endpoints. The 6 other identified studies had significant failings due to deficiencies in 1 or more major criteria. We conclude that higher quality, rigorously standardized studies are needed to more appropriately investigate this promising treatment modality. © 2013 World Institute of Pain.

  17. Clinical observation of medical ozone injection in trigger point on psoas myofascial pain syndrom%医用臭氧疼痛触发点注射治疗腰部肌筋膜疼痛综合征临床研究

    Institute of Scientific and Technical Information of China (English)

    王建国; 耿葆梁; 闫洪涛; 张雷; 冯建来; 郜时华; 贾春雨

    2010-01-01

    目的 评价医用臭氧疼痛触发点注射治疗腰部肌筋膜疼痛综合征(Myofascial Pain Syndrom,MPS)的效果与安全性.方法 采用前瞻性随机对照的研究方法,将78例患者随机分为两组,臭氧治疗组应用低浓度医用臭氧,常规治疗组应用利多卡因+维生素B6+甲钴胺和地塞米松棕榈酸酯,均行疼痛触发点漫润注射.治疗2周后采用视觉模拟评分(Visual Analogue Scale,VAS)和日本骨科学会下腰痛评估量表(Low Lumbar Pain Scales,LLPS)对照评价两组疗效.结果 治疗前后比较,两组VAS评分分别从6.2±1.7降至1.1±0.8和从5.6±1.2降至2.3±1.1(均P<0.05),LLPS明显改善(均P<0.01);两组比较,臭氧组VAS评分降低幅值显著大于对照组(P<0.05),优良率明显高于对照组(89.74%比71.79%,P<0.05);LLPS改善程度明显优干对照组(均P<0.05);不良反应明显少于对照组.结论 医用臭氧疼痛触发点注射治疗腰部MPS与常规麻醉剂加激素封闭同样有效,优良率更高,安全性较高,未见明显不良反应.

  18. Intermuscular force transmission along myofascial chains: a systematic review.

    Science.gov (United States)

    Krause, Frieder; Wilke, Jan; Vogt, Lutz; Banzer, Winfried

    2016-06-01

    The present review aims to provide a systematic overview on tensile transmission along myofascial chains based on anatomical dissection studies and in vivo experiments. Evidence for the existence of myofascial chains is growing, and the capability of force transmission via myofascial chains has been hypothesized. However, there is still a lack of evidence concerning the functional significance and capability for force transfer. A systematic literature research was conducted using MEDLINE (Pubmed), ScienceDirect and Google Scholar. Studied myofascial chains encompassed the superficial backline (SBL), the back functional line (BFL) and the front functional line (FFL). Peer-reviewed human dissection studies as well as in vivo experiments reporting intermuscular tension transfer between the constituents of a myofascial chain were included. To assess methodic quality, two independent investigators rated studies by means of validated assessment tools (QUACS and PEDro Scale). The literature research identified 1022 articles. Nine studies (moderate to excellent methodological quality) were included. Concerning the SBL and the BFL, there is moderate evidence for force transfer at all three transitions (based on six studies), and one of two transitions (three studies). One study yields moderate evidence for a slight, but not significant force transfer at one transition in the FFL. The findings of the present study indicate that tension can be transferred between some of the examined adjacent structures. Force transfer might have an impact in overuse conditions as well as on sports performance. However, different methods of force application and measurement hinder the comparability of results. Considering anatomical variations in the degree of continuity and histological differences of the linking structures is crucial for interpretation. Future studies should focus on the in vivo function of myofascial continuity during isolated active or passive tissue tensioning.

  19. Treatment of fibromyalgia, myofascial pain, and related disorders.

    Science.gov (United States)

    Borg-Stein, Joanne

    2006-05-01

    Chronic muscle pain is a common complaint among patients who seek care for musculoskeletal disorders. A spectrum of clinical presentations exists, ranging from focal or regional complaints that usually represent myofascial pain syndromes to more wide spread pain that may meet criteria for a diagnosis of fibromyalgia. This article addresses the epidemiology, pathophysiology, and clinical management of myofascial pain syndrome and fibromyalgia. These conditions are challenging to treat and require physiatrists to be aware of the wide range of pharmacologic, rehabilitative,and psychosocial interventions that can be helpful.

  20. Cutaneous silent period in myofascial pain syndrome.

    Science.gov (United States)

    Kilinc, Ozden; Sencan, Savas; Ercalik, Tulay; Koytak, Pinar Kahraman; Alibas, Hande; Gunduz, Osman Hakan; Tanridag, Tulin; Uluc, Kayihan

    2017-09-06

    An increased response to painful stimuli without spontaneous pain suggests a role of central hyperexcitability of pain pathways in the pathogenesis of myofascial pain syndrome (MPS). In this study we aimed to test the hypothesis that spinal pain pathways are affected in MPS. We used cutaneous silent period (CSP) parameters to demonstrate the hyperexcitability of spinal pain pathways in MPS. Twenty-nine patients diagnosed with MPS and 30 healthy volunteers were included in the study. The CSP recordings were performed in the right upper and left lower extremities. In both upper and lower extremities, patients had prolonged CSP latencies (P = 0.034 and P = 0.049 respectively) and shortened CSP durations (P = 0.009 and P = 0.008, respectively). Delayed and shortened CSP in MPS patients implies dysfunction in the inhibitory mechanism of the spinal/supraspinal pain pathways, suggesting central sensitization in the pathogenesis of MPS and supporting our research hypothesis. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  1. INNERVATED RECTUS-ABDOMINIS MYOFASCIAL FLAP FOR DYNAMIC CARDIOMYOPLASTY

    NARCIS (Netherlands)

    WIJNBERG, DS; EBELS, T; ROBINSON, PH

    1994-01-01

    This study examined the rectus abdominis myofascial flap as an innervated nap for dynamic cardiomyoplastic purposes. It is common to use the latissimus dorsi to wrap or patch around or in the heart, but there is a need for more innervated skeletal muscle for a variety of reasons. The rectus abdomini

  2. Efficacy of dry needling for treatment of myofascial pain syndrome.

    Science.gov (United States)

    Fogelman, Yacov; Kent, John

    2015-01-01

    Myofascial pain is a major cause of musculoskeletal regional pain. Myofascial pain, which is a high-prevalence but eminently treatable condition, is almost universally underdiagnosed by physicians and undertreated by physical therapy modalities. Large numbers of patients can be left suffering in chronic pain for years. Dry needling, also referred to as Intramuscular Stimulation, is a method in the arsenal of pain management which has been known for almost 200 years in Western medicine, yet has been almost completely ignored. With the increase in research in this field over the past two decades, there are many high-quality studies that demonstrate dry needling to be an effective and safe method for the treatment of myofascial pain when diagnosed and treated by adequately-trained physicians or physical therapists. This article provides an overview of recent literature regarding the treatment of myofascial pain syndrome, evidence for the efficacy of dry needling as a central component of its management, and a glimpse at developments in recent imaging methods to aid in the treatment of these problems.

  3. Evaluation of the Sympathetic Skin Response to the Dry Needling Treatment in Female Myofascial Pain Syndrome Patients.

    Science.gov (United States)

    Ozden, Ali Veysel; Alptekin, Hasan Kerem; Esmaeilzadeh, Sina; Cihan, Cem; Aki, Semih; Aksoy, Cihan; Oncu, Julide

    2016-07-01

    The aim of this study was to evaluate sympathetic nervous system (SNS) activity following dry needling (DN) treatment, by using the sympathetic skin response (SSR) method in female patients diagnosed with myofascial pain syndrome (MPS). Twenty-nine MPS patients with trapezius muscle pain and 31 healthy subjects were included in this study. During a single treatment session, DN treatment was applied into trigger points, for a duration of 10 minutes. Healthy patients were subjected to SSR in weeks 1 and 4; whereas the patient group was subjected to SSR 1 week prior to their treatment and in the first, second, third and fourth weeks following the completion of their treatment. We found diminished latency on both sides. A significantly high algometer measurement (P 0.05). DN is an effective treatment in MPS and trigger point (TP). This original study is the first to deal with the SSR in MPS and weekly SSR trailing, requiring further investigation to solidy findings.

  4. Infrahyoid myofascial flap for tongue reconstruction.

    Science.gov (United States)

    Windfuhr, Jochen P; Remmert, Stephan

    2006-11-01

    For selected cases, reconstruction of the tongue may be required after tumor removal. This study was undertaken to demonstrate a simplified concept of tongue reconstruction with emphasis on infrahyoid myofascial flaps (IMF). The defects of the tongue were classified in 23 patients according to the extent of tumor growth, functional and surgical aspects. The oral tongue (OT; n = 1), base of tongue (BT; n = 12) or both areas (OT and BT; n = 10) were involved, with (n = 14) or without (n = 9) infiltration of adjacent tissues. Minor defects (extent (1/4) or less) required no reconstructive procedure at any area. Major defect closure (extent (1/2)-3/4) was accomplished with a combination of IMF covered by a radial forearm flap (RFF). A complete reconstruction of the OT was achieved with a combination of a bilateral IMF covered by a RFF. Whenever the complete BT has to be removed, interposition of a vein graft to establish a sufficient arterial blood supply to the remaining OT is mandatory. Moreover, a larynx lift to prevent aspiration is recommendable. Resection of adjacent soft tissues requires a larger RFF (OT; BT) or flaps from the shoulder-back region (BT and OT). Whenever the integrity of the mandible has to be sacrificed, a free fibula graft serves as an excellent tool for reconstruction. IMF serves as a reliable tool for minor or major reconstructive procedures of the tongue. Reliability and versatility of IMF may contribute to a reduced time required for surgery since harvesting is performed in the neck area immediately after neck dissection. Moreover, harvesting of the IMF does not result in an increased postoperative morbidity. Hence, functional restoration can be achieved with a more cost-effective procedure.

  5. Estudo comparativo entre toxina botulínica e bupivacaína para infiltração de pontos-gatilho em síndrome miofascial crônica Estudio comparativo entre toxina botulínica y bupivacaína para infiltración de puntos-gatillo en síndrome miofascial crónica Comparative study between botulin toxin and bupivacaine for triggering-points infiltration in chronic myofascial syndrome

    Directory of Open Access Journals (Sweden)

    Eduardo Keiichi Unno

    2005-04-01

    dos grupos. Los pacientes del G1 (n = 10 recibieron 25U de toxina botulínica y los del G2 (n = 10, bupivacaína a 0,25%, de un a tres puntos-gatillo, siendo 0,5 mL por punto. Los pacientes fueron evaluados semanalmente, durante 8 semanas. Fueron asociados 35 mg de orfenadrina, y 300 mg de dipirona, a cada 8 horas, los pacientes fueron sometidos a estimulación eléctrica transcutánea, dos veces por semana, durante 1 hora por sesión. La intensidad del dolor fue evaluada a través de la escala numérica verbal y la calidad de la analgesia, por el paciente, en los momentos cero (antes de la inyección, y después de 30 minutos, 1, 2, 3, 4, 5, 6, 7 y 8 semanas. Los resultados fueron sometidos al análisis estadístico (Mann-Whitney y Exacto de Fisher. RESULTADOS: Después de 30 minutos de la aplicación y con 1 y 4 semanas, la intensidad del dolor en el G1 fue menor que en el G2. Después de 2, 3, 5, 7 y 8 semanas de la infiltración, no hubo diferencia significativa entre los grupos. La calidad de la analgesia fue considerada mejor por los pacientes del G1 que del G2, excepto después de 2 semanas. CONCLUSIONES: El efecto analgésico fue mejor con toxina botulínica (25U que con bupivacaína a 0,25% para infiltración de puntos-gatillo.BACKGROUND AND OBJECTIVES: There are controversies about the efficacy of botulin toxin as compared to local anesthetics for triggering-points infiltration. This study aimed at comparing the analgesic effect of botulin toxin and bupivacaine for triggering-points infiltration in chronic myofascial syndrome. METHODS: Participated in this study 20 patients divided in two groups. G1 patients (n = 10 received 25U botulin toxin and G2 patients (n = 10 received 0.25% bupivacaine in one to three triggering-points, being 0.5 mL per point. Patients were weekly evaluated for 8 weeks. Orphenadrine (35 mg and dipirone (300 mg were associated every 8 hours and patients were submitted to transcutaneous electrical stimulation twice a week during 1 hour

  6. Acupuncture for Myofascial Pain Syndrome: A Network Meta-Analysis of 33 Randomized Controlled Trials.

    Science.gov (United States)

    Li, Xiuxia; Wang, Rong; Xing, Xin; Shi, Xiue; Tian, Jinhui; Zhang, Jun; Ge, Long; Zhang, Jingyun; Li, Lun; Yang, Kehu

    2017-09-01

    Acupuncture techniques are commonly used as initial treatments for myofascial pain syndrome. This study aimed to assess and compare the efficacy and safety of different techniques of acupuncture for myofascial pain syndrome. Network meta-analysis. All selected studies were randomized controlled trials (RCTs). The Cochrane Central Register of Controlled Trials, PubMed, Web of Science, EMBASE, and Chinese Biomedical Literature Database were searched from their inceptions to February 2016. Only full texts of RCTs comparing acupuncture therapies with any other therapies or placebo-sham acupuncture were included. Two reviewers independently assessed eligibility and extracted data. The primary outcomes included pain intensity, PPT, and adverse events. Secondary outcome was physical function. Thirty-three trials with 1,692 patients were included. Patients were allocated to 22 kinds of interventions, of which dry needling and manual acupuncture was the most frequently investigated intervention. Compared with placebo-sham acupuncture, scraping combined with warming acupuncture and moxibustion was found to be more effective for decreasing pain intensity (standardized mean difference (SMD) = -3.6, 95% confidence interval (CI) ranging from -5.2 to -2.1); miniscalpel-needle was more effective for increasing the PPT (SMD = 2.2, 95% CI ranging from 1.2 to 3.1); trigger points injection with bupivacaine was associated with the highest risk of adverse event (odds ratio = 557.2, 95% CI ranging from 3.6 to 86867.3); and only EA showed a significant difference in the ROM (SMD = -4.4, 95% CI ranging from -7.5 to -1.3). Lack of clarity concerning treatment periods, repetitive RCTs, and other valuable outcome measurements. The potential bias might affect the judgment of efficacy and safety. The existing evidence suggests that most acupuncture therapies, including acupuncture combined with other therapies, are effective in decreasing pain and in improving physical function, but additional

  7. Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine.

    Science.gov (United States)

    Mitidieri, Andréia; Gurian, Maria Beatriz; Silva, Ana Paula; Tawasha, Kalil; Poli-Neto, Omero; Nogueira, Antônio; Reis, Francisco; Rosa-E-Silva, Júlio

    2015-12-01

    This study used semiology based on traditional Chinese medicine (TCM) to investigate vital energy (Qi) behavior in women with abdominal myofascial pain syndrome (AMPS). Fifty women diagnosed with chronic pelvic pain (CPP) secondary to AMPS were evaluated by using a questionnaire based on the theories of "yin-yang," "zang-fu", and "five elements". We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs); onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine), menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Patients were between 22 and 56 years old, and most were married (78%), possessed a elementary school (66%), and had one or two children (76%). The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 - 39.0) and 32.4% (range: 10.7 - 45.7), respectively. A large majority of women (96%) exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the pelvic floor and abdominal region.

  8. Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine

    Directory of Open Access Journals (Sweden)

    Andréia Mitidieri

    2015-12-01

    Full Text Available Objectives: This study used semiology based on traditional Chinese medicine (TCM to investigate vital energy (Qi behavior in women with abdominal myofascial pain syndrome (AMPS. Methods: Fifty women diagnosed with chronic pelvic pain (CPP secondary to AMPS were evaluated by using a questionnaire based on the theories of “yin-yang,” “zang-fu”, and “five elements”. We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs; onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine, menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%, possessed a elementary school (66%, and had one or two children (76%. The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 — 39.0 and 32.4% (range: 10.7 — 45.7, respectively. A large majority of women (96% exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the

  9. Contributions of myofascial pain in diagnosis and treatment of shoulder pain. A randomized control trial

    Directory of Open Access Journals (Sweden)

    Gaspar-Calvo Elena

    2009-07-01

    Full Text Available Abstract Background Rotator cuff tendinopathy and subacromial impingement syndrome present complex patomechanical situations, frequent difficulties in clinical diagnosis and lack of effectiveness in treatment. Based on clinical experience, we have therefore considered the existence of another pathological entity as the possible origin of pain and dysfunction. The hypothesis of this study is to relate subacromial impingement syndrome (SIS with myofascial pain syndrome (MPS, since myofascial trigger points (MTrPs cause pain, functional limitation, lack of coordination and alterations in quality of movement, even prior to a tendinopathy. MTrPs can coexist with any degenerative subacromial condition. If they are not taken into consideration, they could perpetuate and aggravate the problem, hindering diagnosis and making the applied treatments ineffective. The aims and methods of this study are related with providing evidence of the relationship that may exist between this condition and MPS in the diagnosis and treatment of rotator cuff tendonitis and/or SIS. Method/design A descriptive transversal study will be made to find the correlation between the diagnosis of SIS and rotator cuff tendonitis, positive provocation test responses, the existence of active MTrPs and the results obtained with ultrasonography (US and Magnetic Renonance Imaging (MRI. A randomized double blinded clinical trial will be carried out in experimental conditions: A Protocolized treatment based on active and passive joint repositioning, stabilization exercises, stretching of the periarticular shoulder muscles and postural reeducation. B. The previously described protocolized treatment, with the addition of dry needling applied to active MTrPs with the purpose of isolating the efficacy of dry needling in treatment. Discussion This study aims to provide a new vision of shoulder pain, from the perspective of MPS. This syndrome can, by itself, account for shoulder pain and

  10. Efficacy of pulsed low-intensity electric neuromuscular stimulation in reducing pain and disability in patients with myofascial syndrome.

    Science.gov (United States)

    Iodice, P; Lessiani, G; Franzone, G; Pezzulo, G

    2016-01-01

    Myofascial pain syndrome (MPS) is characterized by chronic pain in multiple myofascial trigger points and fascial constrictions. In recent years, the scientific literature has recognized the need to include the patient with MPS in a multidimensional rehabilitation project. At the moment, the most widely recognized therapeutic methods for the treatment of myofascial syndrome include the stretch and spray pressure massage. Microcurrent electric neuromuscular stimulation was proposed in pain management for its effects on normalizing bioelectricity of cells and for its sub-sensory application. In this study, we tested the efficacy of low-intensity pulsed electric neuromuscular stimulus (PENS) on pain in patients with MPS of cervical spine muscles. We carried out a prospective-analytic longitudinal study at an outpatient clinic during two weeks. Forty subjects (mean age 42±13 years) were divided into two groups: treatment (TrGr, n=20) and control group (CtrlGr, n=20). Visual-analog scale (VAS) values, concerning the spontaneous and movement-related pain in the cervical-dorsal region at baseline (T0) and at the end of the study (T1), showed a reduction from 7 to 3.81 (p < 0.001) in TrGr. In the CtrlGr, VAS was reduced from 8.2 to 7.2 (n.s.). Moreover, the pressure pain threshold at T0 was 2.1 vs 4.2 at T1 (p < 0.001) in TrG. In the CtrlGR we observed no significant changes. Modulated low-intensity PENS is an innovative therapy permitting to act on the transmission of pain and on the restoration of tissue homeostasis. It seems to affect the transmission of pain through the stimulation of A-beta fibers. The above results show that low-intensity PENS can be considered as an effective treatment to reduce pain and disability in patients with MPS.

  11. Dynamic triggering

    Science.gov (United States)

    Hill, David P.; Prejean, Stephanie; Schubert, Gerald

    2015-01-01

    Dynamic stresses propagating as seismic waves from large earthquakes trigger a spectrum of responses at global distances. In addition to locally triggered earthquakes in a variety of tectonic environments, dynamic stresses trigger tectonic (nonvolcanic) tremor in the brittle–plastic transition zone along major plate-boundary faults, activity changes in hydrothermal and volcanic systems, and, in hydrologic domains, changes in spring discharge, water well levels, soil liquefaction, and the eruption of mud volcanoes. Surface waves with periods of 15–200 s are the most effective triggering agents; body-wave trigger is less frequent. Triggering dynamic stresses can be < 1 kPa.

  12. Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases

    OpenAIRE

    Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

    2010-01-01

    Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain...

  13. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial.

    Science.gov (United States)

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-04-01

    [Purpose] The purpose of this study was to determine the short- and mid-term effects of Kinesio taping on the trapezius muscle in individuals with myofascial pain syndrome. [Subjects and Methods] Thirty-seven patients with active upper trapezius myofascial trigger points were randomly divided to 2 groups: group 1 received Kinesio taping for the upper trapezius muscle, and group 2 received a sham Kinesio taping application. Neck pain (Visual Analog Scale and pressure algometry) and trapezius muscle strength data were collected at baseline, immediately after Kinesio taping application, and at one month follow-up. [Results] The mean changes in Visual Analog Scale scores were significantly different between groups at T2 and T1, with less pain in group 1. The mean changes in algometry scores were significantly different between groups at T3 compared with T2 in favor of group 1. The mean changes in trapezius muscle strength were significantly different between the groups at T2 compared with T1 in favor of group 1. [Conclusion] Patients with myofascial pain syndrome receiving an application of Kinesio taping exhibited statistically significant improvements in pain and upper trapezius muscle strength.

  14. Efficacy of kinesio tape application on pain and muscle strength in patients with myofascial pain syndrome: a placebo-controlled trial

    Science.gov (United States)

    Öztürk, Gülcan; Külcü, Duygu Geler; Mesci, Nilgün; Şilte, Ayşe Duygu; Aydog, Ece

    2016-01-01

    [Purpose] The purpose of this study was to determine the short- and mid-term effects of Kinesio taping on the trapezius muscle in individuals with myofascial pain syndrome. [Subjects and Methods] Thirty-seven patients with active upper trapezius myofascial trigger points were randomly divided to 2 groups: group 1 received Kinesio taping for the upper trapezius muscle, and group 2 received a sham Kinesio taping application. Neck pain (Visual Analog Scale and pressure algometry) and trapezius muscle strength data were collected at baseline, immediately after Kinesio taping application, and at one month follow-up. [Results] The mean changes in Visual Analog Scale scores were significantly different between groups at T2 and T1, with less pain in group 1. The mean changes in algometry scores were significantly different between groups at T3 compared with T2 in favor of group 1. The mean changes in trapezius muscle strength were significantly different between the groups at T2 compared with T1 in favor of group 1. [Conclusion] Patients with myofascial pain syndrome receiving an application of Kinesio taping exhibited statistically significant improvements in pain and upper trapezius muscle strength. PMID:27190430

  15. Detection of changes in SEMG signals with myofascial pain using the pattern-classifier

    Science.gov (United States)

    Jiang, Ching-Fen; Huang, Pao-Tieh

    2013-10-01

    Myofascial pain on the upper back (MFPUB) has been a common occupational hazard associated with consistent computer use. Investigations into any sort neuromuscular functional changes due to myofascial pain are rare. This study aims to differentiate the wavelet energy patterns of the surface electromyography signals measured from 30 normal and 26 patient subjects using the K-means clustering process. The results show that the wavelet energy pattern of patient subjects was different to that of normal subject and reveals a sensitivity of 57.69% at a specificity of 76.67% in the identification of myofascial pain. Therefore, this model could provide a reliable feature for clinical diagnosis of myofascial pain.

  16. Evolution of Muscles Dysfunction From Myofascial Pain Syndrome Through Cervical Disc-Root Conflict to Degenerative Spine Disease.

    Science.gov (United States)

    Lisiński, Przemysław; Huber, Juliusz

    2017-02-01

    Comparative clinical and neurophysiological study in three groups of patients with general diagnosis of neck pain. To determine symptoms of muscles dysfunction in patients with myofascial pain syndrome, disc-root conflict, and degenerative changes at cervical spine. The explanation for cervical pain origin should be based on results from chosen clinical and neurophysiological studies in correlation with neuroimaging findings. Three subgroups of patients (N = 60 each) with certain symptoms were examined. Clinical evaluation included examination of pain intensity in VAS scale, muscle strength in Lovett scale, evaluation of reflexes, Spurling test, assessment of active trigger points (TRPs), and superficial sensory perception. Neurophysiological testing included surface electromyography at rest (rEMG) and during maximal contraction (mcEMG) as well as electroneurography (ENG). The greatest pain intensity with its decentralization phenomenon occurred in patients with disc-root conflict. Significant decrease of muscle strength was detected in trapezius muscle in myofascial pain syndrome subgroup. Weakness of abductor pollicis brevis muscle in patients with disc-root conflict differed them from patients with myofascial pain syndrome (P = 0.05). Patients with disc-root conflict and degenerative spine disease showed differences (P = 0.03) in reflexes evoked from triceps brachii. Positive Spurling symptom was most common (56.7%) in disc-root conflict subgroup. TRPs in trapezius muscle were found in all patients with myofascial pain syndrome. Results of rEMG amplitude measurements differed patients at P = 0.05. Only mcEMG recording from abductor pollicis brevis muscle allows for their clear cut differentiation. ENG studies showed abnormalities in patients with disc-root conflict and degenerative spine disease (P from 0.05 to 0.02). Positive correlation of VAS, TRPs, and rEMG as well as Lovett scores, mcEMG, and ENG results was found. Only applying several

  17. Percutaneous Soft Tissue Release for Treating Chronic Recurrent Myofascial Pain Associated with Lateral Epicondylitis: 6 Case Studies

    Directory of Open Access Journals (Sweden)

    Ming-Ta Lin

    2012-01-01

    Full Text Available Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis. Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin’s technique. Pain intensity (measured with a numerical pain rating scale, pressure pain threshold (measured with a pressure algometer, and grasping strength (measured with a hand dynamometer were assessed before, immediately after, and 3 months and 12 months after the treatment. Results. For every individual case, the pain intensity was significantly reduced (P<0.01 and the pressure pain threshold and the grasping strength were significantly increased (P<0.01 immediately after the treatment. This significant effectiveness lasts for at least one year. Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain.

  18. Effectiveness of Different Deep Dry Needling Dosages in the Treatment of Patients With Cervical Myofascial Pain: A Pilot RCT.

    Science.gov (United States)

    Fernández-Carnero, Josué; Gilarranz-de-Frutos, Laura; León-Hernández, Jose Vicente; Pecos-Martin, Daniel; Alguacil-Diego, Isabel; Gallego-Izquierdo, Tomás; Martín-Pintado-Zugasti, Aitor

    2017-10-01

    To assess the effectiveness of different dosages of local twitch responses (LTRs) elicited by deep dry needling (DDN) in relation to pain intensity, pressure pain threshold (PPT), cervical range of movement (CROM), and disability degree in cervical myofascial pain patients. A randomized, double-blind clinical trial. Eighty-four patients (21 males, 63 females; 27.18 ± 10.91 yrs) with cervical pain. DDN in active myofascial trigger points (MTrPs) in the upper trapezius. Patients were randomly divided into four groups: (a) no LTRs elicited, (b) four LTRs elicited, (c) six LTRs elicited, and (d) needling until no more LTRs were elicited. Pain intensity, PPT, CROM, and disability degree were assessed before treatment, post-immediate, 48 hrs, 72 hrs, and 1 wk after treatment. Significant differences were found in the time factor for all the variables (P 0.05). DDN in the upper trapezius MTrP improved pain at a 1-wk follow-up, but improvements were not significantly different among DDN dosages. A higher number of patients with neck pain improvements superior to the moderate clinically important differences were observed when eliciting 6 LTRs and LTRs until exhaustion compared with not eliciting LTRs.

  19. Percutaneous soft tissue release for treating chronic recurrent myofascial pain associated with lateral epicondylitis: 6 case studies.

    Science.gov (United States)

    Lin, Ming-Ta; Chou, Li-Wei; Chen, Hsin-Shui; Kao, Mu-Jung

    2012-01-01

    Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis. Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs) due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin's technique. Pain intensity (measured with a numerical pain rating scale), pressure pain threshold (measured with a pressure algometer), and grasping strength (measured with a hand dynamometer) were assessed before, immediately after, and 3 months and 12 months after the treatment. Results. For every individual case, the pain intensity was significantly reduced (P < 0.01) and the pressure pain threshold and the grasping strength were significantly increased (P < 0.01) immediately after the treatment. This significant effectiveness lasts for at least one year. Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain.

  20. Latent Period of Relaxation.

    Science.gov (United States)

    Kobayashi, M; Irisawa, H

    1961-10-27

    The latent period of relaxation of molluscan myocardium due to anodal current is much longer than that of contraction. Although the rate and the grade of relaxation are intimately related to both the stimulus condition and the muscle tension, the latent period of relaxation remains constant, except when the temperature of the bathing fluid is changed.

  1. Mechanisms and clinical management of myofascial pain syndrome%肌筋膜疼痛综合征的基础与临床研究

    Institute of Scientific and Technical Information of China (English)

    袁宏杰; 杜诗斌

    2015-01-01

    肌筋膜疼痛综合征是激痛点引起的疼痛性疾病,其发病率非常高,而治疗相对困难.本文对肌筋膜疼痛综合征的机理、诊断以及治疗作一综述.%Myofascial pain syndrome is a kind of painful disease caused by trigger points.It has extremely high prevalence and is refractory to medical therapy.So the mechanisms,diagnosis and treatment principles are reviewed in this article.

  2. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    LENUS (Irish Health Repository)

    Ryan, Aisling M

    2012-02-03

    Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

  3. Evaluation of treatments for myofascial pain syndrome and fibromyalgia.

    Science.gov (United States)

    Rudin, Nathan J

    2003-12-01

    Myofascial pain syndrome (MPS) and fibromyalgia (FM) are complex conditions and pose significant challenges to clinicians and patients. This chapter explores available treatments for MPS and FM in the context of pathophysiology, clinical evidence, and experimental support. This information may prove to be helpful in designing individualized treatment for patients with these complex syndromes. New treatments should be critically and carefully evaluated as they appear.

  4. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    Science.gov (United States)

    Ryan, Aisling M; Bermingham, Niamh; Harrington, Hugh J; Keohane, Catherine

    2006-12-01

    Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

  5. Latent semantics as cognitive components

    DEFF Research Database (Denmark)

    Petersen, Michael Kai; Mørup, Morten; Hansen, Lars Kai

    2010-01-01

    Cognitive component analysis, defined as an unsupervised learning of features resembling human comprehension, suggests that the sensory structures we perceive might often be modeled by reducing dimensionality and treating objects in space and time as linear mixtures incorporating sparsity...... and independence. In music as well as language the patterns we come across become part of our mental workspace when the bottom-up sensory input raises above the background noise of core affect, and top-down trigger distinct feelings reflecting a shift of our attention. And as both low-level semantics and our...... emotional responses can be encoded in words, we propose a simplified cognitive approach to model how we perceive media. Representing song lyrics in a vector space of reduced dimensionality using LSA, we combine bottom-up defined term distances with affective adjectives, that top-down constrain the latent...

  6. Latent fingerprint matching.

    Science.gov (United States)

    Jain, Anil K; Feng, Jianjiang

    2011-01-01

    Latent fingerprint identification is of critical importance to law enforcement agencies in identifying suspects: Latent fingerprints are inadvertent impressions left by fingers on surfaces of objects. While tremendous progress has been made in plain and rolled fingerprint matching, latent fingerprint matching continues to be a difficult problem. Poor quality of ridge impressions, small finger area, and large nonlinear distortion are the main difficulties in latent fingerprint matching compared to plain or rolled fingerprint matching. We propose a system for matching latent fingerprints found at crime scenes to rolled fingerprints enrolled in law enforcement databases. In addition to minutiae, we also use extended features, including singularity, ridge quality map, ridge flow map, ridge wavelength map, and skeleton. We tested our system by matching 258 latents in the NIST SD27 database against a background database of 29,257 rolled fingerprints obtained by combining the NIST SD4, SD14, and SD27 databases. The minutiae-based baseline rank-1 identification rate of 34.9 percent was improved to 74 percent when extended features were used. In order to evaluate the relative importance of each extended feature, these features were incrementally used in the order of their cost in marking by latent experts. The experimental results indicate that singularity, ridge quality map, and ridge flow map are the most effective features in improving the matching accuracy.

  7. Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Ge, Hong-You; Arendt-Nielsen, Lars; Cuadrado, Maria Luz; Pareja, Juan A

    2007-05-01

    Referred pain and pain characteristics evoked from the upper trapezius muscle was investigated in 20 patients with chronic tension-type headache (CTTH) and 20 age- and gender-matched controls. A headache diary was kept for 4 weeks in order to confirm the diagnosis and record the pain history. Both upper trapezius muscles were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold (PPT) were recorded. The results show that referred pain was evoked in 85% and 50% on the dominant and non-dominant sides in CTTH patients, much higher than 55% and 25% in controls (P<0.01). Referred pain spread to the posterior-lateral aspect of the neck ipsi-lateral to the stimulated muscle in both patients and controls, with additional referral to the temple in most patients, but none in controls. Nearly half of the CTTH patients (45%) recognized the referred pain as their usual headache sensation, i.e. active TrPs. CTTH patients with active TrPs in the right upper trapezius muscle showed greater headache intensity and frequency, and longer headache duration than those with latent TrPs. CTTH patients with bilateral TrPs reported significantly decreased PPT than those with unilateral TrP (P<0.01). Our results showed that manual exploration of TrPs in the upper trapezius muscle elicited referred pain patterns in both CTTH patients and healthy subjects. In CTTH patients, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual headache pain, consistent with active TrPs. Our results suggest that spatial summation of perceived pain and mechanical pain sensitivity exists in CTTH patients.

  8. Latent classification models

    DEFF Research Database (Denmark)

    Langseth, Helge; Nielsen, Thomas Dyhre

    2005-01-01

    parametric family ofdistributions.  In this paper we propose a new set of models forclassification in continuous domains, termed latent classificationmodels. The latent classification model can roughly be seen ascombining the \\NB model with a mixture of factor analyzers,thereby relaxing the assumptions...... of the \\NB classifier. In theproposed model the continuous attributes are described by amixture of multivariate Gaussians, where the conditionaldependencies among the attributes are encoded using latentvariables. We present algorithms for learning both the parametersand the structure of a latent...

  9. Trigger point needling: techniques and outcome.

    Science.gov (United States)

    Vulfsons, Simon; Ratmansky, Motti; Kalichman, Leonid

    2012-10-01

    In this review we provide the updates on last years' advancements in basic science, imaging methods, efficacy, and safety of dry needling of myofascial trigger points (MTrPs). The latest studies confirmed that dry needling is an effective and safe method for the treatment of MTrPs when provided by adequately trained physicians or physical therapists. Recent basic studies have confirmed that at the site of an active MTrP there are elevated levels of inflammatory mediators, known to be associated with persistent pain states and myofascial tenderness and that this local milieu changes with the occurrence of local twitch response. Two new modalities, sonoelastography and magnetic resonance elastography, were recently introduced allowing noninvasive imaging of MTrPs. MTrP dry needling, at least partially, involves supraspinal pain control via midbrain periaqueductal gray matter activation. A recent study demonstrated that distal muscle needling reduces proximal pain by means of the diffuse noxious inhibitory control. Therefore, in a patient too sensitive to be needled in the area of the primary pain source, the treatment can be initiated with distal needling.

  10. The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders Holsgaard

    -observer agreement of TP examination among four examiners and whether reproducibility is influenced by examiner clinical experience. Two experienced and two inexperienced clinicians each performed a standardized palpation of the upper Trapezius musculature. Each observer was asked to judge the presents...... in order to improve protocol standardization. Kappa co-efficients were calculated for all possible examiner pairings. Good agreement was noted between the experienced pairing (κ= 0.63). Moderate levels of agreement were observed among the two mixed pairings (κ=0.35 and 0.47 respectively). However, poor......A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter...

  11. Sífilis latente

    OpenAIRE

    Arévalo, Jose David

    2012-01-01

    Trabajo leído por su autor en la Academia Nacional de Medicina, el día 20 de mayo de 1948. La sífilis Latente es aquella en que el organismo se ha defendido biológicamente sin ningún tratamiento, En la sífilis latente hay que distinguir: la latencia clínica, la latencia serológica y la latencia patológica.

  12. Comparison the efficacy of phonophoresis and ultrasound therapy in myofascial pain syndrome.

    Science.gov (United States)

    Ay, Saime; Doğan, Sebnem Koldaş; Evcik, Deniz; Başer, Ozgün Cakmak

    2011-09-01

    The aim of this study is to compare the effect of phonophoresis, ultrasound and placebo ultrasound therapies in the treatment of myofascial pain syndrome (MPS). This is a randomized, double-blind placebo controlled study. Sixty patients (48 women, 12 men, mean age 37.9 ± 12.2 years) with MPS were included in this study. Patients were allocated into three groups. Group 1(n = 20) was received diclofenac phonophoresis, group 2(n = 20) was received ultrasound and group 3(n = 20) was received placebo ultrasound therapies over trigger points, 10 min a day for 15 session during 3 weeks (1 MHz-1,5 watt/cm²). Additionally, all patients were given neck exercise program including isotonic, isometric and stretching. Patients were assessed by means of pain, range of motion (ROM) of neck, number of trigger points (NTP), algometric measurement and disability. Pain severity was measured by visual analog scale (VAS) and Likert scale. The neck pain disability index (NPDI) was used for assessing disability. Measurements were taken before and after treatment. After treatment, there were statistically significant improvements in pain severity, NTP, pressure pain threshold (PPT), ROM and NPDI scores both in phonophoresis and in ultrasound therapy groups (P pain levels, number of trigger points and NPDI score, pressure pain threshold (P > 0.05), also there were no significant differences in all parameters between group 1 and 2 (P = 0.05). Both diclofenac phonophoresis and ultrasound therapy were effective in the treatment of patients with MPS. Phonophoresis was not found to be superior over ultrasound therapy.

  13. Delayed effort-induced swelling with myofasciitis and systemic manifestations: A so far unrecognized type of pressure-induced urticaria

    Science.gov (United States)

    Bursztejn, Anne-Claire; Lipsker, Dan

    2017-01-01

    Abstract Diseases characterized by recurrent symptoms with prolonged intervals without any clinical manifestations can pose diagnostic difficulties. Some diagnoses will be obvious but other situations can be very challenging. To nosologically delineate a new entity characterized by recurrent flares of induration of the forearms and legs with swelling of the extremities accompanied by intense fatigue and variable other symptoms. Retrospective observational study of patients recorded from 2000 to 2015. All patients included were seen during a consultation at the Dermatology Department of the University Hospital of Strasbourg, France. We retrieved the medical records from patients seen and recorded over the last 16 years having induration of the extremities, the forearm and the legs occurring between 4 and 12 hours after a physical effort accompanied by systemic signs that lasted for a few days. We analyzed in detail the clinical and biological features, evolution, and treatments of these patients. We included 6 males, with a mean age of 47 years; mean age at disease onset was 42. All patients were initially misdiagnosed as having rheumatic disorders. The mean delay before diagnosis was 5 years. The main complaint was painful induration or muscle soreness of the forearms and the legs associated with transient functional impairment and prolonged asthenia for a mean duration of 3.5 days. Induration of the deep soft tissues was very suggestive of myofasciitis. The delay between the triggering physical effort and the swelling was between 6 and 12 hours. Physical effort as triggering factor was never spontaneously mentioned. Two patients had partial response to high dose antihistamines and 2 other patients to the interleukin-1 inhibitor anakinra. One patient responded to hydroxychloroquine. The very stereotypical presentation in those 6 patients suggests that this is a recognizable entity characterized by effort-induced induration of forearms and/or legs, due to deep

  14. Comparison of the Efficacy of Dry Needling and High-Power Pain Threshold Ultrasound Therapy with Clinical Status and Sonoelastography in Myofascial Pain Syndrome.

    Science.gov (United States)

    Aridici, Rifat; Yetisgin, Alparslan; Boyaci, Ahmet; Tutoglu, Ahmet; Bozdogan, Erol; Sen Dokumaci, Dilek; Kilicaslan, Nihat; Boyaci, Nurefsan

    2016-10-01

    The aim of this study was to compare the therapeutic efficacy of high-power pain threshold (HPPT) ultrasound therapy applied to the trigger points and dry needling (DN) in myofascial pain syndrome. Sixty-one patients were randomly assigned to an HPPT (n = 30) and dry needling (n = 31) groups. The primary outcome measures were the Visual Analog Scale (VAS) and Neck Pain and Disability Scale (NPDS), both at 1 week and 4 weeks after treatment. The secondary outcome measures were the number of painful trigger points, range of the tragus-acromioclavicular joint, the Short Form-36, the Beck Depression Inventory, the Beck Anxiety Inventory, and sonoelastographic tests after a 1-week treatment. More improvement was seen in anxiety in the HPPT group (P 0.05). A decrease in tissue stiffness was only seen in the HPPT group (P myofascial pain syndrome. Although a significant decrease was shown in tissue stiffness with HPPT, neither of these treatments had an apparent superiority.

  15. Manual acupuncture for myofascial pain syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Rong; Li, Xiuxia; Zhou, Shenghu; Zhang, Xiaogang; Yang, Kehu; Li, Xusheng

    2017-08-01

    To assess the efficacy of manual acupuncture (MA) in the treatment of myofascial pain syndrome (MPS). We searched for randomised controlled trials (RCTs) comparing MA versus sham/placebo or no intervention in patients with MPS in the following databases from inception to January 2016: PubMed; Cochrane Library; Embase; Web of Science; and China Biology Medicine. Two reviewers independently screened the literature extracted data and assessed the quality of the included studies according to the risk of bias tool recommended by the Cochrane Handbook (V.5.1.0). Then, a meta-analysis was performed using RevMan 5.3 software. Ten RCTs were combined in a meta-analysis of MA versus sham, which showed a favourable effect of MA on pain intensity after stimulation of myofascial trigger points (MTrPs; standardised mean difference (SMD) -0.90, 95% CI -1.48 to -0.32; p=0.002) but not traditional acupuncture points (p>0.05). Benefit was seen both after a single treatment (SMD -1.05, 95% CI -1.84 to -0.27; p=0.009) and course of eight sessions (weighted mean difference (WMD) -1.96, 95% CI -2.72 to -1.20; p<0.001). We also found a significant increase in pressure pain threshold following MA stimulation of MTrPs (WMD 1.00, 95% CI 0.32 to 1.67; p=0.004). Two of the included studies reported mild adverse events (soreness/haemorrhage) secondary to MA. Through stimulation of MTrPs, MA might be efficacious in terms of pain relief and reduction of muscle irritability in MPS patients. Additional well-designed/reported studies are required to determine the optimal number of sessions for the treatment of MPS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Myofascial force transmission via extramuscular pathways occurs between antagonistic muscles.

    Science.gov (United States)

    Huijing, Peter A; Baan, Guus C

    2008-01-01

    Most often muscles (as organs) are viewed as independent actuators. To test if this is true for antagonistic muscles, force was measured simultaneously at: (1) the proximal and distal tendons of the extensor digitorum muscle (EDL) to quantify any proximo-distal force differences, as an indicator of myofascial force transmission, (2) at the distal tendons of the whole antagonistic peroneal muscle group (PER) to test if effects of EDL length changes are present and (3) at the proximal end of the tibia to test if myofascially transmitted force is exerted there. EDL length was manipulated either at the proximal or distal tendons. This way equal EDL lengths are attained at two different positions of the muscle with respect to the tibia and antagonistic muscles. Despite its relatively small size, lengthening of the EDL changed forces exerted on the tibia and forces exerted by its antagonistic muscle group. Apart from its extramuscular myofascial connections, EDL has no connections to either the tibia or these antagonistic muscles. Proximal EDL lengthening increased distal muscular forces (active PER DeltaF approximately +1.7%), but decreased tibial forces (passive from 0.3 to 0 N; active DeltaF approximately -5%). Therefore, it is concluded that these antagonistic muscles do not act independently, because of myofascial force transmission between them. Such a decrease in tibial force indicates release of pre-strained connections. Distal EDL lengthening had opposite effects (tripling passive force exerted on tibia; active PER force DeltaF approximately -3.6%). It is concluded that the length and relative position of the EDL is a co-determinant of passive and active force exerted at tendons of nearby antagonistic muscle groups. These results necessitate a new view of the locomotor apparatus, which needs to take into account the high interdependence of muscles and muscle fibres as force generators, as well as proximo-distal force differences and serial and parallel

  17. Latent tuberculosis infection.

    Science.gov (United States)

    Nuermberger, Eric; Bishai, William R; Grosset, Jacques H

    2004-06-01

    Latent tuberculosis infection (LTBI) is a clinical condition characterized by a positive tuberculin skin test in the absence of clinical or radiological signs of active tuberculosis disease. It has been estimated that one third of the world's population is latently infected with Mycobacterium tuberculosis and serves as an enormous reservoir for future cases of active tuberculosis. The detection and treatment of individuals with LTBI and a high risk of progression to active tuberculosis are effective means to control the spread of tuberculosis. Furthermore, a better understanding of the host-pathogen interactions that result in latent infection could provide important insights for future drug or vaccine development. This chapter reviews recent developments in the molecular genetics, natural history, diagnosis, and treatment of LTBI within its historical context, including the impact of human immunodeficiency virus infection. Current treatment recommendations are also summarized.

  18. Potentiation of latent inhibition.

    Science.gov (United States)

    Rodriguez, Gabriel; Hall, Geoffrey

    2008-07-01

    Rats were given exposure either to an odor (almond) or a compound of odor plus taste (almond plus saline), prior to training in which the odor served as the conditioned stimulus. It was found, for both appetitive and aversive procedures, that conditioning was retarded by preexposure (a latent inhibition effect), and the extent of the retardation was greater in rats preexposed to the compound (i.e., latent inhibition to the odor was potentiated by the presence of the taste). In contrast, the presence of the taste during conditioning itself overshadowed learning about the odor. We argue that the presence of the salient taste in compound with the odor enhances the rate of associative learning, producing a rapid loss in the associability of the odor. This loss of associability will generate both overshadowing and the potentiation of latent inhibition that is observed after preexposure to the compound.

  19. Latent classification models

    DEFF Research Database (Denmark)

    Langseth, Helge; Nielsen, Thomas Dyhre

    2005-01-01

    One of the simplest, and yet most consistently well-performing setof classifiers is the \\NB models. These models rely on twoassumptions: $(i)$ All the attributes used to describe an instanceare conditionally independent given the class of that instance,and $(ii)$ all attributes follow a specific...... parametric family ofdistributions.  In this paper we propose a new set of models forclassification in continuous domains, termed latent classificationmodels. The latent classification model can roughly be seen ascombining the \\NB model with a mixture of factor analyzers,thereby relaxing the assumptions...... classification model, and wedemonstrate empirically that the accuracy of the proposed model issignificantly higher than the accuracy of other probabilisticclassifiers....

  20. Triggering Klystrons

    Energy Technology Data Exchange (ETDEWEB)

    Stefan, Kelton D.; /Purdue U. /SLAC

    2010-08-25

    To determine if klystrons will perform to the specifications of the LCLS (Linac Coherent Light Source) project, a new digital trigger controller is needed for the Klystron/Microwave Department Test Laboratory. The controller needed to be programmed and Windows based user interface software needed to be written to interface with the device over a USB (Universal Serial Bus). Programming the device consisted of writing logic in VHDL (VHSIC (Very High Speed Integrated Circuits) hardware description language), and the Windows interface software was written in C++. Xilinx ISE (Integrated Software Environment) was used to compile the VHDL code and program the device, and Microsoft Visual Studio 2005 was used to compile the C++ based Windows software. The device was programmed in such a way as to easily allow read/write operations to it using a simple addressing model, and Windows software was developed to interface with the device over a USB connection. A method of setting configuration registers in the trigger device is absolutely necessary to the development of a new triggering system, and the method developed will fulfill this need adequately. More work is needed before the new trigger system is ready for use. The configuration registers in the device need to be fully integrated with the logic that will generate the RF signals, and this system will need to be tested extensively to determine if it meets the requirements for low noise trigger outputs.

  1. The myofascial compartments of the foot: a cadaver study.

    Science.gov (United States)

    Ling, Z X; Kumar, V P

    2008-08-01

    Compartment syndrome of the foot requires urgent surgical treatment. Currently, there is still no agreement on the number and location of the myofascial compartments of the foot. The aim of this cadaver study was to provide an anatomical basis for surgical decompression in the event of compartment syndrome. We found that there were three tough vertical fascial septae that extended from the hindfoot to the midfoot on the plantar aspect of the foot. These septae separated the posterior half of the foot into three compartments. The medial compartment containing the abductor hallucis was surrounded medially by skin and subcutaneous fat and laterally by the medial septum. The intermediate compartment, containing the flexor digitorum brevis and the quadratus plantae more deeply, was surrounded by the medial septum medially, the intermediate septum laterally and the main plantar aponeurosis on its plantar aspect. The lateral compartment containing the abductor digiti minimi was surrounded medially by the intermediate septum, laterally by the lateral septum and on its plantar aspect by the lateral band of the main plantar aponeurosis. No distinct myofascial compartments exist in the forefoot. Based on our findings, in theory, fasciotomy of the hindfoot compartments through a modified medial incision would be sufficient to decompress the foot.

  2. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

    Science.gov (United States)

    Conti, P C R; Costa, Y M; Gonçalves, D A; Svensson, P

    2016-09-01

    There are relevant clinical overlaps between some of the painful temporomandibular disorders (TMD) and headache conditions that may hamper the diagnostic process and treatment. A non-systematic search for studies on the relationship between TMD and headaches was carried out in the following databases: PubMed, Cochrane Library and Embase. Important pain mechanisms contributing to the close association and complex relationship between TMD and headache disorders are as follows: processes of peripheral and central sensitisation which take place in similar anatomical areas, the possible impairment of the descending modulatory pain pathways and the processes of referred pain. In addition, the clinical examination does not always provide distinguishing information to differentiate between headaches and TMD. So, considering the pathophysiology and the clinical presentation of some types of headache and myofascial TMD, such overlap can be considered not only a matter of comorbid relationship, but rather a question of disorders where the distinction lines are sometimes hard to identify. These concerns are certainly reflected in the current classification systems of both TMD and headache where the clinical consequences of diagnosis such as headache attributed to or associated with TMD are uncertain. There are several similarities in terms of therapeutic strategies used to manage myofascial TMD and headaches. Considering all these possible levels of interaction, we reinforce the recommendation for multidisciplinary approaches, by a team of oro-facial pain specialists and a neurologist (headache specialist), to attain the most precise differential diagnosis and initiate the best and most efficient treatment.

  3. Dynamic Latent Classification Model

    DEFF Research Database (Denmark)

    Zhong, Shengtong; Martínez, Ana M.; Nielsen, Thomas Dyhre

    as possible. Motivated by this problem setting, we propose a generative model for dynamic classification in continuous domains. At each time point the model can be seen as combining a naive Bayes model with a mixture of factor analyzers (FA). The latent variables of the FA are used to capture the dynamics...... in the process as well as modeling dependences between attributes....

  4. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    NARCIS (Netherlands)

    Bron, Carel; Dommerholt, J.; Stegenga, Boudewijn; Wensing, M.; Oostendorp, R.A.B.

    2011-01-01

    Background: Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols.

  5. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    NARCIS (Netherlands)

    Bron, Carel; Dommerholt, J.; Stegenga, Boudewijn; Wensing, M.; Oostendorp, R.A.B.

    2011-01-01

    Background: Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols.

  6. Effectiveness comparison between Thai traditional massage and Chinese acupuncture for myofascial back pain in Thai military personnel: a preliminary report.

    Science.gov (United States)

    Kumnerddee, Wipoo

    2009-02-01

    The objective of this randomized comparative study was to provide preliminary data of comparative effectiveness of Thai traditional massage (TTM) and Chinese acupuncture for the treatment of myofascial back pain in young military personnel. Eighteen Thai military personnel, aged ranging from 20-40 years were randomly divided into TTM and acupuncture groups. Each group received 5 sessions of massage or acupuncture during a 10-day period. The Thai version McGill Pain Questionnaire, 100-mm, visual analog scale (VAS) and summation of pain threshold in each trigger point measured by pressure algometer were assessed at day 0, 3, 8 and 10. At the end of treatment protocols, McGill scores decreased significantly in TTM and acupuncture groups (p = 0.024 and 0.002, respectively). VAS also decreased significantly (p = 0.029 and 0.003, respectively). However, the pain pressure threshold increased significantly in the acupuncture group but not in the TTM group (p = 0.006 and 0.08, respectively). When outcomes were compared between the two groups, no significant difference was found in the VAS (p = 0.115) and pain pressure threshold (p = 0.116), whereas the acupuncture group showed significantly lower McGill scores than the TTM group (p = 0.039). In conclusion, five sessions of Thai traditional massage and Chinese acupuncture were effective for the treatment of myofascial back pain in young Thai military personnel. Significant effects in both groups begin after the first session. Acupuncture is more effective than Thai traditional massage when affective aspect is also evaluated.

  7. EFFECTIVENESS OF MUSCLE ENERGY TECHNIQUE ON PAIN AND CERVICAL RANGE OF MOTION IN PATIENTS WITH MYOFASCIAL PAIN IN UPPER TRAPEZIUS

    Directory of Open Access Journals (Sweden)

    M. Srikanth

    2015-02-01

    Full Text Available Back ground: Myofascial trigger point (MTPt can be defined as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. MTPt is associated with pain on compression, the pain is typically of a referred type. MTPt symptoms, cause severe discomfort and inability to work. The pain is aggravated with activity or stress. Untreated, chronic cases might lead to symptoms like depression, fatigue and behavioural disturbances. The objective of the study is to examine the effectiveness of MET on pain with VAS and cervical ROM with inch tape method in patients with myofascial pain in upper trapezius. Methods: participants were randomized into intervention group (n =15 and control group (n = 15.The intervention group was given muscle energy technique, ischemic compression and ultrasound. The control group was given only ischemic compression and ultrasound. Ultrasound 1 MHz continuous mode, intensity 1.5W/cm2 for 5 minutes. Home exercises taught to both the groups. This program designed for daily for 1 week. Outcome measures: Pain-VAS, ROM-Inch tape method (cervical lateral flexion. Results: values within the groups were compared by using paired `t` test. According to obtained values, the pre & posttest values of pain and ROM had an significant effect on p-values 0.00 in experimental group. The difference between the pretest and posttest scores of 95% confidence intervals for each outcome variable was reported. Conclusion: After 1 week of intervention protocol, the present study concludes that MET has significant improvement in pain, ROM in intervention group.

  8. Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?

    OpenAIRE

    Masi, Alfonse T.

    2014-01-01

    Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hype...

  9. Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?

    OpenAIRE

    Masi, Alfonse T.

    2014-01-01

    Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hype...

  10. An evaluation tool for myofascial adhesions in patients after breast cancer (MAP-BC evaluation tool): Development and interrater reliability

    OpenAIRE

    De Groef, An; Kampen, Marijke; Vervloesem, Nele; De Geyter, Sophie; Dieltjens, Evi; Christiaens, Rose; Neven, Patrick; Geraerts, Inge; Devoogdt, Nele

    2017-01-01

    Purpose To develop a tool to evaluate myofascial adhesions objectively in patients with breast cancer and to investigate its interrater reliability. Methods 1) Development of the evaluation tool. Literature was searched, experts in the field of myofascial therapy were consulted and pilot testing was performed. 2) Thirty patients (63% had a mastectomy, 37% breast-conserving surgery and 97% radiotherapy) with myofascial adhesions were evaluated using the developed tool by 2 independent raters. ...

  11. Latent sensitization: a model for stress-sensitive chronic pain.

    Science.gov (United States)

    Marvizon, Juan Carlos; Walwyn, Wendy; Minasyan, Ani; Chen, Wenling; Taylor, Bradley K

    2015-04-01

    Latent sensitization is a rodent model of chronic pain that reproduces both its episodic nature and its sensitivity to stress. It is triggered by a wide variety of injuries ranging from injection of inflammatory agents to nerve damage. It follows a characteristic time course in which a hyperalgesic phase is followed by a phase of remission. The hyperalgesic phase lasts between a few days to several months, depending on the triggering injury. Injection of μ-opioid receptor inverse agonists (e.g., naloxone or naltrexone) during the remission phase induces reinstatement of hyperalgesia. This indicates that the remission phase does not represent a return to the normal state, but rather an altered state in which hyperalgesia is masked by constitutive activity of opioid receptors. Importantly, stress also triggers reinstatement. Here we describe in detail procedures for inducing and following latent sensitization in its different phases in rats and mice. Copyright © 2015 John Wiley & Sons, Inc.

  12. [Mechanisms of muscle pain : significance of trigger points and tender points].

    Science.gov (United States)

    Brezinschek, H-P

    2008-12-01

    Fibromyalgia syndrome (FMS) and myofascial pain syndrome (MPS) belong to the group of chronic non-inflammatory pain syndromes affecting muscles and tendinous insertions. Important criteria in the diagnosis of both diseases are the presence of "tender points" and "trigger points". According to ACR criteria FMS is characterized by the presence of tender points whereas trigger points are typically found in MPS.The main difference is that until now tender points could only be defined in terms of their localization, whereas trigger points can be found upon palpation which may cause a specific referred pain pattern. In addition, analysis of trigger points by microdialysis demonstrated elevated levels of pro-inflammatory substances at these sites. Moreover, local treatment of trigger points either by manipulative therapy or injection appears to be most effective for prompt relief of symptoms.

  13. The efficacy of progressive muscle relaxation in combination with spinal manipulative therapy on active trigger points of the trapezius muscle

    OpenAIRE

    2013-01-01

    M.Tech. (Chiropractic) Purpose: The trapezius muscle is thought to be the muscle most commonly associated with the presence of active myofascial trigger points (MFTP’s). Studies of the trapezius muscle clearly show that muscular activity significantly increases in response to psychological stress. Cervical spine manipulation has been proven to be highly effective in the treatment of active MFTP’s and muscular tension. Progressive muscle relaxation (PMR) therapy is frequently utilized as a ...

  14. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial.

    Science.gov (United States)

    Tekin, Levent; Akarsu, Selim; Durmuş, Oğuz; Cakar, Engin; Dinçer, Umit; Kıralp, Mehmet Zeki

    2013-03-01

    The objective of this study was to test the hypothesis that dry needling is more effective than sham dry needling in the treatment of myofascial pain syndrome (MPS). This was a prospective, double-blinded, randomized-controlled study conducted in an outpatient clinic. Thirty-nine subjects with established myofascial trigger points were randomized into two groups: study group (N = 22) and placebo group (N = 17). Dry needling was applied using acupuncture needles, and sham dry needling was applied in the placebo group. The treatment was composed of six sessions which were performed in 4 weeks; the first four sessions were performed twice a week (for 2 weeks) and the last two, once a week (for 2 weeks). The visual analog scale (VAS) and Short Form-36 (SF-36) were used. When compared with the initial values, VAS scores of the dry needling group following the first and sixth sessions were significantly lower (p = 0.000 and p dry needling group (p = 0.034 and p dry needling group, whereas only those of vitality scores were found to be increased significantly in the placebo (sham needling) group. The present study shows that the dry needling treatment is effective in relieving the pain and in improving the quality of life of patients with MPS.

  15. Intramuscular Hemangioma Mimicking Myofascial Pain Syndrome : A Case Report

    Science.gov (United States)

    Hwang, Miriam; Kang, Yoon Kyoo; Kim, In Jong; Park, Yoon Kun

    2007-01-01

    Intramuscular hemangioma, an infrequent but important cause of musculoskeletal pain, is often difficult to establish the diagnosis clinically. This report describes a case of a 32-yr-old woman who presented with severe left calf pain for 10 yr. Initial conservative treatments consisting of intramuscular electrical stimulation, herb medication, acupuncture, and intramuscular lidocaine injection under the diagnosis of myofascial pain syndrome in other facilities, failed to alleviate the symptoms. On physical examination, there was no motor weakness or sensory change. Conventional radiography of the leg revealed a soft tissue phlebolith. Conventional angiography study showed hemangioma. Intramuscular hemangioma within the soleus muscle was confirmed by magnetic resonance imaging. Following surgical excision of the hemangioma, the patient's symptom resolved completely. Intramuscular hemangioma is a rare cause of calf pain and should be considered in the differential diagnosis if a patient with muscle pain, particularly if associated with a soft tissue mass, fails to respond to conservative treatment. PMID:17596677

  16. Fibromyalgia and Myofascial Pain Syndrome-A Dilemma

    Science.gov (United States)

    Chandola, H C; Chakraborty, Arunangshu

    2009-01-01

    Summary Pain and fatigue associated to the musculoskeletal system are among the leading causes of patients to visit their physicians and nearly one-third of such patients suffer from fibromyalgia. Fibromyalgia syndrome (FMS) is a chronic debilitating disorder characterized by widespread pain with tenderness in specific areas, leading to fatigue, headache and sleep disorder. Myofascial Pain Syndrome (MPS), is also a localized musculoskeletal pain producing condition whose diagnostic and management criteria differ from FMS but still considered by many only a subtype of FMS. Till date no exact cause has been held responsible for these painful conditions, therefore treatment of these disorders is always a challenge. The therapies are not precise but multimodal including pharmacological and alternative approaches. This article describes the existing knowledge pertaining to these conditions in regard of causative factors diagnosis and management. PMID:20640108

  17. The effects of myofascial release with foam rolling on performance.

    Science.gov (United States)

    Healey, Kellie C; Hatfield, Disa L; Blanpied, Peter; Dorfman, Leah R; Riebe, Deborah

    2014-01-01

    In the last decade, self-myofascial release has become an increasingly common modality to supplement traditional methods of massage, so a masseuse is not necessary. However, there are limited clinical data demonstrating the efficacy or mechanism of this treatment on athletic performance. The purpose of this study was to determine whether the use of myofascial rollers before athletic tests can enhance performance. Twenty-six (13 men and 13 women) healthy college-aged individuals (21.56 ± 2.04 years, 23.97 ± 3.98 body mass index, 20.57 ± 12.21 percent body fat) were recruited. The study design was a randomized crossover design in which subject performed a series of planking exercises or foam rolling exercises and then performed a series of athletic performance tests (vertical jump height and power, isometric force, and agility). Fatigue, soreness, and exertion were also measured. A 2 × 2 (trial × gender) analysis of variance with repeated measures and appropriate post hoc was used to analyze the data. There were no significant differences between foam rolling and planking for all 4 of the athletic tests. However, there was a significant difference between genders on all the athletic tests (p ≤ 0.001). As expected, there were significant increases from pre to post exercise during both trials for fatigue, soreness, and exertion (p ≤ 0.01). Postexercise fatigue after foam rolling was significantly less than after the subjects performed planking (p ≤ 0.05). The reduced feeling of fatigue may allow participants to extend acute workout time and volume, which can lead to chronic performance enhancements. However, foam rolling had no effect on performance.

  18. Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.

    Science.gov (United States)

    Buskila, D

    2000-03-01

    Fibromyalgia and widespread pain were common in Gulf War veterans with unexplained illness referred to a rheumatology clinic. Increased tenderness was demonstrated in the postmenstrual phase of the cycle compared with the intermenstrual phase in normally cycling women but not in users of oral contraceptives. Patients with fibromyalgia had high levels of symptoms that have been used to define silicone implant-associated syndrome. Tender points were found to be a common transient finding associated with acute infectious mononucleosis, but fibromyalgia was an unusual long-term outcome. The common association of fibromyalgia with other rheumatic and systemic illnesses was further explored. A preliminary study revealed a possible linkage of fibromyalgia to the HLA region. Patients with fibromyalgia were found to have an impaired ability to activate the hypothalamic pituitary portion of the hypothalamic pituitary adrenal axis as well as the sympathoadrenal system, leading to reduced corticotropin and epinephrine response to hypoglycemia. Much interest has been expressed in the literature on the possible role of autonomic dysfunction in the development or exacerbation of fatigue and other symptoms in chronic fatigue syndrome. Mycoplasma genus and mycoplasma fermentans were detected by polymerase chain reaction in patients with chronic fatigue syndrome. It was reported that myofascial temporomandibular disorder does not run in families. No major therapeutic trials in fibromyalgia, chronic fatigue syndrome, or myofascial pain syndrome were reported over the past year. The effectiveness of cognitive behavioral therapy and behavior therapy for chronic pain in adults was emphasized. A favorable outcome of fibromyalgia and chronic fatigue syndrome in children and adolescents was reported.

  19. Peach latent mosaic viroid: not so latent.

    Science.gov (United States)

    Flores, Ricardo; Delgado, Sonia; Rodio, María-Elena; Ambrós, Silvia; Hernández, Carmen; Serio, Francesco D I

    2006-07-01

    SUMMARY Taxonomy: Peach latent mosaic viroid (PLMVd) is the type species of the genus Pelamoviroid within the family Avsunviroidae of chloroplastic viroids with hammerhead ribozymes. Physical properties: A small circular RNA of 336-351 nt (differences in size result from the absence or presence of certain insertions) adopting a branched conformation stabilized by a pseudoknot between two kissing loops. This particular conformation is most likely responsible for the insolubility of PLMVd in highly saline conditions (in which other viroids adopting a rod-like conformation are soluble). Both polarity strands are able to form hammerhead structures and to self-cleave during replication as predicted by these ribozymes. Biological properties: Although most infections occur without conspicuous symptoms, certain PLMVd isolates induce leaf mosaics, blotches and in the most extreme cases albinism (peach calico, PC), flower streaking, delays in foliation, flowering and ripening, deformations and decolorations of fruits, which usually present cracked sutures and enlarged roundish stones, bud necrosis, stem pitting and premature ageing of the trees, which also adopt a characteristic growing pattern (open habit). The molecular determinant for PC has been mapped at a 12-14-nt insertion that folds into a hairpin capped by a U-rich loop present only in certain variants. PLMVd is horizontally transmitted by the propagation of infected buds and to a lesser extent by pruning tools and aphids, but not by pollen; the viroid is not vertically transmitted through seed. Interesting features: This provides a suitable system for studying how a minimal non-protein-coding catalytic RNA replicates (subverting a DNA-dependent RNA polymerase to transcribe an RNA template), moves, interferes with the metabolism of its host (inciting specific symptoms and a defensive RNA silencing response) and evolves following a quasi-species model characterized by a complex spectrum of variants.

  20. Angioma em tufo e síndrome dolorosa miofascial Tufted angioma and myofascial pain syndrome

    Directory of Open Access Journals (Sweden)

    Roberto Souto da Silva

    2011-02-01

    Full Text Available O Angioma em tufo é considerado um raro tumor vascular cutâneo adquirido. Caracteriza-se por máculas purpúrico-violáceas, dolorosas que podem evoluir para placas com pápulas angiomatosas. Tem natureza benigna, mas o envolvimento extenso é comum, gerando alteração funcional do membro afetado em caso de dor. Os autores relatam um caso de angioma em tufo associado à síndrome dolorosa miofascial, em que o elemento predisponente foi a presença deste tumor desde a infância. A dor local prejudicou a utilização da musculatura e possibilitou o surgimento da síndrome relatada. A realização de bloqueio anestésico de pontos-gatilhos no membro afetado, levou à melhora total dos sintomas.Tufted angioma is a rare acquired vascular tumor. It is characterized by painful purplish macules that may progress to plaques containing angiomatous papules. The condition is benign; however, it often affects extensive areas of the skin, leading to functional disability of the affected limb if painful. The present report describes a case of a tufted angioma associated with myofascial pain syndrome in which the predisposing element was the presence of this tumor since childhood. Pain at the site of the lesion affected muscle use and led to the onset of the associated syndrome. Complete relief from symptoms was achieved by blocking the trigger points of the affected limb with anesthesia.

  1. Latent inhibition in schizophrenia.

    Science.gov (United States)

    Swerdlow, N R; Braff, D L; Hartston, H; Perry, W; Geyer, M A

    1996-05-01

    Latent inhibition (LI) refers to the retarded acquisition of a conditioned response that occurs if the subject being tested is first preexposed to the to-be-conditioned stimulus (CS) without the paired unconditioned stimulus (UCS). Because the 'irrelevance' of the to-be-conditioned stimulus is established during non-contingent preexposure, the slowed acquisition of the CS-UCS association is thought to reflect the process of overcoming this learned irrelevance. Latent inhibition has been reported to be diminished in acutely hospitalized schizophrenia patients. If acutely hospitalized schizophrenia patients are preexposed to the CS, they learn the association as fast as, and perhaps faster than, patients who are not preexposed to the CS. This finding has been interpreted as reflecting the inability of acute schizophrenia patients to ignore irrelevant stimuli. In this study, the LI paradigm was identical to the one used in previous reports of LI deficits in schizophrenia patients (Baruch et al., 1988). Latent inhibition was observed in normal control subjects (n = 73), including individuals identified as 'psychosis-prone' based on established screening criteria, and in anxiety (n = 19) and mood disorder (n = 13) patients. Learning scores (trials to criterion) in "acutely' hospitalized as well as "chronic' hospitalized schizophrenia patients (n = 45) were significantly elevated in both preexposed and non-preexposed subjects, compared to controls. Acute schizophrenia patients exhibited intact LI. Separate cohorts of acute and chronic schizophrenia patients (n = 23) and normal controls (n = 34) exhibited intact LI when tested in a new, easier-to-acquire computerized LI paradigm. These results fail to identify specific LI deficits in schizophrenia patients, and raise the possibility that previously observed LI deficits in schizophrenia patients may reflect, at least in part, performance deficits related to learning acquisition.

  2. Myofascial force transmission also occurs between antagonistic muscles located within opposite compartments of the rat lower hind limb

    NARCIS (Netherlands)

    Rijkelijkhuizen, Josina M.; Meijer, Hanneke J.M; Baan, Guus C.; Huijing, Peter A.

    2007-01-01

    Force transmission via pathways other than myotendinous ones, is referred to as myofascial force transmission. The present study shows that myofascial force transmission occurs not only between adjacent synergistic muscles or antagonistic muscles in adjacent compartments, but also between most dista

  3. Myofascial force transmission between antagonistic rat lower limb muscles: Effects of single muscle or muscle group lengthening

    NARCIS (Netherlands)

    Meijer, Hanneke J.M; Rijkelijkhuizen, Josina M.; Huijing, Peter A.

    2007-01-01

    Effects of lengthening of the whole group of anterior crural muscles (tibialis anterior and extensor hallucis longus muscles (TA + EHL) and extensor digitorum longus (EDL)) on myofascial interaction between synergistic EDL and TA + EHL muscles, and on myofascial force transmission between anterior c

  4. Vaccines as a trigger for myopathies.

    Science.gov (United States)

    Orbach, H; Tanay, A

    2009-11-01

    Vaccines are considered to be among the greatest medical discoveries, credited with the virtual eradication of some diseases and the consequent improved survival and quality of life of the at-risk population. With that, vaccines are among the environmental factors implicated as triggers for the development of inflammatory myopathies. The sporadic reports on vaccine-induced inflammatory myopathies include cases of hepatitis B virus, bacillus Calmette-Guérin, tetanus, influenza, smallpox, polio, diphtheria, diphtheria-pertussis-tetanus, combination of diphtheria with scarlet fever and diphtheria-pertussis-tetanus with polio vaccines. However, a significant increase in the incidence of dermatomyositis or polymyositis after any massive vaccination campaign has not been reported in the literature. In study patients with inflammatory myopathies, no recent immunization was recorded in any of the patients. Moreover, after the 1976 mass flu vaccination, no increase in the incidence of inflammatory myopathies was observed. Although rare, macrophagic myofasciitis has been reported following vaccination and is attributed to the aluminium hydroxide used as an adjuvant in some vaccines. Prospective multicenter studies are needed to identify potential environmental factors, including vaccines, as potential triggers for inflammatory myopathies.

  5. Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases.

    Science.gov (United States)

    Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

    2010-01-01

    Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are "pathognomonic", clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients' functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis.

  6. The Possible Role of Meditation in Myofascial Pain Syndrome: A New Hypothesis.

    Science.gov (United States)

    Panta, Prashanth

    2017-01-01

    Myofascial pain syndrome (MPS) is the most common musculoskeletal pain disorder of the head and neck area. In the past, several theories were put forth to explain its origin and nature, but none proved complete. Myofascial pain responds to changing psychological states and stress, anxiety, lack of sleep, anger, depression and chronic pain are direct contributional factors. Myofascial pain syndrome may be considered as a psychosomatic disorder. There are numerous accepted palliative approaches, but of all, relaxation techniques stand out and initiate healing at the base level. In this article, the connection between mental factors, MPS and meditation are highlighted. Recent literature has shed light on the fundamental role of free radicals in the emergence of myofascial pain. The accumulating free radicals disrupt mitochondrial integrity and function, leading to sustenance and progression of MPS. Meditation on the other hand was shown to reduce free radical load and can result in clinical improvement. 'Mindfulness' is the working principle behind the effect of all meditations, and I emphasize that it can serve as a potential tool to reverse the neuro-architectural, neurobiological and cellular changes that occur in MPS. The findings described in this paper were drawn from studies on myofascial pain, fibromyalgia, similar chronic pain models and most importantly from self experience (experimentation). Till date, no hypothesis is available connecting MPS and meditation. Mechanisms linking MPS and meditation were identified, and this paper can ignite novel research in this direction.

  7. The possible role of meditation in myofascial pain syndrome: A new hypothesis

    Directory of Open Access Journals (Sweden)

    Prashanth Panta

    2017-01-01

    Full Text Available Background of Hypothesis: Myofascial pain syndrome (MPS is the most common musculoskeletal pain disorder of the head and neck area. In the past, several theories were put forth to explain its origin and nature, but none proved complete. Myofascial pain responds to changing psychological states and stress, anxiety, lack of sleep, anger, depression and chronic pain are direct contributional factors. Myofascial pain syndrome may be considered as a psychosomatic disorder. There are numerous accepted palliative approaches, but of all, relaxation techniques stand out and initiate healing at the base level. In this article, the connection between mental factors, MPS and meditation are highlighted. Recent literature has shed light on the fundamental role of free radicals in the emergence of myofascial pain. The accumulating free radicals disrupt mitochondrial integrity and function, leading to sustenance and progression of MPS. Meditation on the other hand was shown to reduce free radical load and can result in clinical improvement. 'Mindfulness' is the working principle behind the effect of all meditations, and I emphasize that it can serve as a potential tool to reverse the neuro-architectural, neurobiological and cellular changes that occur in MPS. Conclusions: The findings described in this paper were drawn from studies on myofascial pain, fibromyalgia, similar chronic pain models and most importantly from self experience (experimentation. Till date, no hypothesis is available connecting MPS and meditation. Mechanisms linking MPS and meditation were identified, and this paper can ignite novel research in this direction.

  8. Learning multimodal latent attributes.

    Science.gov (United States)

    Fu, Yanwei; Hospedales, Timothy M; Xiang, Tao; Gong, Shaogang

    2014-02-01

    The rapid development of social media sharing has created a huge demand for automatic media classification and annotation techniques. Attribute learning has emerged as a promising paradigm for bridging the semantic gap and addressing data sparsity via transferring attribute knowledge in object recognition and relatively simple action classification. In this paper, we address the task of attribute learning for understanding multimedia data with sparse and incomplete labels. In particular, we focus on videos of social group activities, which are particularly challenging and topical examples of this task because of their multimodal content and complex and unstructured nature relative to the density of annotations. To solve this problem, we 1) introduce a concept of semilatent attribute space, expressing user-defined and latent attributes in a unified framework, and 2) propose a novel scalable probabilistic topic model for learning multimodal semilatent attributes, which dramatically reduces requirements for an exhaustive accurate attribute ontology and expensive annotation effort. We show that our framework is able to exploit latent attributes to outperform contemporary approaches for addressing a variety of realistic multimedia sparse data learning tasks including: multitask learning, learning with label noise, N-shot transfer learning, and importantly zero-shot learning.

  9. Latent semantic analysis.

    Science.gov (United States)

    Evangelopoulos, Nicholas E

    2013-11-01

    This article reviews latent semantic analysis (LSA), a theory of meaning as well as a method for extracting that meaning from passages of text, based on statistical computations over a collection of documents. LSA as a theory of meaning defines a latent semantic space where documents and individual words are represented as vectors. LSA as a computational technique uses linear algebra to extract dimensions that represent that space. This representation enables the computation of similarity among terms and documents, categorization of terms and documents, and summarization of large collections of documents using automated procedures that mimic the way humans perform similar cognitive tasks. We present some technical details, various illustrative examples, and discuss a number of applications from linguistics, psychology, cognitive science, education, information science, and analysis of textual data in general. WIREs Cogn Sci 2013, 4:683-692. doi: 10.1002/wcs.1254 CONFLICT OF INTEREST: The author has declared no conflicts of interest for this article. For further resources related to this article, please visit the WIREs website. © 2013 John Wiley & Sons, Ltd.

  10. Gait changes following myofascial structural integration (Rolfing) observed in 2 children with cerebral palsy.

    Science.gov (United States)

    Hansen, Alexis B; Price, Karen S; Loi, Elizabeth C; Buysse, Christina A; Jaramillo, Theresa M; Pico, Elaine L; Feldman, Heidi M

    2014-10-01

    Children with spastic cerebral palsy experience difficulty with ambulation. Structural changes in muscle and fascia may play a role in abnormal gait. Myofascial structural integration (Rolfing) is a manual therapy that manipulates muscle and soft tissues to loosen fascia layers, reposition muscles, and facilitate alignment. This study aimed to document (1) gait characteristics of 2 children with cerebral palsy and (2) effects of myofascial structural integration on their gait. Children received 3 months of weekly therapy sessions by an experienced practitioner. Gait parameters were recorded at baseline and after treatment using an electronic walkway. Children with cerebral palsy demonstrated abnormal velocity and cadence, decreased step length and single support times, and increased double support time. After treatment, both children demonstrated improvement for 3 months in cadence and double support time. The objective gait analyses demonstrated temporary improvements after myofascial structural integration in children with spastic cerebral palsy.

  11. Effect of Self-myofascial Release on Reduction of Physical Stress: A Pilot Study.

    Science.gov (United States)

    Kim, Kanghoon; Park, Sunghyun; Goo, Bong-Oh; Choi, Seok-Cheol

    2014-11-01

    [Purpose] This study aims to examined the effect of the self-myofascial release induced with a foam roller on the reduction of stress by measuring the serum concentration of cortisol. [Subjects and Methods] The subjects of this study were healthy females in their 20s. They were divided into the experimental and control groups. Both groups, each consisting of 12 subjects, were directed to walk for 30 minutes on a treadmill. The control group rested for 30 minutes of rest by lying down, whereas the experimental group was performed a 30 minutes of self-myofascial release program. [Results] Statistically significant levels of cortisol concentration reduction were observed in both the experimental group, which used the foam roller, and the control group. There was no statistically significant difference between the two groups. [Conclusion] The Self-myofascial release induced with a foam roller did not affect the reduction of stress.

  12. [Diagnostics and surgical correction of postoperative myofascial defects of lateral abdominal wall and lumbar region].

    Science.gov (United States)

    Brekhov, E I; Iurasov, A V; Gribunov, Iu P; Repin, I G; Alekseev, A K; Cherniaeva, N A; Zhitnikov, G V

    2009-01-01

    Myofascial defects of lateral abdominal wall and lumbar region occur chiefly after lumbotomy--the most popular access in urosurgery. Meanwhile lumbotomy remains one of the most traumatic accesses through the lateral abdominal wall. Myofascial defects were diagnosed in 48,9% of operated patients with lumbotomy. Of them true postoperative hernias were found in 35,3%; neuropathic hernias - in 13,6%. Since 2002 the originally developed method of lateral abdominal wall reconstruction had been used for the treatment of such patients. The immediate and long-term results (maximal follow-up period 5 years) showed no hernia recurrence or complications in 26 operated patients.

  13. Clinical features in patients with long-lasting macrophagic myofasciitis

    Directory of Open Access Journals (Sweden)

    Muriel eRIGOLET

    2014-11-01

    Full Text Available Macrophagic myofasciitis (MMF is an emerging condition characterized by specific muscle lesions assessing abnormal long-term persistence of aluminium hydroxide within macrophages at the site of previous immunization. Affected patients usually are middle-aged adults, mainly presenting with diffuse arthromyalgias, chronic fatigue, and marked cognitive deficits, not related to pain, fatigue or depression. Clinical features usually correspond to that observed in chronic fatigue syndrome/myalgic encephalomyelitis. Representative features of MMF-associated cognitive dysfunction include dysexecutive syndrome, visual memory impairment and left ear extinction at dichotic listening test. Most patients fulfil criteria for non-amnestic/dysexecutive mild cognitive impairment, even if some cognitive deficits appear unusually severe. Cognitive dysfunction seems stable over time despite marked fluctuations. Evoked potentials may show abnormalities in keeping with central nervous system involvement, with a neurophysiological pattern suggestive of demyelination. Brain perfusion SPECT shows a pattern of diffuse cortical and subcortical abnormalities, with hypoperfusions correlating with cognitive deficiencies. The combination of musculoskeletal pain, chronic fatigue and cognitive disturbance generates chronic disability with possible social exclusion. Classical therapeutic approaches are usually unsatisfactory making patient care difficult.

  14. Dopamine in plasma - a biomarker for myofascial TMD pain?

    Science.gov (United States)

    Dawson, Andreas; Stensson, Niclas; Ghafouri, Bijar; Gerdle, Björn; List, Thomas; Svensson, Peter; Ernberg, Malin

    2016-12-01

    Dopaminergic pathways could be involved in the pathophysiology of myofascial temporomandibular disorders (M-TMD). This study investigated plasma levels of dopamine and serotonin (5-HT) in patients with M-TMD and in healthy subjects. Fifteen patients with M-TMD and 15 age- and sex-matched healthy subjects participated. The patients had received an M-TMD diagnosis according to the Research Diagnostic Criteria for TMD. Perceived mental stress, pain intensity (0-100-mm visual analogue scale), and pressure pain thresholds (PPT, kPa) over the masseter muscles were assessed; a venous blood sample was taken. Dopamine in plasma differed significantly between patients with M-TMD (4.98 ± 2.55 nM) and healthy controls (2.73 ± 1.24 nM; P dopamine in plasma correlated significantly with present pain intensity (r = 0.53, n = 14, P dopamine might be involved in modulating peripheral pain. This finding, in addition to reports in other studies, suggests that dopaminergic pathways could be implicated in the pathophysiology of M-TMD but also in other chronic pain conditions. More research is warranted to elucidate the role of peripheral dopamine in the pathophysiology of chronic pain.

  15. Myofascial pain syndrome after head and neck cancer treatment: Prevalence, risk factors, and influence on quality of life.

    Science.gov (United States)

    Cardoso, Leticia Rodrigues; Rizzo, Cláudia Carvalho; de Oliveira, Cleyton Zanardo; dos Santos, Carlos Roberto; Carvalho, André Lopes

    2015-12-01

    Patients undergoing treatment for head and neck cancer may develop myofascial pain syndrome as sequelae. The purpose of this study was to determine the prevalence, risk factors, and quality of life (QOL) related to myofascial pain syndrome. This was a prospective study including patients with head and neck cancer with at least a 1-year disease-free interval. One hundred sixty-seven patients were analyzed, and myofascial pain syndrome was diagnosed in 20 (11.9%). In the multivariate analysis, hypopharyngeal tumors (odds ratio [OR] = 6.35; 95% confidence interval [CI] = 1.58-25.56) and neck dissection (OR = 3.43; 95% CI = 1.16-10.17) were independent factors for myofascial pain syndrome. The pain (p myofascial pain syndrome. Myofascial pain syndrome was observed in 1 of 9 patients after head and neck cancer treatment and a worse QOL was observed among them. Tumor site and neck dissection were found to be risk factors for myofascial pain syndrome. © 2014 Wiley Periodicals, Inc.

  16. Ultrasonography in Diagnosis of Myofascial Pain Syndrome and Reliability of Novel Ultrasonic Indexes of Upper Trapezius Muscle.

    Science.gov (United States)

    Taheri, Navid; Okhovatian, Farshad; Rezasoltani, Asghar; Karami, Mehdi; Hosseini, Sayed Mohsen; Mohammadi, Hosein Kouhzad

    2016-03-23

    Myofascial pain syndrome (MPS) is a common non-articular musculoskeletal disorder. It is characterized by local and referred pain due to the presence of myofascial trigger points (MTrPs). MTrPs most commonly involve the upper trapezius muscle and can be visualized using ultrasound imaging. This study was designed to determine the inter-rater reliability of some new ultrasonographic indices of the upper trapezius muscle and the sensitivity and specificity of 2D ultrasound imaging in the diagnosis of MPS. This semi-experimental study enrolled 15 participants of both genders (mean age: 40.60 ± 5.74 years) with suspected symptoms of MPS. In the first step of the study, the sensitivity and specificity of ultrasonography for diagnosis of MPS was determined in a double blind manner. In the second step, some ultrasonographic measurements, such as muscle thickness, area of MTrPs in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and the pennation angle of the upper trapezius muscle were measured twice and their reliability was determined using the value of the mean of the two measurements. The sensitivity and specificity of ultrasonographic diagnosis were 91% and 75%, respectively. The inter-rater reliability of upper trapezius muscle thickness, pennation angle, area of MTrPs, echogenicity of active MTrPs in longitudinal view, echogenicity of muscle with MTrPs in transverse view and echogenicity of muscle with MTrPs in longitudinal view were 0.91, 0.96, 0.93, 0.83, 0.93, and 0.91, respectively. 1. Our findings indicated that ultrasonography is a useful method for the diagnosis of MPS owing to its high sensitivity. 2. Appropriate reliability of the quantitative ultrasonographic indices of interest, especially the area of MTrPs and their echogenicity, could be useful for long-term monitoring and designing interventional studies for better management of the syndrome.

  17. Latent catalyst; Senzaisei shokubai

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    Epoxy resin, an important function material to support such main industries as electric and electronic devices, automobiles, civil engineering, and building construction, is demanded of development of single liquid type resin having excellent quick hardening performance and storage stability. This requirement comes from environmental problems with an intention of saving energies and reducing resin wastes. The Company, using freely its independent phase separation technology that controls molecular structure of catalysts, developed a latent catalyst having excellent storage stability and high-temperature quick hardening performance. Its major features may be summarized as follows: (1) excellent storage stability at room temperature keeping the product stable for 2.5 months or longer (2 days in conventional products); (2) quick hardening performance hardening the resin in seven seconds at 150 degrees C (equivalent to conventional products); and (3) excellent insulation performance of hardened resin at 140 degrees C of 7 times 10 {sup 13} (ohm) (center dot) cm (2 times 10 {sup 12} (ohm) (center dot) cm in conventional products) (translated by NEDO)

  18. Fast discriminative latent Dirichlet allocation

    Data.gov (United States)

    National Aeronautics and Space Administration — This is the code for fast discriminative latent Dirichlet allocation, which is an algorithm for topic modeling and text classification. The related paper is at...

  19. Understanding Latent Heat of Vaporization.

    Science.gov (United States)

    Linz, Ed

    1995-01-01

    Presents a simple exercise for students to do in the kitchen at home to determine the latent heat of vaporization of water using typical household materials. Designed to stress understanding by sacrificing precision for simplicity. (JRH)

  20. The Infinite Latent Events Model

    CERN Document Server

    Wingate, David; Roy, Daniel; Tenenbaum, Joshua

    2012-01-01

    We present the Infinite Latent Events Model, a nonparametric hierarchical Bayesian distribution over infinite dimensional Dynamic Bayesian Networks with binary state representations and noisy-OR-like transitions. The distribution can be used to learn structure in discrete timeseries data by simultaneously inferring a set of latent events, which events fired at each timestep, and how those events are causally linked. We illustrate the model on a sound factorization task, a network topology identification task, and a video game task.

  1. Estimation of influence of myofascial release techniques on esophageal pressure in patients after total laryngectomy.

    Science.gov (United States)

    Marszałek, Sławomir; Zebryk-Stopa, Anna; Kraśny, Jacek; Obrebowski, Andrzej; Golusiński, Wojciech

    2009-08-01

    In patients after total laryngectomy, increased tension in myofascial neck and arm areas might be observed. Via fascial continuity it has an adverse impact on the superior esophageal constrictor forming the "mouth of the oesophagus", which hinders learning of esophageal speech. The aim is to assess the effect of manual myofascial release techniques on esophageal pressure in patients after total laryngectomy. Forty patients (12 F, 28 M), aged 43-75 (mean 56.8 years), 9 months to 13 years (average 3 years) after total laryngectomy, 35 patients (87.5%) after neck lymph node resection, 38 patients (95%) after radiotherapy. Esophageal pressure was assessed using modified Seeman's method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limb areas. Wilcoxon and Shapiro-Wilk's test was used for the purpose of statistical analysis. Statistically significant decrease of the mean esophageal pressure was observed after the physiotherapy treatment. The average pressure among the examined patients decreased from 37.9 to 26.6 mmHg. The application of myofascial manual techniques decreases esophageal pressure, thus allowing patients to learn esophagus speech at a faster pace.

  2. Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies.

    Science.gov (United States)

    Huang, Jen-Ting; Chen, Han-Yu; Hong, Chang-Zern; Lin, Ming-Ta; Chou, Li-Wei; Chen, Hsin-Shui; Tsai, Chien-Tsung; Chang, Wen-Dien

    2014-01-01

    The aim of this study was to demonstrate the effectiveness of lumbar facet joint injection for piriformis myofascial pain syndrome. Fifty-two patients with chronic myofascial pain in the piriformis muscle each received a lumbar facet injection into the ipsilateral L5-S1 facet joint region, using the multiple insertion technique. Subjective pain intensity, trunk extension range, and lumbar facet signs were measured before, immediately after, and 2 weeks after injection. Thirty-six patients received follow-up for 6 months. Immediately after the injection, 27 patients (51.9%) had complete pain subsidence, 19 patients (36.5%) had pain reduction to a tolerable level, and only 6 patients (11.5%) had no pain relief to a tolerable level. Mean pain intensity was reduced from 7.4±0.9 to 1.6±2.1 after injection (Pmyofascial pain syndrome. If this pain is related to lumbar facet lesions, lumbar facet joint injection can immediately suppress piriformis myofascial pain symptoms. This effectiveness may last for at least 6 months in most patients. This study further supports the importance of eliminating the underlying etiological lesion for complete and effective relief of myofascial pain syndrome.

  3. Evaluation of salivary cortisol and anxiety levels in myofascial pain dysfunction syndrome.

    Science.gov (United States)

    Nadendla, Lakshmi Kavitha; Meduri, Venkateswarlu; Paramkusam, Geetha; Pachava, Koteswara Rao

    2014-01-01

    Myofascial pain dysfunction syndrome (MPDS), otherwise called myofascial pain is one of the most common temporomandibular disorders, which in turn is the most common cause of orofacial pain of non-dental origin. Its etiology is multifactorial and still poorly understood. Psychological factors have been shown to play a role in the etiology. The aim of the study was to evaluate the association between anxiety and salivary cortisol levels in patients with myofascial pain. Twenty patients suffering from myofascial pain were recruited as the study group. The same number of age and sex matched healthy individuals were taken as the control group. The salivary samples collected between 9-9:15 am from both groups were analyzed for cortisol levels with the competitive enzyme-linked immunosorbent assay method. Anxiety levels of 40 patients were measured using Hamilton's anxiety scale. The mean serum cortisol level of the MPDS group showed a highly significant difference (p < 0.001) from the controls. The mean anxiety scores of the MPDS group showed a highly significant difference (p < 0.001) from the controls. A positive correlation was found between anxiety and the salivary cortisol levels in MPDS patients. These findings suggest that anxiety plays a vital role in the etio-pathogenesis of MPDS; thus, besides pharmacological treatment, psychological support is also needed.

  4. Pain, Disability and Sleep Quality in Patients With Rotator Cuff Tendinopathy and Concurrent Myofascial Pain

    Directory of Open Access Journals (Sweden)

    Morteza Nakhaei Amroodi

    2016-05-01

    Full Text Available Background Rotator cuff tendinopathy and concurrent myofascial pain may result in sleep disturbances, poor quality of life, and social dysfunction along with chronic annoying pain and progressive physical disability. Objectives The present study aimed to assess severity of pain, physical disability, and sleep quality in patients with rotator cuff tendinopathy and concurrent myofascial pain. Patients and Methods This case-control study was conducted on 30 consecutive patients with rotator cuff tendinopathy without tear (impingement syndrome and concurrent myofascial pain referred to the shoulder clinic in Shafa-Yahyaian Hospital during year 2014 (January to April. Eighteen gender and age-matched healthy individuals without any history of rotator cuff tendinopathy were included as controls. Along with baseline assessment, for determining the level of arm, shoulder and hand disability, the quick disabilities of the arm, shoulder and hand questionnaire was also used. Sleep quality was assessed by the pittsburgh sleep quality index (PSQI. Results Compared to healthy individuals, the mean shoulder disability score was significantly higher in the patient group (P = 0.001. Also, regarding sleep quality, the mean score was significantly higher in the patient group when compared with healthy subjects (P = 0.002. Conclusions Patients with rotator cuff tendinopathy concurrent with myofascial pain experienced low level of sleep quality along with severe pain and physical disability. In order to improve clinical outcome of these patients, improving physical function and sleep quality in these patients is necessary.

  5. Time courses of myofascial temporomandibular disorder complaints during a 12-month follow-up period

    NARCIS (Netherlands)

    M.K.A. van Selms; F. Lobbezoo; M. Naeije

    2009-01-01

    AIMS: To investigate the time courses of myofascial temporomandibular disorder (TMD) pain and mandibular function impairment (MFI), and to identify predictive factors associated with these time courses. METHODS: During a 12-month period following conservative TMD treatment, the time courses of myofa

  6. A randomized, placebo-controlled double-blinded comparative clinical study of five over-the-counter non-pharmacological topical analgesics for myofascial pain: single session findings

    Directory of Open Access Journals (Sweden)

    Avrahami Daniel

    2012-03-01

    Full Text Available Abstract Objectives To investigate the effects of topical agents for the treatment of Myofascial Pain Syndrome (MPS and Myofascial Trigger Point (MTRP. Methods Subjects with an identifiable trigger point in the trapezius muscle, age 18-80 were recruited for a single-session randomized, placebo-blinded clinical study. Baseline measurements of trapezius muscle pressure pain threshold (PPT: by pressure algometer along with right and left cervical lateral flexion (rangiometer were obtained by a blinded examiner. An assessor blinded to the outcomes assessments applied one of 6 topical formulations which had been placed in identical plastic containers. Five of these topicals were proposed active formulations; the control group was given a non-active formulation (PLA. Five minutes after the application of the formula the outcome measures were re-tested. Data were analyzed with a 5-way ANOVA and Holms-adjusted t-tests with an alpha level of 0.05. Results 120 subjects were entered into the study (63 females; ages 16-82; 20 subjects randomly allocated into each group. The pre- and post-treatment results for pressure threshold did show significant intra-group increases for the Ben-Gay Ultra Strength Muscle Pain Ointment (BG, the Professional Therapy MuscleCare Roll-on (PTMC roll-on and Motion Medicine Cream (MM with an increased threshold of 0.5 kg/cm2 (+/-0.15, 0.72 kg/cm2 (+/-0.17 and 0.47 Kg/cm2 (+/-0.19 respectively. With respect to the inter-group comparisons, PTMC roll-on showed significant increases in pressure threshold compared with Placebo (PLA (p = 0.002 and Icy Hot Extra Strength Cream (IH (p = 0.006. In addition, BG demonstrated significant increases in pressure threshold compared with PLA (p = 0.0003. Conclusions With regards to pressure threshold, PTMC roll-on, BG and MM showed significant increases in pain threshold tolerance after a short-term application on a trigger points located in the trapezius muscle. PTMC roll-on and BG were both

  7. Common Asthma Triggers

    Science.gov (United States)

    ... Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Common Asthma Triggers Recommend on Facebook Tweet Share Compartir ... t avoid the triggers. Some of the most common triggers are: Tobacco Smoke Tobacco smoke is unhealthy ...

  8. The prognosis of myofascial pain syndrome (MPS) during a fixed orthodontic treatment.

    Science.gov (United States)

    Tecco, Simona; Marzo, Giuseppe; Crincoli, Vito; Di Bisceglie, Beatrice; Tetè, Stefano; Festa, Felice

    2012-01-01

    Among treatments in the literature for myofascial pain syndrome (MPS), the most reliable therapies in dentistry are spray and stretch, and, although less frequently used, anesthetic injection. Adult MPS subjects are often treated using fixed orthodontic therapy for resolution of malocclusion. There is no clarity in the literature on the prognosis of MPS during orthodontic therapy. The purpose of this study was to analyze the prognosis of MPS during orthodontic treatment of subjects with malocclusion, initially diagnosed as having MPS. The analysis covered the medical records of 91 young adult Caucasians scheduled for orthodontic treatment for various malocclusions. Thirty-seven of the patients were initially diagnosed as also having MPS (T0). Thirty patients began the orthodontic treatment and were recalled for a re-evaluation of MPS after dental alignment and dental class correction was achieved (T1). A wait-and-see strategy was applied in seven subjects who were included as the control subjects. They received no treatment for MPS. At T1, a statistically significant decrease was observed in the study group in the presence of any clicking or creaking noises from the jaw joint, a significant jaw joint and jaw muscle pain reduction, and a quality of life improvement. Among patients who were depressed at the beginning of treatment, the majority felt better at the follow-up evaluation. On muscular palpation, a statistically significant decrease was found on the visual analogic scale value of the middle fibers of the temporalis muscle, temporalis tendon, clavicular and sternal division of the sternocleidomastoid muscle, masseter muscles, and posterior cervical muscles. The temporalis and the masseter muscles showed a significant decrease in the number of subjects with trigger points (TrPs) in all areas in the study group, after treatment. The digastric and sternocleidomastoid muscles also showed a significant reduction in the number of subjects with TrPs. Subjects with

  9. The Effect of Extracorporeal Shock Wave Therapy on Myofascial Pain Syndrome

    Science.gov (United States)

    Jeon, Jong Hyun; Jung, Yun Jae; Lee, Ju Youn; Choi, Ji Soo; Mun, Jeong Hyeon; Park, Won Yong; Seo, Cheong Hoon

    2012-01-01

    Objective To investigate the effect of extracorporeal shock wave therapy (ESWT) on myofascial pain syndrome (MPS). Method Thirty patients with MPS in trapezius muscle were randomly divided into two groups, ESWT group (n=15), and trigger point injections (TPI)+transcutaneous electrical nerve stimulation (TENS) group (n=15). For a total of 3 weeks, ESWT was undertaken with 1,500 pulse each time at one week interval totaling 4,500 pulse, TPI for once a week totaling three times and TENS for five times a week totaling three weeks. Results The changes in pain threshold (lb/cm2) showed the values of 6.86±1.35 before first therapy, 11.43±0.27 after first therapy, and 12.57±0.72 after third therapy, while TPI+TENS group showed the values of 6.20±1.92 before first therapy, 8.80±0.48 after first therapy, and 9.60±2.19 after third therapy, and the changes between the groups were significantly different (p=0.045). The changes in visual analog scale were estimated to be 6.86±0.90 before first therapy, 2.86±0.90 after first therapy, and 1.86±0.69 after third therapy in case of ESWT group, whereas the figures were estimated to be 7.20±1.30 before first therapy, 4.60±0.55 after first therapy, and 2.80±0.84 after third therapy in case of TPI+TENS group, and the changes between the groups were significantly different (p=0.010). The changes in McGill pain questionnaire (p=0.816) and pain rating scale (p=0.644) between the groups were not significantly different. The changes in neck ROM were also not significantly different between the groups (p>0.05). Conclusion The ESWT in patients with MPS in trapezius muscle are as effective as TPI and TENS for the purpose of pain relief and improving cervical range of motion. PMID:23185731

  10. A pilot study of myofascial release therapy compared to Swedish massage in fibromyalgia.

    Science.gov (United States)

    Liptan, Ginevra; Mist, Scott; Wright, Cheryl; Arzt, Anna; Jones, Kim Dupree

    2013-07-01

    Fibromyalgia (FM) is characterized by widespread muscle pain and soft tissue tenderness. However, a lack of definitive muscle pathology has made FM both a diagnostic and a treatment puzzle. Much of the evidence for pathology in FM lies in the central nervous system - in particular abnormal amplification of pain signals in the spinal cord - a manifestation of central sensitization. An emerging body of evidence posits that peripheral pain generated from the muscles and fascia may trigger and maintain central sensitization in FM. Since FM patients so frequently seek manual therapy to relieve muscle symptoms, the present study compared two different manual therapy techniques in a parallel study of women with FM. Eight subjects received myofascial release (MFR) while four subjects received Swedish massage, 90 min weekly for four weeks. Overall symptom burden and physical function were assessed by the Fibromyalgia Impact Questionnaire Revised (FIQ-R). A unique challenge for the manual therapist in treating conditions involving central sensitization is to determine if localized pain reduction can be achieved with targeted therapy in the context of ongoing widespread pain. Localized pain improvement was measured by a novel questionnaire developed for this study, the modified Nordic Musculoskeletal Questionnaire (NMQ). Between-group differences in FIQ-R did not reach statistical significance, but the total change scores on FIQ-R for the MFR group (mean = 10.14, SD = 16.2) trended in the hypothesized and positive direction compared to the Swedish massage group (mean = 0.33, SD = 4.93) yielding a positive Aikin separation test. Although overall modified NMQ scores improved in both groups there were no consistent focal areas of improvement for the Swedish massage group. In contrast, the MFR group reported consistent pain reductions in the neck and upper back regions on the NMQ. These data support the need for larger randomized controlled trials of MFR versus other

  11. Comorbidity of fibromyalgia and cervical myofascial pain syndrome.

    Science.gov (United States)

    Cakit, Burcu Duyur; Taskin, Suhan; Nacir, Baris; Unlu, Irem; Genc, Hakan; Erdem, Hatice Rana

    2010-04-01

    The aims of this study are to determine the frequency of fibromyalgia syndrome (FMS) in patients with chronic cervical myofascial pain (CMP) and to investigate the FMS characteristics in CMP patients. Ninty-three patients with CMP and 30 age-matched healthy women were included in this study. Main outcome measures included visual analog scale (VAS), Beck Depression Inventory (BDI), and pain pressure thresholds. CMP patients were evaluated for the existence of FMS. The severity of FMS was assessed with total myalgic score (TMS) and control point score (CPS). Most common clinical characteristics of FMS were noted. Of the 93 CMP subjects, 22 (23.6%) patients fulfilled the classification criteria for FMS. Number of tender points were higher (p=0.0), while TMS (p=0.0) and CPS (p=0.0) values were lower in comorbid CMP and FMS patients than regional CMP group. There were statistically significant differences between regional CMP patients and comorbid CMP and FMS patients regarding presence of fatigue (p=0.0) and irritable bowel syndrome (p=0.022). There was no statistically significant difference between patient groups regarding VAS values (p>0.05). BDI values of the regional CMP were significantly lower than comorbid CMP and FMS patients (p=0.011). In conclusion, we found that nearly a quarter of CMP patients were comorbid with FMS, and psychological and comorbid symptoms were more prominent in comorbid patients. We thought that, these two syndromes might be overlapping conditions and as a peripheral pain generator or inducer of central sensitisation, MPS might lead to FMS or precipitate and worsen the FMS symptoms.

  12. Hyaluronan within fascia in the etiology of myofascial pain.

    Science.gov (United States)

    Stecco, Carla; Stern, R; Porzionato, A; Macchi, V; Masiero, S; Stecco, A; De Caro, R

    2011-12-01

    The layers of loose connective tissue within deep fasciae were studied with particular emphasis on the histochemical distribution of hyaluronan (HA). Samples of deep fascia together with the underlying muscles were taken from neck, abdomen and thigh from three fresh non-embalmed cadavers. Samples were stained with hematoxylin-eosin, Azan-Mallory, Alcian blue and a biotinylated HA-binding protein specific for HA. An ultrasound study was also performed on 22 voluntary subjects to analyze the thickness of these deep fasciae and their sublayers. The deep fascia presented a layer of HA between fascia and the muscle and within the loose connective tissue that divided different fibrous sublayers of the deep fascia. A layer of fibroblast-like cells that stained prominently with Alcian blue stain was observed. It was postulated that these are cells specialized for the biosynthesis of the HA-rich matrix. These cells we have termed "fasciacytes", and may represent a new class of cells not previously recognized. The ultrasound study highlighted a mean thickness of 1.88 mm of the fascia lata, 1.68 mm of the rectus sheath, and 1.73 mm of the sternocleidomastoid fascia. The HA within the deep fascia facilitates the free sliding of two adjacent fibrous fascial layers, thus promoting the normal function associated with the deep fascia. If the HA assumes a more packed conformation, or more generally, if the loose connective tissue inside the fascia alters its density, the behavior of the entire deep fascia and the underlying muscle would be compromised. This, we predict, may be the basis of the common phenomenon known as "myofascial pain."

  13. Injecction of trigger points in the temporal muscles of patients with miofascial syndrome

    Directory of Open Access Journals (Sweden)

    Svetlana Sabatke

    2015-10-01

    Full Text Available Objective : The aim was to examine the effect of blocking trigger points in the temporal muscles of patients with masticatory myofascial pain syndrome, fibromyalgia and headache.Method : Seventy patients with one trigger point were randomly divided into 3 groups: injection with saline or anesthetic and non-injected (control.Results : Pain was reduced in 87.71% patients injected with saline and 100% injected with anesthetic. Similar results were obtained for headache frequency. With regard to headache intensity, the injection groups differed from the control group, but not between themselves.Conclusion : Treatment with injection at trigger points decreased facial pain and frequency and intensity of headache. Considering the injected substance there was no difference.

  14. The accurate assessment and physiotherapeutic treatment of rotator cuff myofascial Pain Syndrome: A case report

    Directory of Open Access Journals (Sweden)

    B. B. Barker

    2011-02-01

    Full Text Available Management  of  patients  with  rotator  cuff  myofascial  pain syndrome varies  and  successful  intervention  is  dependent  on accurate assessment. The aim of this case report is to show the importance of accurate assessment  and  clinical  reasoning  in  the  physiotherapeutic management  of a  patient  suffering  from  ante-cubital  and  anterior shoulder  pain.  The  patient was  referred  for  physiotherapy  after proving refractory  to  treatment  with  non-steroidal anti-inflammatory medication. The physiotherapist diagnosed a rotator cuff myofascial pain syndrome and treatment proceeded on that basis. Treatment consisted of twitch-obtaining dry needling, myofascial release and exercise therapy.  The result was a change in the harryman rotator cuff functional Assessment Scale score from 22/52 to 43/52 over eight treatments. Strength was regained and subjective pain report on the visual rating scale was improved to 1/10. The case study highlights the importance of accurate assessment and consideration of alternative myofascial sources for pain even in circumstances which initially seem trauma related. Precise diagnosis of the cause - in this case rotator cuff myofascial pain syndrome – will result in effective treatment being administered.

  15. Turn-Amplitude Analysis as a Diagnostic Test for Myofascial Syndrome in Patients with Chronic Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Fernando Itza

    2015-01-01

    Full Text Available BACKGROUND: Myofascial pain syndrome of the pelvic floor (MPSPF is a common disease in the context of chronic pelvic pain (CPP; however, there is currently no gold-standard test to diagnose it.

  16. Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Maria F. M. Aranha

    2015-02-01

    Full Text Available BACKGROUND: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions. OBJECTIVE: The aim was to evaluate the effect of electroacupuncture (EAC and acupuncture (AC for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. METHOD: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05. RESULTS: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001. A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05, which showed an increase in left rotation (P=0.049. The AC group showed increases in inclination (P=0.005 sustained until follow-up and rotation to the right (P=0.032. CONCLUSION : EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly.

  17. An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing

    OpenAIRE

    PEACOCK, COREY A.; KREIN, DARREN D.; Silver, Tobin A.; Sanders, Gabriel J; VON CARLOWITZ, KYLE-PATRICK A.

    2014-01-01

    Recent developments in the strength and conditioning field have shown the incorporation of foam rolling self-myofascial release in adjunct with a dynamic warm-up. This is thought to improve overall training performance; however, minimal research exists supporting this theory. Therefore, determining if an acute bout of foam rolling self-myofascial release in addition to a dynamic warm-up could influence performance is of importance. In order to do so, eleven athletically trained male subjects ...

  18. Latent geometry of bipartite networks

    Science.gov (United States)

    Kitsak, Maksim; Papadopoulos, Fragkiskos; Krioukov, Dmitri

    2017-03-01

    Despite the abundance of bipartite networked systems, their organizing principles are less studied compared to unipartite networks. Bipartite networks are often analyzed after projecting them onto one of the two sets of nodes. As a result of the projection, nodes of the same set are linked together if they have at least one neighbor in common in the bipartite network. Even though these projections allow one to study bipartite networks using tools developed for unipartite networks, one-mode projections lead to significant loss of information and artificial inflation of the projected network with fully connected subgraphs. Here we pursue a different approach for analyzing bipartite systems that is based on the observation that such systems have a latent metric structure: network nodes are points in a latent metric space, while connections are more likely to form between nodes separated by shorter distances. This approach has been developed for unipartite networks, and relatively little is known about its applicability to bipartite systems. Here, we fully analyze a simple latent-geometric model of bipartite networks and show that this model explains the peculiar structural properties of many real bipartite systems, including the distributions of common neighbors and bipartite clustering. We also analyze the geometric information loss in one-mode projections in this model and propose an efficient method to infer the latent pairwise distances between nodes. Uncovering the latent geometry underlying real bipartite networks can find applications in diverse domains, ranging from constructing efficient recommender systems to understanding cell metabolism.

  19. Identifying asthma triggers.

    Science.gov (United States)

    McCarty, Justin C; Ferguson, Berrylin J

    2014-02-01

    Asthma has many triggers including rhinosinusitis; allergy; irritants; medications (aspirin in aspirin-exacerbated respiratory disease); and obesity. Paradoxic vocal fold dysfunction mimics asthma and may be present along with asthma. This article reviews each of these triggers, outlining methods of recognizing the trigger and then its management. In many patients more than one trigger may be present. Full appreciation of the complexity of these relationships and targeted therapy to the trigger is needed to best care for the patient with asthma.

  20. Biomarkers of latent TB infection

    DEFF Research Database (Denmark)

    Ruhwald, Morten; Ravn, Pernille

    2009-01-01

    For the last 100 years, the tuberculin skin test (TST) has been the only diagnostic tool available for latent TB infection (LTBI) and no biomarker per se is available to diagnose the presence of LTBI. With the introduction of M. tuberculosis-specific IFN-gamma release assays (IGRAs), a new area...... of in vitro immunodiagnostic tests for LTBI based on biomarker readout has become a reality. In this review, we discuss existing evidence on the clinical usefulness of IGRAs and the indefinite number of potential new biomarkers that can be used to improve diagnosis of latent TB infection. We also present...... early data suggesting that the monocyte-derived chemokine inducible protein-10 may be useful as a novel biomarker for the immunodiagnosis of latent TB infection....

  1. Dolor de origen muscular: dolor miofascial y fibromialgia Muscular pain: myofascial pain syndrome and fibromyalgia

    Directory of Open Access Journals (Sweden)

    M. Ruiz

    2007-01-01

    estiramiento y relajación junto a la terapia psicológica, ayudarán a disminuir la intensidad de los síntomasMyofascial pain syndromes have a very high prevalence. Two concepts are essential: muscular tension and trigger points. Autonomous and central sensitization components are implicated. Physical examination and a complete clinical history are mandatory. It requires a multidisciplinary treatment, especially with physical therapy. Fibromyalgia is characterized by chronic widespread pain and the presence of tender points. In its origin numerous theories exist, but none is totally accepted. Patients present morning rigidity, chronic fatigue, cephalalgia, sleep disturbances, paresthesia, mood disorders, irritable bowel and joint pain. The diagnosis is based upon the classification criteria of the American College of Rheumatology 1990. The treatment aims to recover functionality and quality of life, at least partially. Tricyclic antidepressants therapy will improve depression and sleep disturbances. The non pharmacological treatment with stretching and relaxation programs alongside psychological therapy will help to reduce the intensity of symptoms

  2. A Latent Consolidation Phase in Auditory Identification Learning: Time in the Awake State Is Sufficient

    Science.gov (United States)

    Roth, Daphne Ari-Even; Kishon-Rabin, Liat; Hildesheimer, Minka; Karni, Avi

    2005-01-01

    Large gains in performance, evolving hours after practice has terminated, were reported in a number of visual and some motor learning tasks, as well as recently in an auditory nonverbal discrimination task. It was proposed that these gains reflect a latent phase of experience-triggered memory consolidation in human skill learning. It is not clear,…

  3. The Central Trigger Processor (CTP)

    CERN Multimedia

    Franchini, Matteo

    2016-01-01

    The Central Trigger Processor (CTP) receives trigger information from the calorimeter and muon trigger processors, as well as from other sources of trigger. It makes the Level-1 decision (L1A) based on a trigger menu.

  4. Modeling Relational Data via Latent Factor Blockmodel

    CERN Document Server

    Gao, Sheng; Gallinari, Patrick

    2012-01-01

    In this paper we address the problem of modeling relational data, which appear in many applications such as social network analysis, recommender systems and bioinformatics. Previous studies either consider latent feature based models but disregarding local structure in the network, or focus exclusively on capturing local structure of objects based on latent blockmodels without coupling with latent characteristics of objects. To combine the benefits of the previous work, we propose a novel model that can simultaneously incorporate the effect of latent features and covariates if any, as well as the effect of latent structure that may exist in the data. To achieve this, we model the relation graph as a function of both latent feature factors and latent cluster memberships of objects to collectively discover globally predictive intrinsic properties of objects and capture latent block structure in the network to improve prediction performance. We also develop an optimization transfer algorithm based on the general...

  5. BEYOND SEM: GENERAL LATENT VARIABLE MODELING

    National Research Council Canada - National Science Library

    Muthén, Bengt O

    2002-01-01

    This article gives an overview of statistical analysis with latent variables. Using traditional structural equation modeling as a starting point, it shows how the idea of latent variables captures a wide variety of statistical concepts...

  6. Proper elimination of latent variables

    NARCIS (Netherlands)

    Polderman, Jan W.

    1997-01-01

    We consider behaviors in which we distinguish two types of variables, manifest variables, the variables that are of interest to the user and latent variables, the variables that are introduced to obtain a first representation. The problem is to find a representation of the manifest behavior, that

  7. Evaluation of the Effects of Intravenous and Percutaneous Low Level Laser Therapy in the Management of Shoulder Myofascial Pain Syndrome.

    Science.gov (United States)

    Momenzadeh, Sirous; Akhyani, Vahid; Razaghi, Zahra; Ebadifar, Asghar; Abbasi, Mohammadzaki

    2016-01-01

    Myofascial pain syndrome (MPS) treatment is challenging with a high recurrence rate and still lacks a clear treatment frame. Therefore research on new, more efficient and long lasting effect treatment modalities is necessary. This study looked at the effects of intravenous laser therapy (IVL) and percutaneous low level laser (PLLL) in the management of shoulder MPS. In this randomized controlled trial, 30 patients fulfilling inclusion criteria were randomly equally allocated to 3 groups, control, IVL and PLLL. Control group received 12 sessions of placebo low level laser, IVL group received 12 sessions of IVL therapy, and PLLL group received 12 sessions of PLLL therapy. All patients were trained for better body posture, body mechanics, gentle massage of trigger points, stretching exercises of affected muscle (trapezius), and received 10 mg of oral nortriptyline regimen every night for 3 months. Outcomes included pain severity, functional disability, and quality of life. Patients were assessed using Numeric Rating Scale (NRS), Pain Disability Index (PDI), and Short Form Health Survey (SF-12). Data collected were analyzed using analysis of variance (ANOVA), Mann-Whitney and t tests. The mean of PDI and maximum pain intensity during day and night significantly reduced in both PLLL and IVL groups compared to control group. Although pain severity and PDI reduction was more pronounced in IVL group compared to PLLL group, the differences were not statistically significant. Also, quality of life statistically significantly improved in both IVL and PLLL groups compared to control group was more, and although higher in IVL group, the difference was not statistically significant when compared to PLLL group. No side effects were observed in the intervention groups. Intravenous laser and PLLL therapy had a positive effect on pain severity and PDI reduction, and quality of life in this study. Also no adverse event was recorded. Thus, intravenous lasers and PLLL therapy seem to

  8. Is self myofascial release an effective preexercise and recovery strategy? A literature review.

    Science.gov (United States)

    Schroeder, Allison N; Best, Thomas M

    2015-01-01

    The use of self myofascial release (SMR) via a foam roller or roller massager is becoming increasingly popular both to aid recovery from exercise and prevent injury. Our objective was to review the literature on SMR and its use for preexercise, recovery, or maintenance. PUBMED, EBSCO (MEDLINE), EMBASE, and CINAHL were searched for variations and synonyms of "self myofascial release" and "foam rolling." Data from nine studies were examined, and overall quality varied based on study protocol, muscle group targeted, and outcomes measured. Despite the heterogeneity of these studies, SMR appears to have a positive effect on range of motion and soreness/fatigue following exercise, but further study is needed to define optimal parameters (timing and duration of use) to aid performance and recovery.

  9. Unusual fatal petrositis presenting as myofascial pain and dysfunction of the temporal muscle.

    Science.gov (United States)

    Loretan, Stefan; Duvoisin, Bernard; Scolozzi, Paolo

    2011-05-01

    Petrositis is a rare and severe complication of acute otitis media and mastoiditis. Although the extension of the inflammatory process from the petrous apex to the adjacent Meckel cave can lead to trigeminal pain, an irritation of the trigeminal nerve roots resulting in acute or chronic hyperactivity of masticatory muscles has never been reported. We report here the unusual case of an 86-year-old man who presented with a handicapping myofascial pain and dysfunction syndrome of the right temporal muscle as a heralding manifestation of an unusual form of petrositis. The patient progressively developed a retropharyngeal abscess, a right sphenoid sinusitis, and fatal meningitis. This case demonstrated that (1) myofascial pain and dysfunction syndrome that does not respond to conventional treatments may suggest an unusual etiology and warrant further medical investigations and a detailed medical history and that (2) petrositis can manifest itself with atypical clinical symptoms and radiologic signs.

  10. Superficial temporal myofascial flap application in temporomandibular joint arthroplasty in a cat

    Directory of Open Access Journals (Sweden)

    Lisa A Mestrinho

    2015-07-01

    Full Text Available Case summary A 2-year-old, intact female domestic longhair cat was referred for surgical treatment after diagnosis of closed jaw locking secondarily to right temporomandibular joint ankylosis and left pseudoankylosis. The animal underwent successful surgical management with bilateral excision arthroplasty followed by interposition of a temporal superficial myofascial flap. Immediately after surgery, the full range of lower jaw movement was achieved and normal occlusion was maintained. Ankylosis did not recur in the 1 year postoperative follow-up period. Relevance and novel information A temporal myofascial flap could be considered as interposition material after temporomandibular joint arthroplasty to avoid postoperative re-ankylosis and mandibular drift. The main advantages of this flap are its autogenous origin, and the ability to maintain separation between the two bones, preserve mobility and disrupt new bone formation.

  11. EFFECTS OF NEURAL MOBILIZATION IN POSTERIOR MYOFASCIAL CHAIN FLEXIBILITY IN NORMAL SUBJECTS

    Directory of Open Access Journals (Sweden)

    Stuti Sharma

    2015-08-01

    Full Text Available Aims and objectives: The aim of this research is to see the effectiveness of neural mobilization on posterior myofascial chain flexibility. Methodology: Samples of 70 subjects were recruited for the study. Pre mobilization readings for finger floor distance, tibiotarsal angle and finger floor grades were taken for each individual, after whom slump mobilization was given and post mobilization readings were again taken in the same sequence after mobilization. Results: Both finger floor distance and grades were significantly changed, while tibiotarsal angle showed no significant difference. Discussion: Neural mobilization tries to restore the nervous system’s movement and elasticity, rehabilitating its normal functions by relieving the tensions in the muscular chains thereby increasing its flexibility. Conclusion: This study concludes that neural mobilization can improve posterior myofascial chain flexibility.

  12. Thermal temporal summation and decay of after-sensations in temporomandibular myofascial pain patients with and without comorbid fibromyalgia

    Science.gov (United States)

    Janal, Malvin N; Raphael, Karen G; Cook, Dane B; Sirois, David A; Nemelivsky, Lena; Staud, Roland

    2016-01-01

    Introduction Chronic myofascial temporomandibular disorders (TMD) may have multiple etiological and maintenance factors. One potential factor, central pain sensitization, was quantified here as the response to the temporal summation (TS) paradigm, and that response was compared between case and control groups. Objectives As previous research has shown that fibromyalgia (FM) is diagnosed iñ20% of TMD patients, Aim 1 determined whether central sensitization is found preferentially in myofascial TMD cases that have orofacial pain as a regional manifestation of FM. Aim 2 determined if the report of after-sensations (AS) following TS varied depending on whether repeated stimuli were rated as increasingly painful. Methods One hundred sixty-eight women, 43 controls, 100 myofascial TMD-only cases, and 25 myofascial TMD + FM cases, were compared on thermal warmth and pain thresholds, thermal TS, and decay of thermal AS. All cases met Research Diagnostic Criteria for TMD; comorbid cases also met the 1990 American College of Rheumatology criteria for FM. Results Pain thresholds and TS were similar in all groups. When TS was achieved (~60%), significantly higher levels of AS were reported in the first poststimulus interval, and AS decayed more slowly over time, in myofascial TMD cases than controls. By contrast, groups showed similar AS decay patterns following steady state or decreasing responses to repetitive stimulation. Conclusion In this case–control study, all myofascial TMD cases were characterized by a similar delay in the decay of AS. Thus, this indicator of central sensitization failed to suggest different pain maintenance factors in myofascial TMD cases with and without FM. PMID:27672341

  13. Current concepts in MRI of rectus femoris musculotendinous (myotendinous) and myofascial injuries in elite athletes

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, A., E-mail: Kassarjian@mac.com [Consultant Radiologist, Corades, S. L., Calle Galeon 2, 28220 Majadahonda, Madrid (Spain); Rodrigo, R.M., E-mail: rmrodrigo@resonanciamagneticabilbao.com [Resonancia Magnetica Bilbao, Hospital San Francisco Javier, Gordoniz 12, 40010 Bilbao, Vizcaya, Basque Country (Spain); Santisteban, J.M., E-mail: j.santisteban@athletic-club.net [Medical Services, Athletic Club Bilbao, Basurto Medical Institute, Faculty of Medicine and Odontology, University of the Basque Country, Barrio de Garaioltza 147, 48197 Lezama, Vizcaya, Basque Country (Spain)

    2012-12-15

    Rectus femoris injuries are extremely common in athletes, particularly in soccer players, rugby player, and sprinters. Magnetic resonance imaging (MRI) plays a key role in diagnosis, prognosis, and rehabilitation of these injuries. The current article discusses current concepts in the diagnosis and treatment of rectus femoris injuries in elite athletes, including a discussion of the less well known myofascial injuries and key prognostic factors as seen at MR imaging.

  14. Effectiveness of ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis

    OpenAIRE

    Xia P; Wang XJ; Lin Q; Cheng K; Li XP

    2017-01-01

    Peng Xia,* Xiaoju Wang,* Qiang Lin, Kai Cheng, Xueping Li Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China *These authors contributed equally to this work Objective: The objective of this review was to assess the therapeutic effect of ultrasound (US) on myofascial pain syndrome (MPS).Date sources: PubMed, Embase, and Cochrane Library were searched to find relevant studies from January 1966 to Ma...

  15. Effectiveness of ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis

    OpenAIRE

    XIA, PENG; Wang, Xiaoju; Lin, Qiang; Cheng, Kai; Li, Xueping

    2017-01-01

    Peng Xia,* Xiaoju Wang,* Qiang Lin, Kai Cheng, Xueping Li Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China *These authors contributed equally to this work Objective: The objective of this review was to assess the therapeutic effect of ultrasound (US) on myofascial pain syndrome (MPS).Date sources: PubMed, Embase, and Cochrane Library were searched to find relevant studies from Ja...

  16. [Neurovascular infrahyoidal myofascial flap. Anatomic and topographic study of the innervation and blood supply].

    Science.gov (United States)

    Remmert, S; Meyer, S; Majocco, A

    1998-06-01

    The neurovascular infrahyoidal myofascial flap: An anatomical and topographical study of the innervation and blood supply. 15 cadavers had bilaterally been examined for the topography of the upper thyroid artery and vein and of the lower cervical ansa, as an axial bundle of vessels and nerves for the infrahyoidal myofascial flap. With the injection of methylene blue the vascular territories of the upper thyroid artery had been demonstrated. The upper thyroid artery and vein could be found in all cases. This artery was deriving in 47% from the external carotid artery, in 30% from the bifurcation and in 23% from the common carotid artery. The vein flowed in 43% into the facial vein and in 37% into the internal jugular vein. In the remaining 20% several segmental veins were found, which flowed into the jugular vein separately. In case of a far caudally situated vascular bundle the radius of rotation can be limited in cranial direction. The voluntary innervation of the muscles of this flap is derived from the lower cervical ansa. The upper radix of the ansa can be found 1 cm in latero-cranial direction of the greater horn of the hyoid bone, where it is separating from the hypoglossal nerve. The upper thyroid artery is supplying the infrahyoidal musculature in the whole extension from the hyoid bone to the sternum. Therefore it is possible to develop a myofascial flap of 3.5 cm x 11.5 cm in size, which is pedicled at an upper vascular and nerval bundle. Depending on the radius of rotation defects of the floor of mouth, of the tongue and of the oro- and hypopharynx can well be covered with this new neurovascular myofascial flap.

  17. EFFECTS OF NEURAL MOBILIZATION IN POSTERIOR MYOFASCIAL CHAIN FLEXIBILITY IN NORMAL SUBJECTS

    OpenAIRE

    Stuti Sharma; Shiv Kumar Verma; Vaibhav Agarwal

    2015-01-01

    Aims and objectives: The aim of this research is to see the effectiveness of neural mobilization on posterior myofascial chain flexibility. Methodology: Samples of 70 subjects were recruited for the study. Pre mobilization readings for finger floor distance, tibiotarsal angle and finger floor grades were taken for each individual, after whom slump mobilization was given and post mobilization readings were again taken in the same sequence after mobilization. Results: Both finger floor di...

  18. EFFECT OF COGNITIVE BEHAVIOR THERAPY AS COMPARED TO MYOFASCIAL RELEASE TECHNIQUE IN FIBROMYALGIA SYNDROME

    OpenAIRE

    Kaur kusumpreet; Armugam Narkeesh; Khurana Sonia

    2013-01-01

    Background and introduction:Fibromyalgia or fibromyalgic syndrome is a common form of non-articularrheumatism characterized by variety of non-specific symptoms including diffuse widespread musculoskeletalaching associated with fatigue, morning stiffness and sleep disturbances (Bennett, 1997). The current study willcompare the beneficial effects of Cognitive behavior therapy (CBT) and Myofascial release (MFR) along withconventional treatment. This study tries to find out new effective method f...

  19. A critical overview of the current myofascial pain literature - July 2016.

    Science.gov (United States)

    Dommerholt, Jan; Grieve, Rob; Finnegan, Michelle; Hooks, Todd

    2016-07-01

    The overview of the myofascial pain literature includes a wide variety of basic and clinical studies, ranging from assessing muscle activation patterns to the impact of platelet-rich plasma injections. Contributions to the literature once again came from all corners of the world, such as Australia, Belgium, Brazil, Germany, Greece, Iran, Italy, Japan, Korea, the Netherlands, Norway, Poland, Spain, Taiwan, Turkey, and the USA. A total of 30 papers are included in this overview.

  20. A Multicomponent Latent Trait Model for Diagnosis

    Science.gov (United States)

    Embretson, Susan E.; Yang, Xiangdong

    2013-01-01

    This paper presents a noncompensatory latent trait model, the multicomponent latent trait model for diagnosis (MLTM-D), for cognitive diagnosis. In MLTM-D, a hierarchical relationship between components and attributes is specified to be applicable to permit diagnosis at two levels. MLTM-D is a generalization of the multicomponent latent trait…

  1. Analysis of latent structures in linear systems

    DEFF Research Database (Denmark)

    Høskuldsson, Agnar

    2004-01-01

    In chemometrics the emphasis is on latent structure models. The latent structure is the part of the data that the modeling task is based upon. This paper is addressing some fundamental issues, when latent structures are used. The paper consists of three parts. The first part is concerned defining...

  2. Asthma triggers (image)

    Science.gov (United States)

    ... things make your asthma worse. These are called asthma "triggers". Avoiding them is your first step toward feeling better. The most common asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors ...

  3. Asthma Triggers: Gain Control

    Science.gov (United States)

    ... Search Asthma Contact Us Share Asthma Triggers: Gain Control Breathing Freely: Controlling Asthma Triggers This video features ... Air Quality: Biological Pollutants Help Your Child Gain Control Over Asthma Top of Page Molds About Molds ...

  4. EFFECT OF COGNITIVE BEHAVIOR THERAPY AS COMPARED TO MYOFASCIAL RELEASE TECHNIQUE IN FIBROMYALGIA SYNDROME

    Directory of Open Access Journals (Sweden)

    Kaur kusumpreet

    2013-10-01

    Full Text Available Background and introduction:Fibromyalgia or fibromyalgic syndrome is a common form of non-articularrheumatism characterized by variety of non-specific symptoms including diffuse widespread musculoskeletalaching associated with fatigue, morning stiffness and sleep disturbances (Bennett, 1997. The current study willcompare the beneficial effects of Cognitive behavior therapy (CBT and Myofascial release (MFR along withconventional treatment. This study tries to find out new effective method for reducing the problemsof pain,anxiety and sleep disturbance in fibromyalgia.Method:24 subjects selected according to the inclusion andexclusion criteria were randomly divided in to three groups: Conventional group, Myofascial releasealong withconventional treatment and Cognitive behavior therapy along with conventional treatment. Pre and post readingsat 0 day, 7thday and 14thday were recorded for Fibromyalgia Impact Questionnaire (FIQ, Epworth SleepinessScale (ESS and State Trait Anxiety Inventory (STAI.Results:After two week protocol it was found that all threetreatment approaches were effective in reducing the problem of pain, anxiety and sleep disturbance to someextent. However on comparing three treatment approaches , CBT is the most effective in reducing theaboveparameters. (p<0.05Conclusion:Cognitive behavior therapy is more effective than Myofascial release tehniquesin reducing fibromyalgia symptoms.

  5. Role of the pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage laryngectomy.

    Science.gov (United States)

    Sharma, S; Chaukar, D A; Laskar, S G; Kapre, N; Deshmukh, A; Pai, P; Chaturvedi, P; D'Cruz, A

    2016-09-01

    This study aimed to assess the utility of onlay pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage total laryngectomy. A retrospective analysis was performed of 172 patients who underwent salvage laryngectomy for recurrent carcinoma of the larynx or hypopharynx between 1999 and 2014. One hundred and ten patients underwent primary closure and 62 patients had pectoralis major myofascial flap onlay. The overall pharyngocutaneous fistula rate was 43 per cent, and was similar in both groups (primary closure group, 43.6 per cent; onlay flap group, 41.9 per cent; p = 0.8). Fistulae in the onlay flap group healed faster: the median and mean fistula duration were 37 and 55 days, respectively, in the primary closure group and 20 and 25 days, respectively, in the onlay flap group (p = 0.008). Use of an onlay pectoralis major myofascial flap did not decrease the pharyngocutaneous fistula rate, although fistula duration was shortened. A well-designed randomised-controlled trial is needed to establish parameters for its routine use in clinical practice.

  6. The KLOE trigger system

    Energy Technology Data Exchange (ETDEWEB)

    Adinolfi, M.; Aloisio, A.; Ambrosino, F.; Andryakov, A.; Antonelli, A.; Antonelli, M.; Anulli, F.; Bacci, C.; Bankamp, A.; Barbiellini, G.; Bellini, F.; Bencivenni, G.; Bertolucci, S.; Bini, C.; Bloise, C.; Bocci, V.; Bossi, F.; Branchini, P.; Bulychjov, S.A.; Cabibbo, G.; Calcaterra, A.; Caloi, R.; Campana, P.; Capon, G.; Carboni, G.; Cardini, A.; Casarsa, M.; Cataldi, G.; Ceradini, F.; Cervelli, F.; Cevenini, F.; Chiefari, G.; Ciambrone, P.; Conetti, S.; Conticelli, S.; De Lucia, E.; De Robertis, G.; De Sangro, R.; De Simone, P.; De Zorzi, G.; Dell' Agnello, S.; Denig, E.; Di Domenico, A.; Di Donato, C.; Di Falco, S.; Doria, A.; Drago, E.; Elia, V.; Erriquez, O.; Farilla, A.; Felici, G.; Ferrari, A.; Ferrer, M.L.; Finocchiaro, G.; Forti, C.; Franceschi, A.; Franzini, P.; Gao, M.L.; Gatti, C.; Gauzzi, P.; Giovannella, S.; Golovatyuk, V.; Gorini, E.; Grancagnolo, F.; Grandegger, W.; Graziani, E.; Guarnaccia, P.; Hagel, U. von; Han, H.G.; Han, S.W.; Huang, X.; Incagli, M.; Ingrosso, L.; Jang, Y.Y.; Kim, W.; Kluge, W.; Kulikov, V.; Lacava, F.; Lanfranchi, G.; Lee-Franzini, J.; Lomtadze, F.; Luisi, C.; Mao, C.S.; Martemianov, M.; Matsyuk, M.; Mei, W.; Merola, L.; Messi, R.; Miscetti, S.; Moalem, A.; Moccia, S.; Moulson, M.; Mueller, S.; Murtas, F.; Napolitano, M.; Nedosekin, A.; Panareo, M.; Pacciani, L.; Pages, P.; Palutan, M.; Paoluzi, L.; Pasqualucci, E.; Passalacqua, L.; Passaseo, M.; Passeri, A.; Patera, V.; Petrolo, E.; Petrucci, G.; Picca, D.; Pirozzi, G.; Pistillo, C.; Pollack, M.; Pontecorvo, L.; Primavera, M.; Ruggieri, F.; Santangelo, P.; Santovetti, E.; Saracino, G.; Schamberger, R.D.; Schwick, C.; Sciascia, B. E-mail: barbara.sciascia@romal.infn.it; Sciubba, A.; Scuri, F.; Sfiligoi, I.; Shan, J.; Silano, P.; Spadaro, T.; Spagnolo, S.; Spiriti, E.; Stanescu, C.; Tong, G.L.; Tortora, L.; Valente, E.; Valente, P.; Valeriani, B.; Venanzoni, G.; Veneziano, S.; Wu, Y.; Xie, Y.G.; Zhao, P.P.; Zhou, Y

    2001-04-01

    A double-level trigger system has been developed for the KLOE experiment. Custom electronics asserts a trigger in a 2 {mu}s decision time. The decision is based on the combined information of the electromagnetic calorimeter and the drift chamber. The entire trigger system is continuously monitored, and data flowing from the trigger system have allowed both an efficient online monitoring of the detector and an online luminosity measurement.

  7. Selenium and Zinc Status in Chronic Myofascial Pain: Serum and Erythrocyte Concentrations and Food Intake

    Science.gov (United States)

    Barros-Neto, João Araújo; Souza-Machado, Adelmir; Kraychete, Durval Campos; de Jesus, Rosangela Passos; Cortes, Matheus Lopes; Lima, Michele dos Santos; Freitas, Mariana Carvalho; Santos, Tascya Morganna de Morais; Viana, Gustavo Freitas de Sousa; Menezes-Filho, José Antonio

    2016-01-01

    Introduction Nutritional disorders have been reported to be important causal factors that can intensify or cause a painful response in individuals with chronic musculoskeletal pain. Aim To assess the habitual intake of and the serum and erythrocyte levels of selenium and zinc in patients with chronic myofascial pain. Materials and Methods A case-control study of 31 patients with chronic myofascial pain (group I) and 31 subjects without pain (group II). Dietary record in five days for assessing food intake were used. The serum and erythrocyte concentrations of selenium and zinc were analyzed using an atomic absorption spectrophotometry. Pain intensity was assessed using a visual analog scale. Results The group of patients with chronic myofascial pain, compared with the control group, showed a lower erythrocyte concentration of selenium (79.46 ± 19.79 μg/L vs. 90.80 ± 23.12 μg/L; p = 0.041) and zinc (30.56 ± 7.74 μgZn/gHb vs. 38.48 ± 14.86 μgZn/gHb, respectively; p = 0.004). In this study, a compromised food intake of zinc was observed in the majority of the subjects in both groups. The selenium intake was considered to be safe in 80% of the subjects in both groups; however, the likelihood of inadequate intake of this mineral was twice as high in group I (49.5% vs. 24.4%, respectively). In the logistic regression analysis, the erythrocyte concentration of zinc was associated with the presence of pain. In each additional 1 mg of Zn2+ per gram of hemoglobin, a reduction of 12.5% was observed in the risk of the individual having chronic myofascial pain (B = -0.133; adjusted OR = 0.875, 95% CI = 0.803 to 0.954, Wald = 9.187, standard error = 0.044, p = 0.002). Physical inactivity and obesity were noted more commonly in group I compared with the control group. Conclusion In this study, patients with chronic myofascial pain showed lower intracellular stores of zinc and selenium and inadequate food intake of these nutrients. PMID:27755562

  8. Latent geometry of bipartite networks

    CERN Document Server

    Kitsak, Maksim; Krioukov, Dmitri

    2016-01-01

    Despite the abundance of bipartite networked systems, their organizing principles are less studied, compared to unipartite networks. Bipartite networks are often analyzed after projecting them onto one of the two sets of nodes. As a result of the projection, nodes of the same set are linked together if they have at least one neighbor in common in the bipartite network. Even though these projections allow one to study bipartite networks using tools developed for unipartite networks, one-mode projections lead to significant loss of information and artificial inflation of the projected network with fully connected subgraphs. Here we pursue a different approach for analyzing bipartite systems that is based on the observation that such systems have a latent metric structure: network nodes are points in a latent metric space, while connections are more likely to form between nodes separated by shorter distances. This approach has been developed for unipartite networks, and relatively little is known about its appli...

  9. Advancement of Latent Trait Theory.

    Science.gov (United States)

    1988-02-01

    Estimation with the Multiple-Choice Test Item. American Educational Research Association Meeting, New Orleans, 1984. (Coauthorship with Paul S. Changas...Chicago, 1985. U. S. A. (Coauthorship with Paul S. Changas) (10) Expansion of the General Model for the Homogeneous Case of the Continuous Response Level...17-20. [2] Lazarsfeld , P. F. Latent structure analysis. In S. Koch (Ed.), Psychology: a study of a science, Volume 3. McGraw-Hill, 1959, pages 476-542

  10. Platelet-rich plasma versus dry needling of myofascial meridian trigger points in the treatment of plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Reem El Mallah

    2017-01-01

    Conclusion PRP injection is a promising line of treatment for chronic PF with documented ultrasonographic healing effect. Dry needling is a simple and safe technique for treating pain associated with PF, yet it is more invasive and less effective compared with PRP injection.

  11. Latent heat of vehicular motion

    Science.gov (United States)

    Ahmadi, Farzad; Berrier, Austin; Habibi, Mohammad; Boreyko, Jonathan

    2016-11-01

    We have used the thermodynamic concept of latent heat, where a system loses energy due to a solid-to-liquid phase transition, to study the flow of a group of vehicles moving from rest. During traffic flow, drivers keep a large distance from the car in front of them to ensure safe driving. When a group of cars comes to a stop, for example at a red light, drivers voluntarily induce a "phase transition" from this "liquid phase" to a close-packed "solid phase." This phase transition is motivated by the intuition that maximizing displacement before stopping will minimize the overall travel time. To test the effects of latent heat on flow efficiency, a drone captured the dynamics of cars flowing through an intersection on a Smart Road where the initial spacing between cars at the red light was systematically varied. By correlating the experimental results with the Optimal Velocity Model (OVM), we find that the convention of inducing phase transitions at intersections offers no benefit, as the lag time (latent heat) of resumed flow offsets the initial increase in displacement. These findings suggest that in situations where gridlock is not an issue, drivers should not decrease their spacing during stoppages in order to maximize safety with no loss in flow efficiency.

  12. Trigger-Point Dry Needling for the SOF Medic.

    Science.gov (United States)

    Cavett, Thomas; Solarczyk, Justin

    We propose that trigger-point dry needle (TrP-DN) therapy is an effective low-risk treatment for pain associated with myofascial trigger points (MTrP), and should be incorporated into the Special Operations Forces (SOF) Medic's scope of practice. Furthermore, TrP-DN therapy can be used as a treatment adjunct on the SOF continuum of care, providing analgesia and increased tolerance for rehabilitative therapy, thereby facilitating improved patient outcomes and faster return to operational readiness. The incidence of musculoskeletal injuries in the SOF community is discussed, as are available treatment options TrP-DN methods, a case study of a Soldier deployed to Afghanistan, the science behind the subject of MTrP and TrP-DN, and the risks associated with TrP-DN and how we can mitigate them effectively. Caution should be used in the interpretation of a body of literature based largely on case studies. Although the amount of published evidence in support of the potential benefits of TrP-DN is growing, larger, randomized, placebo-controlled trials and studies that evaluate the effects of TrP-DN in a methodologically rigorous and statistically significant way are needed. Based on anecdotal evidence of and personal experience with the success of the therapy, as well as its growing use within both civilian and military medicine, the possible therapeutic benefit of TrP-DN is relevant for the SOF community. 2016.

  13. The Effect of Dry Needling on Range of Motion of Neck Lateral Flexion in Subjects With Active Trigger Point in Upper Trapezius Muscle

    Directory of Open Access Journals (Sweden)

    Ziaeifar

    2014-12-01

    Full Text Available Background Myofascial trigger point is one of the most common causes of musculoskeletal disorders. Myofascial trigger point in upper trapezius has been reported as a symptom in patients with neck and upper thoracic pain. Objectives The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on trigger point in upper trapezius muscle. Materials and Methods 28 subjects with myofascial trigger point in upper trapezius participated in this study. The subjects were randomly assigned to two groups: dry needling (n = 13 and ischemic pressure (n = 15. The neck lateral flexion range of motion was measured before and after treatment in both groups using a standard goniometer. Paired t-test was used to determine any significant difference in range of motion after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis. Results Statistical analysis (paired t-test revealed significant increase in neck lateral flexion range of motion in contra-lateral side after treatment sessions in control and experimental group compared with pre-treatment score (P < 0.05. However, only dry needling was effective in increase of range of motion in Ipsi-lateral side (P = 0.001. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups in the after treatment sessions (P = 0.06 and (P = 0.15. Conclusions The application of DN produces an improvement in ILF and CLF can be prescribed for subjects with MTP in UT muscles.

  14. Triggering trigeminal neuralgia.

    Science.gov (United States)

    Di Stefano, Giulia; Maarbjerg, Stine; Nurmikko, Turo; Truini, Andrea; Cruccu, Giorgio

    2017-01-01

    Introduction Although it is widely accepted that facial pain paroxysms triggered by innocuous stimuli constitute a hallmark sign of trigeminal neuralgia, very few studies to date have systematically investigated the role of the triggers involved. In the recently published diagnostic classification, triggered pain is an essential criterion for the diagnosis of trigeminal neuralgia but no study to date has been designed to address this issue directly. In this study, we set out to determine, in patients with trigeminal neuralgia, how frequently triggers are present, which manoeuvres activate them and where cutaneous and mucosal trigger zones are located. Methods Clinical characteristics focusing on trigger factors were collected from 140 patients with trigeminal neuralgia, in a cross-sectional study design. Results Provocation of paroxysmal pain by various trigger manoeuvres was reported by 136 of the 140 patients. The most frequent manoeuvres were gentle touching of the face (79%) and talking (54%). Trigger zones were predominantly reported in the perioral and nasal region. Conclusion This study confirms that in trigeminal neuralgia, paroxysmal pain is associated with triggers in virtually all patients and supports the use of triggers as an essential diagnostic feature of trigeminal neuralgia.

  15. Emerging concepts in the treatment of myofascial pain: a review of medications, modalities, and needle-based interventions.

    Science.gov (United States)

    Annaswamy, Thiru Mandyam; De Luigi, Arthur J; O'Neill, Bryan J; Keole, Nandita; Berbrayer, David

    2011-10-01

    Significant developments and changes in the use of interventions and treatments for the management of myofascial pain syndrome have occurred in the past 10 years. These emerging concepts have changed the approach for clinicians who manage these pain disorders. However, wide variations in practice patterns prevail, and no clear consensus exists regarding when and how to use these interventions; in addition, awareness of the evidence basis behind their use is limited. This review examines the most recent advances in the treatment of myofascial pain syndromes. Specifically, the evidence basis of various emerging interventions is reviewed and recommendations for routine clinical practice and their rationale are provided. The purpose of this review is to provide the clinician with a better understanding of emerging concepts in the interventions used for myofascial pain syndromes.

  16. Reactivation of latent viruses after treatment with biological therapies

    Directory of Open Access Journals (Sweden)

    Asthana AK

    2014-06-01

    Full Text Available Anil Kumar Asthana,1 John Samuel Lubel2,31Department of Gastroenterology, The Alfred Hospital, Melbourne, 2Department of Gastroenterology and Hepatology, Eastern Health, 3Eastern Health Clinical School, Monash University, Melbourne, VIC, AustraliaAbstract: Biological therapies are used extensively for malignant (eg, lymphoma and autoimmune (eg, rheumatoid arthritis conditions. These agents include anti-tumor necrosis factor antagonists, such as infliximab, and B-cell-depleting therapies, such as rituximab. In the past decade, there has been an explosion in the types and numbers of agents being used. One of the known risks with these agents is infection. In particular, there is increasing awareness regarding latent virus reactivation. This occurs when a latent virus is reactivated into its active replicative phase as a result of an internal or external trigger, such as immunosuppression. It is challenging, however, to quantitatively attribute the risk of reactivation to biological therapy alone because the underlying malignant or autoimmune condition could also be a contributing factor. There is well documented evidence regarding the reactivation of viruses such as hepatitis B virus and cytomegalovirus with drugs such as rituximab. Long-term data are lacking; such data are essential to guide risk stratification and chemoprophylaxis. Universally accepted viral screening guidelines prior to commencement of immunosuppression are lacking. As an example, the US Centers for Disease Control and Prevention have published recommendations regarding hepatitis B virus screening prior to commencing immunosuppression, but this action has not translated into universally accepted guidelines. Some of the other relevant viruses involved include cytomegalovirus, hepatitis C virus, varicella zoster virus, Epstein–Barr virus, and other members of the herpes family. This article reviews the current literature on the risk of latent viral reactivation with biological

  17. Reliability of assessment of upper trapezius morphology, its mechanical properties and blood flow in female patients with myofascial pain syndrome using ultrasonography.

    Science.gov (United States)

    Adigozali, Hakimeh; Shadmehr, Azadeh; Ebrahimi, Esmail; Rezasoltani, Asghar; Naderi, Farrokh

    2017-01-01

    In the present study, the intra-rater reliability of upper trapezius morphology, its mechanical properties and intramuscular blood circulation in females with myofascial pain syndrome were assessed using ultrasonography. A total of 37 patients (31.05 ± 10 years old) participated in this study. Ultrasonography producer was set up in three stages: a) Gray-scale: to measure muscle thickness, size and area of trigger points; b) Ultrasound elastography: to measure muscle stiffness; and c) Doppler imaging: to assess blood flow indices. According to data analysis, all variables, except End Diastolic Velocity (EDV), had excellent reliability (>0.806). Intra-class Correlation Coefficient (ICC) for EDV was 0.738, which was considered a poor to good reliability. The results of this study introduced a reliable method for developing details of upper trapezius features using muscular ultrasonography in female patients. These variables could be used for objective examination and provide guidelines for treatment plans in clinical settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Short-term effects of self-massage combined with home exercise on pain, daily activity, and autonomic function in patients with myofascial pain dysfunction syndrome.

    Science.gov (United States)

    Chan, Yuan-Chi; Wang, Tzyy-Jiuan; Chang, Cheng-Chiang; Chen, Liang-Cheng; Chu, Heng-Yi; Lin, Shiou-Ping; Chang, Shin-Tsu

    2015-01-01

    [Purpose] The aim of the present was to investigate the short-term effects of a program combining self-massage and home exercise for patients with myofascial pain dysfunction syndrome (MPDS). [Subjects and Methods] In this retrospective study, 63 patients were allocated to the experimental (n = 32) and control (n = 31) groups. Both groups received 6 sessions of treatment with physical modalities over the course of two weeks. The experimental group completed an additional program with a combination of self-massage and home exercise. The outcome measurements included a pain scale, pressure pain threshold (PPT), neck disability index (NDI), patient-specific functional scales (PSFS), and heart rate variability (HRV). The interactions between the groups and over time were analyzed using two-way repeated measures ANOVA. [Results] Only the experimental group demonstrated significant improvements in the pain scale with varying conditions. The PPTs of the trigger points increased significantly in the experimental group, and significant functional improvements in NDI and PSFS were observed in the same group. There were significant increases in high-frequency HRV and high-frequency % in the experimental group. [Conclusion] Treatment with physical modalities plus combination of self-massage and home exercise is more effective than the physical modalities treatment alone.

  19. The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study.

    Science.gov (United States)

    Dundar, U; Evcik, D; Samli, F; Pusak, H; Kavuncu, V

    2007-06-01

    The efficacy of low-level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. A prospective, double-blind, randomized controlled trial was conducted in patients with chronic MPS in the neck to evaluate the effects of low-level 830-nm gallium arsenide aluminum (Ga-As-Al) laser therapy. The study group consisted of 64 MPS patients. The patients were randomly assigned into two groups. In group 1 (n = 32), Ga-As-Al laser treatment was applied over three trigger points bilaterally for 2 min over each point once a day for 15 days during a period of 3 weeks. In group 2 (n = 32), the same treatment protocol was given, but the laser instrument was switched off during applications. All patients in both groups performed daily isometric exercise and stretching exercises for cervical region. Parameters were measured at baseline and after 4 weeks. All patients were evaluated with respect to pain (at rest, movement, and night) and assessed by visual analog scale, measurement of active range of motion using an inclinometer and a goniometer, and the neck disability index. In both groups, statistically significant improvements were detected in all outcome measures compared with baseline (p 0.05). In conclusion, although the laser therapy has no superiority over placebo groups in this study, we cannot exclude the possibility of effectivity with another treatment regimen including different laser wavelengths and dosages (different intensity and density and/or treatment interval).

  20. Latent herpesvirus infection arms NK cells.

    Science.gov (United States)

    White, Douglas W; Keppel, Catherine R; Schneider, Stephanie E; Reese, Tiffany A; Coder, James; Payton, Jacqueline E; Ley, Timothy J; Virgin, Herbert W; Fehniger, Todd A

    2010-06-03

    Natural killer (NK) cells were identified by their ability to kill target cells without previous sensitization. However, without an antecedent "arming" event, NK cells can recognize, but are not equipped to kill, target cells. How NK cells become armed in vivo in healthy hosts is unclear. Because latent herpesviruses are highly prevalent and alter multiple aspects of host immunity, we hypothesized that latent herpesvirus infection would arm NK cells. Here we show that NK cells from mice latently infected with Murid herpesvirus 4 (MuHV-4) were armed as evidenced by increased granzyme B protein expression, cytotoxicity, and interferon-gamma production. NK-cell arming occurred rapidly in the latently infected host and did not require acute viral infection. Furthermore, NK cells armed by latent infection protected the host against a lethal lymphoma challenge. Thus, the immune environment created by latent herpesvirus infection provides a mechanism whereby host NK-cell function is enhanced in vivo.

  1. Myofascial pain and fibromyalgia: two different but overlapping disorders.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Arendt-Nielsen, Lars

    2016-05-01

    There is good evidence supporting that people with fibromyalgia syndrome (FMS) exhibit central sensitization. The role of peripheral nociception is under debate in FMS. It seems that widespread pain experienced in FMS is considered multiple regional pains; therefore, several authors proposed that muscles play a relevant role in FMS. Trigger points (TrPs) have long been a contentious issue in relation to FMS. Preliminary evidence reported that the overall spontaneous pain is reproduced by referred pain from active TrPs, suggesting that FMS pain is largely composed of pain arising, at least partially, from TrPs. Finally, there is preliminary evidence suggesting that management of TrPs is able to modulate the CNS and is effective for reducing pain in FMS, although results are conflicting and future studies are clearly needed.

  2. Latent methane in fossil coals

    Energy Technology Data Exchange (ETDEWEB)

    A.D. Alexeev; E.V. Ulyanova; G.P. Starikov; N.N. Kovriga [Academy of Sciences of Ukraine, Donetsk (Ukraine). Institute for Physics of Mining Processes

    2004-07-01

    It is established experimentally using 1H NMR wide line spectroscopy that methane can exist in coals not only in open or closed porosity and fracture systems but also in solid solutions in coal substance, in particular, under methane pressure 2 MPa or higher. Methane dissolved in coal minerals reversibly modifies their lattice parameters as determined from X-ray diffraction analysis. Co-existence of these methane forms in fossil coals causes multi-step desorption kinetics. It is shown experimentally that the long-term latent methane desorption is effected mainly by closed porosity, which in turn is determined by coal rank. 21 refs., 3 figs., 2 tabs.

  3. Enhanced latent inhibition in high schizotypy individuals

    OpenAIRE

    Granger, Kiri T.; Moran, Paula M.; Buckley, Matthew G.; Haselgrove, Mark

    2016-01-01

    Latent inhibition refers to a retardation in learning about a stimulus that has been rendered familiar by non-reinforced preexposure, relative to a non-preexposed stimulus. Latent inhibition has been shown to be inversely correlated with schizotypy, and abnormal in people with schizophrenia, but these findings are inconsistent. One potential contributing factor to this inconsistency is that many tasks that purport to measure latent inhibition are confounded by alternative effects that also re...

  4. [Application of shear wave elastography in the evaluation of neck-shoulder myofascial pain syndrome].

    Science.gov (United States)

    Guo, Ling; Zhang, Chen; Zhang, Ding-ding; Gao, Jing-hua; Liu, Guang-hui; Wang, Shang-quan

    2016-02-01

    To study clinical value of shear wave elastography (SWE) in the evaluation of neck-shoulder myofascial pain syndrome. From December 2013 to July 2014,30 patients diagnosed as neck-shoulder myofascial pain syndrome were in the treatment group,including 17 males and 13 females, with an average age of (44 ± 3) years old. Thirty healthy people were in the control group, including 22 males and 8 females, with a mean age of (37 ± 5) years old. The patients in the treatment group were treated with manipulation, once every other day, total 7 times. The SWE was used to detect tension part of trapezius muscle of patients in the treatment group before and after treatment, as well as to detect muscle belly at the descending part of trapezius muscle in the control group. The tissue elasticity and Yang's modulus value were recorded and compared. The tissue elasticity chart of patients in the treatment group before treatment was mainly greenish blue with the score of 3.70 ± 1.53, and the Yang's modulus was (43.4 ± 15.6) kPa. The tissue elasticity figure after treatment was mainly blue with the score of 2.40 ± 0.87, and the Yang's modulus was (29.0 ± 5.9) kPa. Whereas in the control group, the tissue elasticity figure was mainly blue with the score of 1.60 ± 0.72, and the Yang's modulus was (24.0 ± 7.6) kPa. These were statistical differences between the two groups (P = 0.000). SWE can be used as an evaluation method of manipulation treatment for neck-shoulder myofascial pain syndrome, which is an objective and sensitive detection method.

  5. Masticatory Muscle Sleep Background EMG Activity is Elevated in Myofascial TMD Patients

    Science.gov (United States)

    Raphael, Karen G.; Janal, Malvin N.; Sirois, David A.; Dubrovsky, Boris; Wigren, Pia E.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2013-01-01

    Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n=124) with a demographically matched control group without TMD (n=46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artifacts were removed. Results indicated that median background EMG during these non SB-event periods was significantly higher (p<.01) for women with myofascial TMD (median=3.31 μV and mean=4.98 μV) than for control women (median=2.83 μV and mean=3.88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0–10 numerical scale) on post sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance. PMID:24237356

  6. Masticatory muscle sleep background electromyographic activity is elevated in myofascial temporomandibular disorder patients.

    Science.gov (United States)

    Raphael, K G; Janal, M N; Sirois, D A; Dubrovsky, B; Wigren, P E; Klausner, J J; Krieger, A C; Lavigne, G J

    2013-12-01

    Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular disorder (TMD). The current case-control study compares a large sample of women suffering from chronic myofascial TMD (n = 124) with a demographically matched control group without TMD (n = 46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artefacts were removed. Results indicated that median background EMG during these non-SB event periods was significantly higher (P myofascial TMD (median = 3·31 μV and mean = 4·98 μV) than for control women (median = 2·83 μV and mean = 3·88 μV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post-sleep waking. These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of pain induction or maintenance.

  7. Comparing complementary alternative treatment for chronic shoulder pain of myofascial origin

    Science.gov (United States)

    Pan, Ru-Yu; Hsu, Yung-Chi; Wong, Chih-Shung; Lin, Shinn-Long; Li, Tsung-Ying; Cherng, Chen-Hwan; Ko, Shan-Chi; Yeh, Chun-Chang

    2016-01-01

    Abstract The aim of this study was to compare the short-term outcomes between 2 different treatments for unilateral chronic shoulder pain of myofascial origin, that is, local tender area related meridians (LTARMs) treatment and collateral meridian therapy (CMT), which were performed 6 times over a period of 4 weeks. Seventy patients with unilateral shoulder pain of chronic myofascial origin were enrolled. The patients were randomly assigned to 2 different treatment groups: 1 group received CMT (n = 35) and the other received LTARM (n = 35). Before and after the 2 treatment processes, all patients rated their overall pain intensity on a visual analogue scale (VAS) and a validated 13-question shoulder pain and disability index (SPADI) questionnaire was used to measure shoulder pain and functional impairment after therapy for 4 weeks. After CMT, the pain intensity was reduced after CMT. VAS score is reduced from 5.90 ± 2.07 (a mean of 5.90 and standard deviation of 2.07) to 3.39 ± 1.2. This was verified by the SPADI pain subscale scores (from 0.58 ± 0.193 to 0.33 ± 0.14). The pain-relief effect of CMT was significantly better than that of LTARM (VAS score from 5.78 ± 1.64 to 4.58 ± 1.40; P myofascial origin than the LTARM treatment, where treatment with the former resulted in better functional recovery after 4 weeks than the latter. PMID:27583882

  8. Bayesian variable selection for latent class models.

    Science.gov (United States)

    Ghosh, Joyee; Herring, Amy H; Siega-Riz, Anna Maria

    2011-09-01

    In this article, we develop a latent class model with class probabilities that depend on subject-specific covariates. One of our major goals is to identify important predictors of latent classes. We consider methodology that allows estimation of latent classes while allowing for variable selection uncertainty. We propose a Bayesian variable selection approach and implement a stochastic search Gibbs sampler for posterior computation to obtain model-averaged estimates of quantities of interest such as marginal inclusion probabilities of predictors. Our methods are illustrated through simulation studies and application to data on weight gain during pregnancy, where it is of interest to identify important predictors of latent weight gain classes.

  9. Effects of Dry Needling on Spinal Mobility and Trigger Points in Patients with Fibromyalgia Syndrome.

    Science.gov (United States)

    Castro-Sanchez, Adelaida Maria; Garcia-Lopez, Hector; Mataran-Penarrocha, Guillermo A; Fernandez-Sanchez, Manuel; Fernandez-Sola, Cayetano; Granero-Molina, Jose; Aguilar-Ferrandiz, Maria Encarnacion

    2017-02-01

    The etiology of fibromyalgia syndrome (FMS) is inconclusive, but central mechanisms are well accepted for this pain condition. Myofascial pain syndrome (MPS) is one of the most common musculoskeletal pain diseases and is characterized by myofascial trigger points (MTrPs). It has been suggest that MTrPs have an important factor in the genesis of FMS. The purpose of the current randomized clinical trial was to compare the effectiveness of dry needling versus cross tape on spinal mobility and MTrPs in spinal muscles in patients with FMS. A single-blind randomized controlled trial was conducted on patients with FMS. Clinical setting. Sixty-four patients with FMS were randomly assigned to an experimental group receiving dry needling therapy or to a control group for cross tape therapy in the MTrPs in the latissimus dorsi, iliocostalis, multifidus, and quadratus lumbourum muscles. Spinal mobility measures and MTrPs algometry were recorded at baseline and after 5 weeks of treatment. The repeated measures analysis of variance (ANOVA) demonstrated that significant differences between groups were achieved for the MTrPs in latissimus dorsi muscle (right axillary portion: F = 9.80, P = 0.003); multifidus muscle (right L2 level: F = 11.80, P = 0.001); quadratus lumborum (right lateral superficial upper: F = 6.67, P = 0.012; and right lateral superficial lower: F = 5.38, P = 0.024). In addition, the ANOVA repeated measures test showed significant differences between groups for the segmental amplitude thoracic spine in the standing erect position (F = 7.33, P = 0.009), and segmental amplitude of lumbar spine (F = 11.60, P = 0.001) in the sitting erect position. The outcomes were not collected from a long-term follow-up period. Dry needling therapy or cross tape were used alone when in reality physical therapists usually treat patients with FMS using a multi-modal approach. A non-treatment control group was not included. This study has demonstrated that dry needling therapy

  10. Análise da atividade eletromiográfica de superfície de pontos gatilhos miofasciais Surface electromyography activity analysis of the miofascial triggers points

    Directory of Open Access Journals (Sweden)

    Aline Bigongiari

    2008-12-01

    Full Text Available Os pontos gatilhos miofasciais (PGMs são manifestações comumente encontradas na prática clínica e estão relacionados à alteração de tônus e à síndrome dolorosa miofascial (SDM. OBJETIVO: Avaliar a capacidade da EMG de superfície e detectar alterações da atividade neuromuscular no PGM, em situações de repouso e de contração isométrica voluntária máxima. MÉTODO: Participaram do estudo 56 indivíduos distribuídos em dois grupos: grupo Saudável com 28 indivíduos, que necessariamente não possuíam PGM, e o grupo Dor, constituído de 28 indivíduos que possuíam necessariamente PGM no músculo escolhido. O grupo Dor apresentava indivíduos com PGM latente e ativo, e com e sem fenômenos autonômicos (FA. RESULTADOS: O sinal EMG da porção muscular com PGM mostrou-se significativamente maior quando comparado com a porção muscular sadia do grupo Dor, e do grupo Saudável durante o repouso (26,56 ± 44,54, 5,39 ± 6,29 e 1,56 ± 0,76, respectivamente, p = 0,0001. Os indivíduos com PGM ativo obtiveram maior intensidade do sinal EMG do que aqueles que apresentaram PGM latente (17,85 ± 30,25 versus 3,74 ± 1,52, p = 0,04. Além disso, os indivíduos que apresentaram fenômenos autonômicos tiveram maior intensidade do sinal EMG do que aqueles que não os apresentaram (16,78 ± 28,44 versus 3,51 ± 3,65, na condição de repouso. CONLUSÃO: A EMG de superfície é capaz de mensurar a atividade do PGM, principalmente na condição de repouso.There are examples of common clinical conditions that clinical signals are related to alterations in muscle tone, including myofascial pain syndrome. OBJECTIVE: to discuss the application of surface EMG to detect effect of miofascial trigger point (MTP on neuromuscular activity at rest and maximum voluntary contraction of the trapezoid muscle. METHODS: Fifty-six subjects participated in the study and were divided into two groups: Healthy group (n = 28, with subjects who necessarily did not

  11. Comparison of therapeutic efficacy between acupuncture and low level laser in the treatment of cervical myofascial pain syndrome: a single blinded randomized clinical trial study

    Directory of Open Access Journals (Sweden)

    Fariba Eslamian

    2014-01-01

    Full Text Available Abstract Background: Neck pain is a medical and public problem with a prevalence of 9-18 percent in general population. Myofascial pain syndrome (MPS is a regional pain syndrome that is characterized with muscular tender and triggers points. Laser therapy and acupuncture are two methods applied in the treatment of MPS. The aim of this study was to compare the effects of acupuncture and low level laser in cervical MPS treatment. Material and Methods: In a randomized clinical trial study, during a 15-month period, 60 patients with CMPs, referred to physical medicine and rehabilitation clinic, were divided into three groups Gr1 underwent acupuncture plus drugs, Gr2 laser therapy plus drugs and Gr3 only medication. Pain severity using visual analogue scale (VAS, Range of motion (ROM with goniometry, palpation sensitivity with finger compression and daily function with neck questionnaire were assessed before, immediately after and two months after treatment. The obtained data were analyzed using statistical software SPSS version 16. Results: Sixty patients of CMPs were included in this study. In acupuncture group, 5 male and 15 female (mean age of 38.8±6.36, in laser group, 6 male and 14 female (mean age of 37.7±5.64 and in control group, 8 male and 12 female (mean age of 37.6±5.17 were evaluated. There was significant difference in majority of parameters in two treatment groups compared to control group. But neck ROM in left lateral bending and VAS score, showed better improvement in acupuncture group than the other 2 groups (P<0.001. Nevertheless two months afterwards, no significant difference was detected between laser and acupuncture groups. Conclusion: This study demonstrated that both acupuncture and laser therapy along with exercise and drugs are more effective than routine and only medication treatments in management of CMPs. However, with respect to myofascial pain pathology, acupuncture, at least in short term has more beneficial

  12. Exercise, especially combined stretching and strengthening exercise, reduces myofascial pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Juliano Bergamaschine Mata Diz

    2017-01-01

    Full Text Available Question: Among people with myofascial pain, does exercise reduce the intensity of the pain and disability? Design: Systematic review of randomised and quasi-randomised controlled trials. Participants: People with myofascial pain of any duration. Intervention: Exercise versus minimal or no intervention and exercise versus other intervention. Outcome measures: Pain intensity and disability. Results: Eight studies involving 255 participants were included. Pooled estimates from six studies showed statistically significant effects of exercise when compared with minimal or no intervention (support and encouragement or no treatment on pain intensity at short-term follow-up. The weighted mean difference in pain intensity due to exercise was –1.2 points (95% CI –2.3 to –0.1 on a 0 to 10 scale. Pooled estimates from two studies showed a non-significant effect of exercise when compared with other interventions (electrotherapy or dry needling on pain intensity at short-term follow-up. The weighted mean difference in pain intensity due to exercise instead of other therapies was 0.4 points (95% CI –0.3 to 1.1 on a 0 to 10 scale. Individual studies reported no significant effects of exercise on disability compared with minimal intervention (–0.4, 95% CI –1.3 to 0.5 and other interventions (0.0, 95% CI –0.8 to 0.8 at short-term follow-up. Sensitivity analysis suggested that combining stretching and strengthening achieves greater short-term effects on pain intensity compared with minimal or no intervention (–2.3, 95% CI –4.1 to –0.5. Conclusion: Evidence from a limited number of trials indicates that exercise has positive small-to-moderate effects on pain intensity at short-term follow-up in people with myofascial pain. A combination of stretching and strengthening exercises seems to achieve greater effects. These estimates may change with future high-quality studies. [Mata Diz JB, de Souza JRLM, Leopoldino AAO, Oliveira VC (2016 Exercise

  13. Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome.

    Science.gov (United States)

    Oh, Ji Youn; Lim, Jin Hun; Kim, Yong Seok; Kwon, Young Eun; Yu, Jae Yong; Lee, Jun Hak

    2016-01-01

    Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome.

  14. Effect of dry needling on myofascial pain syndrome of the quadratus femoris: A case report.

    Science.gov (United States)

    Anandkumar, Sudarshan

    2017-09-18

    This case report describes a 40-year-old male who presented with posterior thigh pain managed unsuccessfully with massage therapy, chiropractic adjustments, and physical therapy. The diagnosis of myofascial pain syndrome (MPS) involving the quadratus femoris (QF) was purely clinical, based on palpatory findings and ruling out other conditions through deductive reasoning. This is potentially a first time report, describing the successful management of MPS of the QF with dry needling (DN) using a recently published DN grading system. Immediate improvements were noted in all the outcome measures after the first treatment, with complete pain-resolution maintained at a 4-month follow-up.

  15. A case of facial myofascial pain syndrome presenting as trigeminal neuralgia.

    Science.gov (United States)

    Yoon, Seung Zhoo; Lee, Sang Ik; Choi, Sung Uk; Shin, Hye Won; Lee, Hye Won; Lim, Hae Ja; Chang, Seong Ho

    2009-03-01

    Facial pain has many causes, including idiopathic factors, trigeminal neuralgia, dental problems, temporomandibular joint disorders, cranial abnormalities, and infections. However, the clinical diagnosis of facial pain is sometimes difficult to establish because clinical manifestations commonly overlap. The diagnosis of trigeminal neuralgia is based solely on clinical findings. Therefore, a careful evaluation of the patient history and a thorough physical examination are essential. This case describes a patient with facial myofascial pain syndrome involving the right zygomaticus, orbicularis oculi, and levator labii muscles, which presented as trigeminal neuralgia.

  16. Efficacy Of Electroacupuncture For Myofascial Pain In The Upper Trapezius Muscle: A Case Series.

    OpenAIRE

    Aranha,Maria F. M.; ALVES,MARCELO C.; Bérzin, Fausto; Gavião, Maria B. D.

    2015-01-01

    BACKGROUND: Electroacupunture (EA) includes the passage of an electrical current through the acupuncture needle and is commonly used for pain relief. OBJECTIVE: To evaluate the EA treatment effects for myofascial pain in the upper trapezius muscle. METHODS: Twenty women aged ranging from 18 to 40 years (mean=24.95; SD=5.88 years), with a body mass index ranging from 19 to 25 kg/m2 (mean=22.33; SD=0.56 kg/m2), with regular menstrual cycles controlled by oral contraceptive, local or referred pa...

  17. AMY trigger system

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Yoshihide [National Laboratory for High Energy Physics, Tsukuba, Ibaraki (Japan)

    1989-04-01

    A trigger system of the AMY detector at TRISTAN e{sup +}e{sup -} collider is described briefly. The system uses simple track segment and shower cluster counting scheme to classify events to be triggered. It has been operating successfully since 1987.

  18. Research on seismic stress triggering

    Institute of Scientific and Technical Information of China (English)

    万永革; 吴忠良; 周公威; 黄静; 秦立新

    2002-01-01

    This paper briefly reviews basic theory of seismic stress triggering. Recent development on seismic stress triggering has been reviewed in the views of seismic static and dynamic stress triggering, application of viscoelastic model in seismic stress triggering, the relation between earthquake triggering and volcanic eruption or explosion, other explanation of earthquake triggering, etc. And some suggestions for further study on seismic stress triggering in near future are given.

  19. Efficacy of EMLA cream phonophoresis comparison with ultrasound therapy on myofascial pain syndrome of the trapezius: a single-blind, randomized clinical study.

    Science.gov (United States)

    Ustun, Nilgun; Arslan, Fatma; Mansuroglu, Ayhan; Inanoglu, Deniz; Yagız, Abdullah Erman; Guler, Hayal; Turhanoglu, Ayse Dicle

    2014-04-01

    The aim of this study is to investigate whether eutectic mixture of local anesthetics (EMLA) cream phonophoresis superior to conventional US over the trigger points (TPs) in terms of improvements of pain, range of motion and disability in myofascial pain syndrome (MPS). Fifty patients (42 female, 8 male) diagnosed with MPS were included in the study. Patients were randomly assigned into two treatment groups including phonophoresis (PH) group (n = 25) and ultrasound (US) group (n = 25). PH group received EMLA cream phonophoresis (2.5 % lidocaine, 2.5 % prilocaine); US group received conventional ultrasound therapy over the all active TPs on trapezius muscle for 10 min a day for 15 sessions. Outcome measures were performed before the treatment course and at the end of a 15-session course of treatment. Student T, Mann-Whitney U, chi-square and Wilcoxon tests were used for statistical analysis. At the end of the therapy, there was statistically significant decrease in both PH group and US group in terms of number of trigger point (NTP) (p = 0.001, p = 0.029), pain intensity on movement (p = 0.001 vs. 0.002) and right/left cervical lateral ROMs (p = 0.001/p = 0.001, p = 0.009/p = 0.020) relative to baseline. The NTP decrease in PH group was significantly higher than that in US group (1.84 ± 1.46 vs. 0.72 ± 1.45; p = 0.01). Pain intensity at rest (p = 0.001) and NPDI scores (p = 0.001) were statistically improvement in only PH group. EMLA cream phonophoresis is more effective than conventional ultrasound therapy in terms of pain and associated neck disability, and it seems the complementary treatment option for MPS.

  20. A comparison of the effectiveness of low-, moderate- and high-dose ultrasound therapy applied in the treatment of myofascial pain syndrome.

    Science.gov (United States)

    Koca, Irfan; Tutoglu, Ahmet; Boyaci, Ahmet; Ucar, Mehmet; Yagiz, Erman; Isik, Mustafa; Bahsi, Ayse

    2014-07-01

    This study aimed to compare and evaluate the effects of ultrasound (US) treatment applied at low-, medium- and high-power-pain threshold (HPPT) doses to trigger points in the treatment of myofascial pain syndrome (MPS). The study comprised 61 (40 female and 21 male) patients diagnosed with MPS, aged between 18 and 60 years. The patients were randomly allocated to three groups for the US application at different dosages. Group I patients received treatment of medium-dose US (1.5 Watt/cm(2)), Group II received HPPT US, and Group III received low-dose US (0.5 W/cm(2)). The patients were evaluated pre-treatment and 3 weeks after treatment in respect of visual analogue scale (VAS) scores, number of trigger points (NTP), pressure pain threshold (PPT), Range of Tragus-Acromioclavicular joint (RT-AJ) and neck pain disability scores (NPDS). A significant improvement was determined after treatment in all scores except PPT in Group I, in all scores in Group II, and only in the VAS score in Group III. When the groups were compared post-treatment in respect of improvement in NTP, VAS, RT-AJ and NPDS scores, Group II showed significant superiority over Group I, and Group I was determined to have significant superiority over Group III in respect of VAS, RT-AJ and NPDS scores (p < 0.05). In the treatment of MPS, US therapy at HPPT dose can be considered as an alternative therapy method, which is more economical and more effective than low-dose and conventional US therapy.

  1. Greater Resting Lumbar Extensor Myofascial Stiffness in Younger Ankylosing Spondylitis Patients Than Age-Comparable Healthy Volunteers Quantified by Myotonometry.

    Science.gov (United States)

    Andonian, Brian J; Masi, Alfonse T; Aldag, Jean C; Barry, Alexander J; Coates, Brandon A; Emrich, Katherine; Henderson, Jacqueline; Kelly, Joseph; Nair, Kalyani

    2015-11-01

    To quantify resting lumbar erector myofascial stiffness in younger patients with ankylosing spondylitis (AS) and age-comparable healthy control subjects using a handheld mechanical impulse-based myotonometric device. A case-control study of 24 patients with AS and 24 age-comparable healthy control subjects. University physical therapy department. Patients with AS (men: n=19; women: n=5; total: N=24) and healthy volunteers (men: n=19; women: n=5; total: N=24) without low back pain (age range, 18-46y). Not applicable. Lumbar myofascial stiffness. At the initial measurements, median stiffness (Nm) of the averaged right- and left-sided values was greater (P=.021) in 24 patients with AS than 24 control subjects (268.9 vs 238.9, respectively). Repeated measurements after a 10-minute prone resting period were also greater (P=.007) in patients with AS than control subjects (281.0 vs 241.4, respectively). The 48 averaged right- and left-sided values from baseline and 10-minute measurements were compared in each subject group. The patients with AS more frequently (P=.012) had stiffness values >250 Nm (35 [72.9%] vs 22 [45.8%] in control subjects). Lumbar myofascial stiffness was greater in 24 patients with AS than in the control subjects. A hypothesized biomechanical concept of increased resting lumbar myofascial stiffness in AS may be supported by this preliminary controlled study. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. The effect of abdominal drawing-in exercise and myofascial release on pain, flexibility, and balance of elderly females

    Science.gov (United States)

    Yu, Seong Hun; Sim, Yong Hyeon; Kim, Myung Hoon; Bang, Ju Hee; Son, Kyung Hyun; Kim, Jae Woong; Kim, Hyun Jin

    2016-01-01

    [Purpose] This study is designed to compare the effects of abdominal drawing-in exercise and myofascial release on pain, flexibility, and balance of elderly females. [Subjects and Methods] Forty elderly females aged 65 or older who had complained of low back pain for three months or longer were selected as the subjects. They were randomly and equally assigned to either an abdominal drawing-in group or a myofascial release group. The subjects conducted exercise three times per week, 40 minutes each time, for eight weeks. As evaluation tools, visual analogue scale for pain, remodified schober test for flexibility, and upright posture with eye opening on hard platform, upright posture with eye closing on hard platform, upright posture with eye opening on soft platform, upright posture with eye closing on soft platform using tetrax for balance were used. [Results] The abdominal drawing-in exercise group saw significant difference in pain and balance after the exercise compared to before the exercise. The myofascial release group saw significant difference in pain and flexibility after exercise compared to before the exercise. [Conclusion] The above study showed that abdominal drawing-in exercise affected elderly females regarding pain and balance and myofascial release influenced their pain and flexibility. PMID:27821941

  3. Self-Reported Migraine and Chronic Fatigue Syndrome Are More Prevalent in People with Myofascial vs Nonmyofascial Temporomandibular Disorders.

    Science.gov (United States)

    Dahan, Haissam; Shir, Yoram; Nicolau, Belinda; Keith, David; Allison, Paul

    2016-01-01

    To compare the number of comorbidities and the prevalence of five specific comorbidities in people who have temporomandibular disorders (TMD) with or without myofascial pain. This cross-sectional study included 180 patients seeking TMD treatment in Boston and Montreal hospitals. A self-administered questionnaire was used to collect information on sociodemographic and behavioral factors, as well as the presence of the following five comorbidities: migraine, chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis, and restless leg syndrome. TMD was diagnosed using the Research Diagnostic Criteria for TMD. Chi-square and Student t tests were used for categorical and continuous variables, respectively, to test for differences between myofascial (n = 121) and nonmyofascial (n = 59) TMD groups. Multiple logistic regression analysis was used to compare the type and number of self-reported comorbidities in both groups, controlling for confounding variables. The following were found to be significantly higher in the myofascial TMD group than in the nonmyofascial TMD group: self-reported migraine (55% vs 28%, P = .001), chronic fatigue syndrome (19% vs 5%, P = .01), and the mean total number of comorbidities (1.30 vs 0.83, P = .01). Individuals with myofascial TMD had a higher prevalence of self-reported migraine and chronic fatigue syndrome than those with nonmyofascial TMD.

  4. Comparison of effectiveness of Transcutaneous Electrical Nerve Stimulation and Kinesio Taping added to exercises in patients with myofascial pain syndrome.

    Science.gov (United States)

    Azatcam, Gokmen; Atalay, Nilgun Simsir; Akkaya, Nuray; Sahin, Fusun; Aksoy, Sibel; Zincir, Ozge; Topuz, Oya

    2017-01-01

    Although there are several studies of Transcutaneous Electrical Nerve Stimulation (TENS) and exercise in myofascial pain syndrome, there are no studies comparing the effectiveness of Kinesio Taping (KT) and TENS in myofascial pain syndrome patients. To compare the early and late effects of TENS and KT on pain, disability and range of motion in myofascial pain syndrome patients. Sixty-nine patients were divided into three groups randomly as TENS+Exercise, KT+Exercise and exercise groups. Visual Analogue Scale (VAS), pain threshold, Neck Disability Index and cervical contralateral lateral flexion were employed in the evaluation of the patients performed before treatment, after treatment and 3rd month after treatment. The VAS, pain threshold, Neck Disability Index and contralateral lateral flexion values were improved in all groups both in after treatment and 3rd month after treatment (pmyofascial pain syndrome patients. Addition of TENS or KT to the exercise therapy resulted in more significant improvement compared to exercise therapy alone with a more pronounced improvement in KT group compared to the TENS group in the early period. Because KT was found to be more effective in decreasing the pain and had the advantage of being used in every 3 days, it seems to be beneficial in acute painful periods in myofascial pain syndrome patients.

  5. Substantial effects of epimuscular myofascial force transmission on muscular mechanics have major implications on spastic muscle and remedial surgery

    NARCIS (Netherlands)

    Yucesoy, Can A.; Huijing, Peter A.

    2007-01-01

    The specific aim of this paper is to review the effects of epimuscular myofascial force transmission on muscular mechanics and present some new results on finite element modeling of non-isolated aponeurotomized muscle in order to discuss the dependency of mechanics of spastic muscle, as well as surg

  6. Mechanisms causing effects of muscle position on proximo-distal muscle force differences in extra-muscular myofascial force transmission.

    NARCIS (Netherlands)

    Yucesoy, C.A.; Maas, J.H.; Maas, Huub; Koopman, Hubertus F.J.M.; Grootenboer, H.J.; Huijing, P.A.J.B.M.

    2006-01-01

    Certain recent studies showed that extra-muscular myofascial force transmission affects the length–force characteristics of rat extensor digitorium longus (EDL) muscle significantly after distal or proximal lengthening. This suggested that the relative position of a muscle with respect to its

  7. The effect of abdominal drawing-in exercise and myofascial release on pain, flexibility, and balance of elderly females.

    Science.gov (United States)

    Yu, Seong Hun; Sim, Yong Hyeon; Kim, Myung Hoon; Bang, Ju Hee; Son, Kyung Hyun; Kim, Jae Woong; Kim, Hyun Jin

    2016-10-01

    [Purpose] This study is designed to compare the effects of abdominal drawing-in exercise and myofascial release on pain, flexibility, and balance of elderly females. [Subjects and Methods] Forty elderly females aged 65 or older who had complained of low back pain for three months or longer were selected as the subjects. They were randomly and equally assigned to either an abdominal drawing-in group or a myofascial release group. The subjects conducted exercise three times per week, 40 minutes each time, for eight weeks. As evaluation tools, visual analogue scale for pain, remodified schober test for flexibility, and upright posture with eye opening on hard platform, upright posture with eye closing on hard platform, upright posture with eye opening on soft platform, upright posture with eye closing on soft platform using tetrax for balance were used. [Results] The abdominal drawing-in exercise group saw significant difference in pain and balance after the exercise compared to before the exercise. The myofascial release group saw significant difference in pain and flexibility after exercise compared to before the exercise. [Conclusion] The above study showed that abdominal drawing-in exercise affected elderly females regarding pain and balance and myofascial release influenced their pain and flexibility.

  8. Extramuscular myofascial force transmission alters substantially the acute effects of surgical aponeurotomy: assessment by finite element modeling

    NARCIS (Netherlands)

    Yucesoy, Can; Koopman, Bart; Grootenboer, Henk; Huijing, Peter

    2007-01-01

    Effects of extramuscular myofascial force transmission on the acute effects of aponeurotomy were studied using finite element modeling and implications of such effects on surgery were discussed. Aponeurotomized EDL muscle of the rat was modeled in two conditions: (1) fully isolated (2) with intact

  9. A Framework for Understanding the Relationship between Descending Pain Modulation, Motor Corticospinal, and Neuroplasticity Regulation Systems in Chronic Myofascial Pain

    Science.gov (United States)

    Botelho, Leonardo M.; Morales-Quezada, Leon; Rozisky, Joanna R.; Brietzke, Aline P.; Torres, Iraci L. S.; Deitos, Alicia; Fregni, Felipe; Caumo, Wolnei

    2016-01-01

    Myofascial pain syndrome (MPS) is a leading cause of chronic musculoskeletal pain. However, its neurobiological mechanisms are not entirely elucidated. Given the complex interaction between the networks involved in pain process, our approach, to providing insights into the neural mechanisms of pain, was to investigate the relationship between neurophysiological, neurochemical and clinical outcomes such as corticospinal excitability. Recent evidence has demonstrated that three neural systems are affected in chronic pain: (i) motor corticospinal system; (ii) internal descending pain modulation system; and (iii) the system regulating neuroplasticity. In this cross-sectional study, we aimed to examine the relationship between these three central systems in patients with chronic MPS of whom do/do not respond to the Conditioned Pain Modulation Task (CPM-task). The CPM-task was to immerse her non-dominant hand in cold water (0−1°C) to produce a heterotopic nociceptive stimulus. Corticospinal excitability was the primary outcome; specifically, the motor evoked potential (MEP) and intracortical facilitation (ICF) as assessed by transcranial magnetic stimulation (TMS). Secondary outcomes were the cortical excitability parameters [current silent period (CSP) and short intracortical inhibition (SICI)], serum brain-derived neurotrophic factor (BDNF), heat pain threshold (HPT), and the disability related to pain (DRP). We included 33 women, (18–65 years old). The MANCOVA model using Bonferroni's Multiple Comparison Test revealed that non-responders (n = 10) compared to responders (n = 23) presented increased intracortical facilitation (ICF; mean ± SD) 1.43 (0.3) vs. 1.11 (0.12), greater motor-evoked potential amplitude (μV) 1.93 (0.54) vs. 1.40 (0.27), as well a higher serum BDNF (pg/Ml) 32.56 (9.95) vs. 25.59 (10.24), (P pain inhibition was associated with an increase in ICF, serum BDNF levels, and DRP. We propose a framework to explain the relationship and potential

  10. A Framework for Understanding the Relationship between Descending Pain Modulation, Motor Corticospinal, and Neuroplasticity Regulation Systems in Chronic Myofascial Pain.

    Science.gov (United States)

    Botelho, Leonardo M; Morales-Quezada, Leon; Rozisky, Joanna R; Brietzke, Aline P; Torres, Iraci L S; Deitos, Alicia; Fregni, Felipe; Caumo, Wolnei

    2016-01-01

    Myofascial pain syndrome (MPS) is a leading cause of chronic musculoskeletal pain. However, its neurobiological mechanisms are not entirely elucidated. Given the complex interaction between the networks involved in pain process, our approach, to providing insights into the neural mechanisms of pain, was to investigate the relationship between neurophysiological, neurochemical and clinical outcomes such as corticospinal excitability. Recent evidence has demonstrated that three neural systems are affected in chronic pain: (i) motor corticospinal system; (ii) internal descending pain modulation system; and (iii) the system regulating neuroplasticity. In this cross-sectional study, we aimed to examine the relationship between these three central systems in patients with chronic MPS of whom do/do not respond to the Conditioned Pain Modulation Task (CPM-task). The CPM-task was to immerse her non-dominant hand in cold water (0-1°C) to produce a heterotopic nociceptive stimulus. Corticospinal excitability was the primary outcome; specifically, the motor evoked potential (MEP) and intracortical facilitation (ICF) as assessed by transcranial magnetic stimulation (TMS). Secondary outcomes were the cortical excitability parameters [current silent period (CSP) and short intracortical inhibition (SICI)], serum brain-derived neurotrophic factor (BDNF), heat pain threshold (HPT), and the disability related to pain (DRP). We included 33 women, (18-65 years old). The MANCOVA model using Bonferroni's Multiple Comparison Test revealed that non-responders (n = 10) compared to responders (n = 23) presented increased intracortical facilitation (ICF; mean ± SD) 1.43 (0.3) vs. 1.11 (0.12), greater motor-evoked potential amplitude (μV) 1.93 (0.54) vs. 1.40 (0.27), as well a higher serum BDNF (pg/Ml) 32.56 (9.95) vs. 25.59 (10.24), (P pain inhibition was associated with an increase in ICF, serum BDNF levels, and DRP. We propose a framework to explain the relationship and potential

  11. Introduction to Latent Class Analysis with Applications

    Science.gov (United States)

    Porcu, Mariano; Giambona, Francesca

    2017-01-01

    Latent class analysis (LCA) is a statistical method used to group individuals (cases, units) into classes (categories) of an unobserved (latent) variable on the basis of the responses made on a set of nominal, ordinal, or continuous observed variables. In this article, we introduce LCA in order to demonstrate its usefulness to early adolescence…

  12. Introduction to Latent Class Analysis with Applications

    Science.gov (United States)

    Porcu, Mariano; Giambona, Francesca

    2017-01-01

    Latent class analysis (LCA) is a statistical method used to group individuals (cases, units) into classes (categories) of an unobserved (latent) variable on the basis of the responses made on a set of nominal, ordinal, or continuous observed variables. In this article, we introduce LCA in order to demonstrate its usefulness to early adolescence…

  13. Sampling Weights in Latent Variable Modeling

    Science.gov (United States)

    Asparouhov, Tihomir

    2005-01-01

    This article reviews several basic statistical tools needed for modeling data with sampling weights that are implemented in Mplus Version 3. These tools are illustrated in simulation studies for several latent variable models including factor analysis with continuous and categorical indicators, latent class analysis, and growth models. The…

  14. Latent Class and Latent Transition Analysis With Applications in the Social, Behavioral, and Health Sciences

    CERN Document Server

    Collins, Linda M

    2010-01-01

    One of the few books on latent class analysis (LCA) and latent transition analysis (LTA) with a comprehensive treatment of longitudinal latent class models, Latent Class and Latent Transition Analysis reflects improvements in statistical computing as the most up-to-date reference for theoretical, technical, and practical issues in cross-sectional and longitudinal data. Plentiful examples enable the reader to acquire a thorough conceptual and technical understanding and to apply techniques to address empirical research questions. Researchers seeking an advanced introduction to LCA and LTA and g

  15. Thermal temporal summation and decay of after-sensations in temporomandibular myofascial pain patients with and without comorbid fibromyalgia

    Directory of Open Access Journals (Sweden)

    Janal MN

    2016-09-01

    Full Text Available Malvin N Janal,1 Karen G Raphael,2 Dane B Cook,3 David A Sirois,2 Lena Nemelivsky,2 Roland Staud4 1Epidemiology and Health Promotion, 2Oral and Maxillofacial Pathology, Radiology, and Medicine, NYU College of Dentistry, New York, NY, 3Department of Kinesiology, University of Wisconsin, Madison, WI, 4Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA Introduction: Chronic myofascial temporomandibular disorders (TMD may have multiple etiological and maintenance factors. One potential factor, central pain sensitization, was quantified here as the response to the temporal summation (TS paradigm, and that response was compared between case and control groups. Objectives: As previous research has shown that fibromyalgia (FM is diagnosed in ~20% of TMD patients, Aim 1 determined whether central sensitization is found preferentially in myofascial TMD cases that have orofacial pain as a regional manifestation of FM. Aim 2 determined if the report of after-sensations (AS following TS varied depending on whether repeated stimuli were rated as increasingly painful. Methods: One hundred sixty-eight women, 43 controls, 100 myofascial TMD-only cases, and 25 myofascial TMD + FM cases, were compared on thermal warmth and pain thresholds, thermal TS, and decay of thermal AS. All cases met Research Diagnostic Criteria for TMD; comorbid cases also met the 1990 American College of Rheumatology criteria for FM. Results: Pain thresholds and TS were similar in all groups. When TS was achieved (~60%, significantly higher levels of AS were reported in the first poststimulus interval, and AS decayed more slowly over time, in myofascial TMD cases than controls. By contrast, groups showed similar AS decay patterns following steady state or decreasing responses to repetitive stimulation. Conclusion: In this case–control study, all myofascial TMD cases were characterized by a similar delay in the decay of AS. Thus, this indicator of

  16. Evaluation of laser therapy and routine treatment modalities in the management of myofascial pain dysfunction syndrome

    Directory of Open Access Journals (Sweden)

    Smriti B Jagdhari

    2015-01-01

    Full Text Available Objective: To evaluate the efficacy of laser as a monotherapy and in combination with exercise therapy in comparison to only exercise in the treatment of Myofascial Pain Dysfunction Syndrome (MPDS or Temporomandibular Myofascial Pain. Materials and Methods: A total of 60 patients with MPDS were included in the study and were randomly divided into three groups: exercise, laser, and the combination of both (exercise and laser. Results: Significant reduction in pain at rest and pain on movement was observed with all three types of treatment modalities. Pain reduction was more in those patients who received combination of exercise and laser therapy. Similarly, decrease in the muscle tenderness was more when combination of exercise and laser therapy was used. Conclusion: The ideal therapy should be fast, cheap, and have a long-term effect. Laser (Helium Neon as monotherapy or in combination with exercise had shown promising results and can be used as an effective treatment modality for the treatment of MPDS.

  17. Extracorporeal shock wave therapy in myofascial pain syndrome of upper trapezius.

    Science.gov (United States)

    Ji, Hye Min; Kim, Ho Jeong; Han, Soo Jeong

    2012-10-01

    To evaluate the effect of extracorporeal shock wave therapy (ESWT) in myofascial pain syndrome of upper trapezius with visual analogue scale (VAS) and pressure threshold by digital algometer. Twenty-two patients diagnosed with myofascial pain syndrome in upper trapezius were selected. They were assigned to treatment and standard care (control) groups balanced by age and sex, with eleven subjects in each group. The treated group had done four sessions of ESWT (0.056 mJ/mm(2), 1,000 impulses, semiweekly) while the control group was treated by the same protocol but with different energy levels applied, 0.001 mJ/mm(2). The VAS and pressure threshold were measured twice: before and after last therapy. We evaluated VAS of patients and measured the pressure threshold by using algometer. There were two withdrawals and the remaining 20 patients were three men and 17 women. Age was distributed with 11 patients in their twenties and 9 over 30 years old. There was no significant difference of age, sex, pre-VAS and pre-pressure threshold between 2 groups (p>0.05) found. The VAS significantly decreased from 4.91±1.76 to 2.27±1.27 in the treated group (pmyofascial pain syndrome of upper trapezius is effective to relieve pain after four times therapies in two weeks. But further study will be required with more patients, a broader age range and more males.

  18. [A comparative study of immune and clinical indicators in radicular and myofascial back pain].

    Science.gov (United States)

    Levashova, A I; Morozova, V S; Petrochenko, S N; Myagkova, М А; Moseikin, I A

    To compare immunochemical and clinical parameters in patients with chronic radicular and myofascial back pain. A study included 92 patients (55 men and 37 women) with radicular pain syndrome and 97 patients (33 men and 64 women) with myofascial pain syndrome. Pain status was assessed with the differential visual analogous scale (at rest, on movement, at night and during spontaneous pain). Tensor algometry was used to measure pain intolerance thresholds at day and night. Levels of natural antibodies (nAB) to endogenous pain regulators (β-endorphin, orphanin, serotonin, dopamine, histamine and angiotensin) were determined in the blood serum by ELISA. Patients were examined at admission to the hospital, on 10th and 21st days of treatment. There was a significant decrease in pain syndrome in all patients to the 21st day. Pain intensity was higher in patients with radicular pain syndrome (р<0.05) in all functional states. Pain intolerance thresholds were initially reduced in both groups. No significant between-group differences in the dynamics were not found either in men or women. Women had lower pain intolerance thresholds compared to men. An analysis of nAB profiles to pain regulators showed that they were correlated with higher and high indices, with the predominance of nAB to β-endorphin, orphanin and histamine in both groups. The increased levels of antibodies circulate in the blood serum of patients with dorsalgia for a long time can further be a factor of pain chronification.

  19. Latent inhibition in human adults without masking.

    Science.gov (United States)

    Escobar, Martha; Arcediano, Francisco; Miller, Ralph R

    2003-09-01

    Latent inhibition refers to attenuated responding to Cue X observed when the X-outcome pairings are preceded by X-alone presentations. It has proven difficult to obtain in human adults unless the preexposure (X-alone) presentations are embedded within a masking (i.e., distracting) task. The authors hypothesized that the difficulty in obtaining latent inhibition with unmasked tasks is related to the usual training procedures, in which the preexposure and conditioning experiences are separated by a set of instructions. Experiment 1 reports latent inhibition without masking in a task in which preexposure and conditioning occur without interruption. Experiments 2 and 3 demonstrate that this attenuation in responding to target Cue X does not pass a summation test for conditioned inhibition and is context specific, thereby confirming that it is latent inhibition. Experiments 3 and 4 confirm that introducing instructions between preexposure and conditioning disrupts latent inhibition.

  20. Treatment of Latent Tuberculosis Infection.

    Science.gov (United States)

    Haley, Connie A

    2017-04-01

    There are approximately 56 million people who harbor Mycobacterium tuberculosis that may progress to active tuberculosis (TB) at some point in their lives. Modeling studies suggest that if only 8% of these individuals with latent TB infection (LTBI) were treated annually, overall global incidence would be 14-fold lower by 2050 compared to incidence in 2013, even in the absence of additional TB control measures. This highlights the importance of identifying and treating latently infected individuals, and that this intervention must be scaled up to achieve the goals of the Global End TB Strategy. The efficacy of LTBI treatment is well established, and the most commonly used regimen is 9 months of daily self-administered isoniazid. However, its use has been hindered by limited provider awareness of the benefits, concern about potential side effects such as hepatotoxicity, and low rates of treatment completion. There is increasing evidence that shorter rifamycin-based regimens are as effective, better tolerated, and more likely to be completed compared to isoniazid. Such regimens include four months of daily self-administered rifampin monotherapy, three months of once weekly directly observed isoniazid-rifapentine, and three months of daily self-administered isoniazid-rifampin. The success of LTBI treatment to prevent additional TB disease relies upon choosing an appropriate regimen individualized to the patient, monitoring for potential adverse clinical events, and utilizing strategies to promote adherence. Safer, more cost-effective, and more easily completed regimens are needed and should be combined with interventions to better identify, engage, and retain high-risk individuals across the cascade from diagnosis through treatment completion of LTBI.

  1. Calo trigger acquisition system

    CERN Multimedia

    Franchini, Matteo

    2016-01-01

    Calo trigger acquisition system - Evolution of the acquisition system from a multiple boards system (upper, orange cables) to a single board one (below, light blue cables) where all the channels are collected in a single board.

  2. Aspartame-Triggered Migraine

    OpenAIRE

    J Gordon Millichap

    2001-01-01

    Two patients with known aspartame-triggered and rizatriptan-responsive migraine had their headaches worsened following use of an aspartame-containing formulation of rizatriptan (Maxalt-MLT), in a report from Albert Einstein College of Medicine, Bronx, NY.

  3. Calorimetry triggering in ATLAS

    CERN Document Server

    Igonkina, O; Adragna, P; Aharrouche, M; Alexandre, G; Andrei, V; Anduaga, X; Aracena, I; Backlund, S; Baines, J; Barnett, B M; Bauss, B; Bee, C; Behera, P; Bell, P; Bendel, M; Benslama, K; Berry, T; Bogaerts, A; Bohm, C; Bold, T; Booth, J R A; Bosman, M; Boyd, J; Bracinik, J; Brawn, I, P; Brelier, B; Brooks, W; Brunet, S; Bucci, F; Casadei, D; Casado, P; Cerri, A; Charlton, D G; Childers, J T; Collins, N J; Conde Muino, P; Coura Torres, R; Cranmer, K; Curtis, C J; Czyczula, Z; Dam, M; Damazio, D; Davis, A O; De Santo, A; Degenhardt, J; Delsart, P A; Demers, S; Demirkoz, B; Di Mattia, A; Diaz, M; Djilkibaev, R; Dobson, E; Dova, M, T; Dufour, M A; Eckweiler, S; Ehrenfeld, W; Eifert, T; Eisenhandler, E; Ellis, N; Emeliyanov, D; Enoque Ferreira de Lima, D; Faulkner, P J W; Ferland, J; Flacher, H; Fleckner, J E; Flowerdew, M; Fonseca-Martin, T; Fratina, S; Fhlisch, F; Gadomski, S; Gallacher, M P; Garitaonandia Elejabarrieta, H; Gee, C N P; George, S; Gillman, A R; Goncalo, R; Grabowska-Bold, I; Groll, M; Gringer, C; Hadley, D R; Haller, J; Hamilton, A; Hanke, P; Hauser, R; Hellman, S; Hidvgi, A; Hillier, S J; Hryn'ova, T; Idarraga, J; Johansen, M; Johns, K; Kalinowski, A; Khoriauli, G; Kirk, J; Klous, S; Kluge, E-E; Koeneke, K; Konoplich, R; Konstantinidis, N; Kwee, R; Landon, M; LeCompte, T; Ledroit, F; Lei, X; Lendermann, V; Lilley, J N; Losada, M; Maettig, S; Mahboubi, K; Mahout, G; Maltrana, D; Marino, C; Masik, J; Meier, K; Middleton, R P; Mincer, A; Moa, T; Monticelli, F; Moreno, D; Morris, J D; Mller, F; Navarro, G A; Negri, A; Nemethy, P; Neusiedl, A; Oltmann, B; Olvito, D; Osuna, C; Padilla, C; Panes, B; Parodi, F; Perera, V J O; Perez, E; Perez Reale, V; Petersen, B; Pinzon, G; Potter, C; Prieur, D P F; Prokishin, F; Qian, W; Quinonez, F; Rajagopalan, S; Reinsch, A; Rieke, S; Riu, I; Robertson, S; Rodriguez, D; Rogriquez, Y; Rhr, F; Saavedra, A; Sankey, D P C; Santamarina, C; Santamarina Rios, C; Scannicchio, D; Schiavi, C; Schmitt, K; Schultz-Coulon, H C; Schfer, U; Segura, E; Silverstein, D; Silverstein, S; Sivoklokov, S; Sjlin, J; Staley, R J; Stamen, R; Stelzer, J; Stockton, M C; Straessner, A; Strom, D; Sushkov, S; Sutton, M; Tamsett, M; Tan, C L A; Tapprogge, S; Thomas, J P; Thompson, P D; Torrence, E; Tripiana, M; Urquijo, P; Urrejola, P; Vachon, B; Vercesi, V; Vorwerk, V; Wang, M; Watkins, P M; Watson, A; Weber, P; Weidberg, T; Werner, P; Wessels, M; Wheeler-Ellis, S; Whiteson, D; Wiedenmann, W; Wielers, M; Wildt, M; Winklmeier, F; Wu, X; Xella, S; Zhao, L; Zobernig, H; de Seixas, J M; dos Anjos, A; Asman, B; Özcan, E

    2009-01-01

    The ATLAS experiment is preparing for data taking at 14 TeV collision energy. A rich discovery physics program is being prepared in addition to the detailed study of Standard Model processes which will be produced in abundance. The ATLAS multi-level trigger system is designed to accept one event in 2 105 to enable the selection of rare and unusual physics events. The ATLAS calorimeter system is a precise instrument, which includes liquid Argon electro-magnetic and hadronic components as well as a scintillator-tile hadronic calorimeter. All these components are used in the various levels of the trigger system. A wide physics coverage is ensured by inclusively selecting events with candidate electrons, photons, taus, jets or those with large missing transverse energy. The commissioning of the trigger system is being performed with cosmic ray events and by replaying simulated Monte Carlo events through the trigger and data acquisition system.

  4. Topological Trigger Developments

    CERN Document Server

    Likhomanenko, Tatiana

    2015-01-01

    The main b-physics trigger algorithm used by the LHCb experiment is the so-called topological trigger. The topological trigger selects vertices which are a) detached from the primary proton-proton collision and b) compatible with coming from the decay of a b-hadron. In the LHC Run 1, this trigger utilized a custom boosted decision tree algorithm, selected an almost 100% pure sample of b-hadrons with a typical efficiency of 60-70%, and its output was used in about 60% of LHCb papers. This talk presents studies carried out to optimize the topological trigger for LHC Run 2. In particular, we have carried out a detailed comparison of various machine learning classifier algorithms, e.g., AdaBoost, MatrixNet and uBoost. The topological trigger algorithm is designed to select all "interesting" decays of b-hadrons, but cannot be trained on every such decay. Studies have therefore been performed to determine how to optimize the performance of the classification algorithm on decays not used in the training. These inclu...

  5. LHCb Topological Trigger Reoptimization

    CERN Document Server

    Likhomanenko, Tatiana; Khairullin, Egor; Rogozhnikov, Alex; Ustyuzhanin, Andrey; Williams, Michael

    2015-01-01

    The main b-physics trigger algorithm used by the LHCb experiment is the so-called topological trigger. The topological trigger selects vertices which are a) detached from the primary proton-proton collision and b) compatible with coming from the decay of a b-hadron. In the LHC Run 1, this trigger, which utilized a custom boosted decision tree algorithm, selected a nearly 100% pure sample of b-hadrons with a typical efficiency of 60-70%; its output was used in about 60% of LHCb papers. This talk presents studies carried out to optimize the topological trigger for LHC Run 2. In particular, we have carried out a detailed comparison of various machine learning classifier algorithms, e.g., AdaBoost, MatrixNet and neural networks. The topological trigger algorithm is designed to select all "interesting" decays of b-hadrons, but cannot be trained on every such decay. Studies have therefore been performed to determine how to optimize the performance of the classification algorithm on decays not used in the training. ...

  6. Electromagnetic calorimeter trigger at Belle

    CERN Document Server

    Cheon, B G; Lee, S H; Won, E; Park, I C; Hur, T W; Park, C S; Kim, S K; Kim, H J; Kim, H O; Chu, T H; Usov, Y V; Aulchenko, V M; Kuzmin, A S; Bondar, A E; Shwartz, B A; Eidelman, S; Krokovnyi, P P; Hayashii, H; Sagawa, H; Fukushima, M

    2002-01-01

    The performance of CsI(Tl) electromagnetic calorimeter trigger system in the Belle experiment is described. Two kinds of trigger schemes have been taken into account, namely a total energy trigger and a cluster counting trigger which are complementary to each other. In addition, the system has provided the online/offline luminosity information using the Bhabha event trigger scheme. An upgrade of the trigger is discussed.

  7. COMPARISON OF ACTIVE RELEASE TECHNIQUE AND MYOFASCIAL RELEASE TECHNIQUE ON PAIN, GRIP STRENGTH & FUNCTIONAL PERFORMANCE IN PATIENTS WITH CHRONIC LATERAL EPICONDYLITIS

    Directory of Open Access Journals (Sweden)

    Parth Trivedi

    2014-06-01

    Full Text Available Background & Purpose: Lateral epicondylitis is the most common lesion of the elbow. Tennis elbow or lateral epicondylitis is defined as a syndrome of pain in the wrist extensor muscles at or near their lateral epicondyle origin or pain directly over the lateral epicondyle. So, the aim of this study was to compare the effectiveness of Active Release Technique (ART and Myofascial Release Technique (MFR in the treatment of Chronic Lateral Epicondylitis (CLE. Methodology: The study included thirty-six patients with Chronic Lateral Epicondylitis of age group range between 30 to 45 years. Patients were randomly divided into three groups: Control Group (A, Active Release Technique Group (B and Myofascial Release Technique Group (C. The patients were treated for 4 weeks and three outcome measures: 0-10 NPRS, Hand Dynamometer and PRTEE were taken for assessment and analysis at baseline and after 4th weeks was done. Result: In this study the result showed that Active Release Technique and Myofascial Release Technique were effective in all three outcome measures when compared to Control Group. Myofascial Release Technique was more effective in improving grip strength & reducing pain & disability when compared to Active Release Technique.(p<0.05 Conclusion: Active Release Technique and Myofascial Release Technique are effective in patients with Chronic Lateral Epicondylitis. Myofascial Release Technique demonstrated better outcomes than Active Release Technique in the management of Chronic Lateral Epicondylitis.

  8. Analysis of latent structures in linear systems

    DEFF Research Database (Denmark)

    Høskuldsson, Agnar

    2004-01-01

    that are useful, when studying latent structures. It is shown how loading weight vectors are generated and how they can be interpreted in analyzing the latent structure. It is shown how the covariance can be used to get useful ‘apriori’ information on the modeling task. Also some simple methods are presented...... to use for deciding if single or multiple latent structures should be used. The last part is about choosing the variables that should be used in the analysis. The traditional procedures to select variables to include in the model are presented and the insufficiencies of such approaches are demonstrated...

  9. The CMS trigger system

    Energy Technology Data Exchange (ETDEWEB)

    Khachatryan, Vardan; et al.

    2016-09-08

    This paper describes the CMS trigger system and its performance during Run 1 of the LHC. The trigger system consists of two levels designed to select events of potential physics interest from a GHz (MHz) interaction rate of proton-proton (heavy ion) collisions. The first level of the trigger is implemented in hardware, and selects events containing detector signals consistent with an electron, photon, muon, tau lepton, jet, or missing transverse energy. A programmable menu of up to 128 object-based algorithms is used to select events for subsequent processing. The trigger thresholds are adjusted to the LHC instantaneous luminosity during data taking in order to restrict the output rate to 100 kHz, the upper limit imposed by the CMS readout electronics. The second level, implemented in software, further refines the purity of the output stream, selecting an average rate of 400 Hz for offline event storage. The objectives, strategy and performance of the trigger system during the LHC Run 1 are described.

  10. The CMS trigger system

    CERN Document Server

    Khachatryan, Vardan; Tumasyan, Armen; Adam, Wolfgang; Aşılar, Ece; Bergauer, Thomas; Brandstetter, Johannes; Brondolin, Erica; Dragicevic, Marko; Erö, Janos; Flechl, Martin; Friedl, Markus; Fruehwirth, Rudolf; Ghete, Vasile Mihai; Hartl, Christian; Hörmann, Natascha; Hrubec, Josef; Jeitler, Manfred; Knünz, Valentin; König, Axel; Krammer, Manfred; Krätschmer, Ilse; Liko, Dietrich; Matsushita, Takashi; Mikulec, Ivan; Rabady, Dinyar; Rahbaran, Babak; Rohringer, Herbert; Schieck, Jochen; Schöfbeck, Robert; Strauss, Josef; Treberer-Treberspurg, Wolfgang; Waltenberger, Wolfgang; Wulz, Claudia-Elisabeth; Mossolov, Vladimir; Shumeiko, Nikolai; Suarez Gonzalez, Juan; Alderweireldt, Sara; Cornelis, Tom; De Wolf, Eddi A; Janssen, Xavier; Knutsson, Albert; Lauwers, Jasper; Luyckx, Sten; Van De Klundert, Merijn; Van Haevermaet, Hans; Van Mechelen, Pierre; Van Remortel, Nick; Van Spilbeeck, Alex; Abu Zeid, Shimaa; Blekman, Freya; D'Hondt, Jorgen; Daci, Nadir; De Bruyn, Isabelle; Deroover, Kevin; Heracleous, Natalie; Keaveney, James; Lowette, Steven; Moreels, Lieselotte; Olbrechts, Annik; Python, Quentin; Strom, Derek; Tavernier, Stefaan; Van Doninck, Walter; Van Mulders, Petra; Van Onsem, Gerrit Patrick; Van Parijs, Isis; Barria, Patrizia; Brun, Hugues; Caillol, Cécile; Clerbaux, Barbara; De Lentdecker, Gilles; Fasanella, Giuseppe; Favart, Laurent; Grebenyuk, Anastasia; Karapostoli, Georgia; Lenzi, Thomas; Léonard, Alexandre; Maerschalk, Thierry; Marinov, Andrey; Perniè, Luca; Randle-conde, Aidan; Reis, Thomas; Seva, Tomislav; Vander Velde, Catherine; Vanlaer, Pascal; Yonamine, Ryo; Zenoni, Florian; Zhang, Fengwangdong; Beernaert, Kelly; Benucci, Leonardo; Cimmino, Anna; Crucy, Shannon; Dobur, Didar; Fagot, Alexis; Garcia, Guillaume; Gul, Muhammad; Mccartin, Joseph; Ocampo Rios, Alberto Andres; Poyraz, Deniz; Ryckbosch, Dirk; Salva Diblen, Sinem; Sigamani, Michael; Strobbe, Nadja; Tytgat, Michael; Van Driessche, Ward; Yazgan, Efe; Zaganidis, Nicolas; Basegmez, Suzan; Beluffi, Camille; Bondu, Olivier; Brochet, Sébastien; Bruno, Giacomo; Caudron, Adrien; Ceard, Ludivine; Da Silveira, Gustavo Gil; Delaere, Christophe; Favart, Denis; Forthomme, Laurent; Giammanco, Andrea; Hollar, Jonathan; Jafari, Abideh; Jez, Pavel; Komm, Matthias; Lemaitre, Vincent; Mertens, Alexandre; Musich, Marco; Nuttens, Claude; Perrini, Lucia; Pin, Arnaud; Piotrzkowski, Krzysztof; Popov, Andrey; Quertenmont, Loic; Selvaggi, Michele; Vidal Marono, Miguel; Beliy, Nikita; Hammad, Gregory Habib; Aldá Júnior, Walter Luiz; Alves, Fábio Lúcio; Alves, Gilvan; Brito, Lucas; Correa Martins Junior, Marcos; Hamer, Matthias; Hensel, Carsten; Mora Herrera, Clemencia; Moraes, Arthur; Pol, Maria Elena; Rebello Teles, Patricia; Belchior Batista Das Chagas, Ewerton; Carvalho, Wagner; Chinellato, Jose; Custódio, Analu; Melo Da Costa, Eliza; De Jesus Damiao, Dilson; De Oliveira Martins, Carley; Fonseca De Souza, Sandro; Huertas Guativa, Lina Milena; Malbouisson, Helena; Matos Figueiredo, Diego; Mundim, Luiz; Nogima, Helio; Prado Da Silva, Wanda Lucia; Santoro, Alberto; Sznajder, Andre; Tonelli Manganote, Edmilson José; Vilela Pereira, Antonio; Ahuja, Sudha; Bernardes, Cesar Augusto; De Souza Santos, Angelo; Dogra, Sunil; Tomei, Thiago; De Moraes Gregores, Eduardo; Mercadante, Pedro G; Moon, Chang-Seong; Novaes, Sergio F; Padula, Sandra; Romero Abad, David; Ruiz Vargas, José Cupertino; Aleksandrov, Aleksandar; Hadjiiska, Roumyana; Iaydjiev, Plamen; Rodozov, Mircho; Stoykova, Stefka; Sultanov, Georgi; Vutova, Mariana; Dimitrov, Anton; Glushkov, Ivan; Litov, Leander; Pavlov, Borislav; Petkov, Peicho; Ahmad, Muhammad; Bian, Jian-Guo; Chen, Guo-Ming; Chen, He-Sheng; Chen, Mingshui; Cheng, Tongguang; Du, Ran; Jiang, Chun-Hua; Plestina, Roko; Romeo, Francesco; Shaheen, Sarmad Masood; Spiezia, Aniello; Tao, Junquan; Wang, Chunjie; Wang, Zheng; Zhang, Huaqiao; Asawatangtrakuldee, Chayanit; Ban, Yong; Li, Qiang; Liu, Shuai; Mao, Yajun; Qian, Si-Jin; Wang, Dayong; Xu, Zijun; Avila, Carlos; Cabrera, Andrés; Chaparro Sierra, Luisa Fernanda; Florez, Carlos; Gomez, Juan Pablo; Gomez Moreno, Bernardo; Sanabria, Juan Carlos; Godinovic, Nikola; Lelas, Damir; Puljak, Ivica; Ribeiro Cipriano, Pedro M; Antunovic, Zeljko; Kovac, Marko; Brigljevic, Vuko; Kadija, Kreso; Luetic, Jelena; Micanovic, Sasa; Sudic, Lucija; Attikis, Alexandros; Mavromanolakis, Georgios; Mousa, Jehad; Nicolaou, Charalambos; Ptochos, Fotios; Razis, Panos A; Rykaczewski, Hans; Bodlak, Martin; Finger, Miroslav; Finger Jr, Michael; Assran, Yasser; El Sawy, Mai; Elgammal, Sherif; Ellithi Kamel, Ali; Mahmoud, Mohammed; Calpas, Betty; Kadastik, Mario; Murumaa, Marion; Raidal, Martti; Tiko, Andres; Veelken, Christian; Eerola, Paula; Pekkanen, Juska; Voutilainen, Mikko; Härkönen, Jaakko; Karimäki, Veikko; Kinnunen, Ritva; Lampén, Tapio; Lassila-Perini, Kati; Lehti, Sami; Lindén, Tomas; Luukka, Panja-Riina; Mäenpää, Teppo; Peltola, Timo; Tuominen, Eija; Tuominiemi, Jorma; Tuovinen, Esa; Wendland, Lauri; Talvitie, Joonas; Tuuva, Tuure; Besancon, Marc; Couderc, Fabrice; Dejardin, Marc; Denegri, Daniel; Fabbro, Bernard; Faure, Jean-Louis; Favaro, Carlotta; Ferri, Federico; Ganjour, Serguei; Givernaud, Alain; Gras, Philippe; Hamel de Monchenault, Gautier; Jarry, Patrick; Locci, Elizabeth; Machet, Martina; Malcles, Julie; Rander, John; Rosowsky, André; Titov, Maksym; Zghiche, Amina; Antropov, Iurii; Baffioni, Stephanie; Beaudette, Florian; Busson, Philippe; Cadamuro, Luca; Chapon, Emilien; Charlot, Claude; Dahms, Torsten; Davignon, Olivier; Filipovic, Nicolas; Florent, Alice; Granier de Cassagnac, Raphael; Lisniak, Stanislav; Mastrolorenzo, Luca; Miné, Philippe; Naranjo, Ivo Nicolas; Nguyen, Matthew; Ochando, Christophe; Ortona, Giacomo; Paganini, Pascal; Pigard, Philipp; Regnard, Simon; Salerno, Roberto; Sauvan, Jean-Baptiste; Sirois, Yves; Strebler, Thomas; Yilmaz, Yetkin; Zabi, Alexandre; Agram, Jean-Laurent; Andrea, Jeremy; Aubin, Alexandre; Bloch, Daniel; Brom, Jean-Marie; Buttignol, Michael; Chabert, Eric Christian; Chanon, Nicolas; Collard, Caroline; Conte, Eric; Coubez, Xavier; Fontaine, Jean-Charles; Gelé, Denis; Goerlach, Ulrich; Goetzmann, Christophe; Le Bihan, Anne-Catherine; Merlin, Jeremie Alexandre; Skovpen, Kirill; Van Hove, Pierre; Gadrat, Sébastien; Beauceron, Stephanie; Bernet, Colin; Boudoul, Gaelle; Bouvier, Elvire; Carrillo Montoya, Camilo Andres; Chierici, Roberto; Contardo, Didier; Courbon, Benoit; Depasse, Pierre; El Mamouni, Houmani; Fan, Jiawei; Fay, Jean; Gascon, Susan; Gouzevitch, Maxime; Ille, Bernard; Lagarde, Francois; Laktineh, Imad Baptiste; Lethuillier, Morgan; Mirabito, Laurent; Pequegnot, Anne-Laure; Perries, Stephane; Ruiz Alvarez, José David; Sabes, David; Sgandurra, Louis; Sordini, Viola; Vander Donckt, Muriel; Verdier, Patrice; Viret, Sébastien; Toriashvili, Tengizi; Tsamalaidze, Zviad; Autermann, Christian; Beranek, Sarah; Edelhoff, Matthias; Feld, Lutz; Heister, Arno; Kiesel, Maximilian Knut; Klein, Katja; Lipinski, Martin; Ostapchuk, Andrey; Preuten, Marius; Raupach, Frank; Schael, Stefan; Schulte, Jan-Frederik; Verlage, Tobias; Weber, Hendrik; Wittmer, Bruno; Zhukov, Valery; Ata, Metin; Brodski, Michael; Dietz-Laursonn, Erik; Duchardt, Deborah; Endres, Matthias; Erdmann, Martin; Erdweg, Sören; Esch, Thomas; Fischer, Robert; Güth, Andreas; Hebbeker, Thomas; Heidemann, Carsten; Hoepfner, Kerstin; Klingebiel, Dennis; Knutzen, Simon; Kreuzer, Peter; Merschmeyer, Markus; Meyer, Arnd; Millet, Philipp; Olschewski, Mark; Padeken, Klaas; Papacz, Paul; Pook, Tobias; Radziej, Markus; Reithler, Hans; Rieger, Marcel; Scheuch, Florian; Sonnenschein, Lars; Teyssier, Daniel; Thüer, Sebastian; Cherepanov, Vladimir; Erdogan, Yusuf; Flügge, Günter; Geenen, Heiko; Geisler, Matthias; Hoehle, Felix; Kargoll, Bastian; Kress, Thomas; Kuessel, Yvonne; Künsken, Andreas; Lingemann, Joschka; Nehrkorn, Alexander; Nowack, Andreas; Nugent, Ian Michael; Pistone, Claudia; Pooth, Oliver; Stahl, Achim; Aldaya Martin, Maria; Asin, Ivan; Bartosik, Nazar; Behnke, Olaf; Behrens, Ulf; Bell, Alan James; Borras, Kerstin; Burgmeier, Armin; Campbell, Alan; Choudhury, Somnath; Costanza, Francesco; Diez Pardos, Carmen; Dolinska, Ganna; Dooling, Samantha; Dorland, Tyler; Eckerlin, Guenter; Eckstein, Doris; Eichhorn, Thomas; Flucke, Gero; Gallo, Elisabetta; Garay Garcia, Jasone; Geiser, Achim; Gizhko, Andrii; Gunnellini, Paolo; Hauk, Johannes; Hempel, Maria; Jung, Hannes; Kalogeropoulos, Alexis; Karacheban, Olena; Kasemann, Matthias; Katsas, Panagiotis; Kieseler, Jan; Kleinwort, Claus; Korol, Ievgen; Lange, Wolfgang; Leonard, Jessica; Lipka, Katerina; Lobanov, Artur; Lohmann, Wolfgang; Mankel, Rainer; Marfin, Ihar; Melzer-Pellmann, Isabell-Alissandra; Meyer, Andreas Bernhard; Mittag, Gregor; Mnich, Joachim; Mussgiller, Andreas; Naumann-Emme, Sebastian; Nayak, Aruna; Ntomari, Eleni; Perrey, Hanno; Pitzl, Daniel; Placakyte, Ringaile; Raspereza, Alexei; Roland, Benoit; Sahin, Mehmet Özgür; Saxena, Pooja; Schoerner-Sadenius, Thomas; Schröder, Matthias; Seitz, Claudia; Spannagel, Simon; Trippkewitz, Karim Damun; Walsh, Roberval; Wissing, Christoph; Blobel, Volker; Centis Vignali, Matteo; Draeger, Arne-Rasmus; Erfle, Joachim; Garutti, Erika; Goebel, Kristin; Gonzalez, Daniel; Görner, Martin; Haller, Johannes; Hoffmann, Malte; Höing, Rebekka Sophie; Junkes, Alexandra; Klanner, Robert; Kogler, Roman; Kovalchuk, Nataliia; Lapsien, Tobias; Lenz, Teresa; Marchesini, Ivan; Marconi, Daniele; Meyer, Mareike; Nowatschin, Dominik; Ott, Jochen; Pantaleo, Felice; Peiffer, Thomas; Perieanu, Adrian; Pietsch, Niklas; Poehlsen, Jennifer; Rathjens, Denis; Sander, Christian; Scharf, Christian; Schettler, Hannes; Schleper, Peter; Schlieckau, Eike; Schmidt, Alexander; Schwandt, Joern; Sola, Valentina; Stadie, Hartmut; Steinbrück, Georg; Tholen, Heiner; Troendle, Daniel; Usai, Emanuele; Vanelderen, Lukas; Vanhoefer, Annika; Vormwald, Benedikt; Akbiyik, Melike; Barth, Christian; Baus, Colin; Berger, Joram; Böser, Christian; Butz, Erik; Chwalek, Thorsten; Colombo, Fabio; De Boer, Wim; Descroix, Alexis; Dierlamm, Alexander; Fink, Simon; Frensch, Felix; Friese, Raphael; Giffels, Manuel; Gilbert, Andrew; Haitz, Dominik; Hartmann, Frank; Heindl, Stefan Michael; Husemann, Ulrich; Katkov, Igor; Kornmayer, Andreas; Lobelle Pardo, Patricia; Maier, Benedikt; Mildner, Hannes; Mozer, Matthias Ulrich; Müller, Thomas; Müller, Thomas; Plagge, Michael; Quast, Gunter; Rabbertz, Klaus; Röcker, Steffen; Roscher, Frank; Sieber, Georg; Simonis, Hans-Jürgen; Stober, Fred-Markus Helmut; Ulrich, Ralf; Wagner-Kuhr, Jeannine; Wayand, Stefan; Weber, Marc; Weiler, Thomas; Wöhrmann, Clemens; Wolf, Roger; Anagnostou, Georgios; Daskalakis, Georgios; Geralis, Theodoros; Giakoumopoulou, Viktoria Athina; Kyriakis, Aristotelis; Loukas, Demetrios; Psallidas, Andreas; Topsis-Giotis, Iasonas; Agapitos, Antonis; Kesisoglou, Stilianos; Panagiotou, Apostolos; Saoulidou, Niki; Tziaferi, Eirini; Evangelou, Ioannis; Flouris, Giannis; Foudas, Costas; Kokkas, Panagiotis; Loukas, Nikitas; Manthos, Nikolaos; Papadopoulos, Ioannis; Paradas, Evangelos; Strologas, John; Bencze, Gyorgy; Hajdu, Csaba; Hazi, Andras; Hidas, Pàl; Horvath, Dezso; Sikler, Ferenc; Veszpremi, Viktor; Vesztergombi, Gyorgy; Zsigmond, Anna Julia; Beni, Noemi; Czellar, Sandor; Karancsi, János; Molnar, Jozsef; Szillasi, Zoltan; Bartók, Márton; Makovec, Alajos; Raics, Peter; Trocsanyi, Zoltan Laszlo; Ujvari, Balazs; Mal, Prolay; Mandal, Koushik; Sahoo, Deepak Kumar; Sahoo, Niladribihari; Swain, Sanjay Kumar; Bansal, Sunil; Beri, Suman Bala; Bhatnagar, Vipin; Chawla, Ridhi; Gupta, Ruchi; Bhawandeep, Bhawandeep; Kalsi, Amandeep Kaur; Kaur, Anterpreet; Kaur, Manjit; Kumar, Ramandeep; Mehta, Ankita; Mittal, Monika; Singh, Jasbir; Walia, Genius; Kumar, Ashok; Bhardwaj, Ashutosh; Choudhary, Brajesh C; Garg, Rocky Bala; Kumar, Ajay; Malhotra, Shivali; Naimuddin, Md; Nishu, Nishu; Ranjan, Kirti; Sharma, Ramkrishna; Sharma, Varun; Bhattacharya, Satyaki; Chatterjee, Kalyanmoy; Dey, Sourav; Dutta, Suchandra; Jain, Sandhya; Majumdar, Nayana; Modak, Atanu; Mondal, Kuntal; Mukherjee, Swagata; Mukhopadhyay, Supratik; Roy, Ashim; Roy, Debarati; Roy Chowdhury, Suvankar; Sarkar, Subir; Sharan, Manoj; Abdulsalam, Abdulla; Chudasama, Ruchi; Dutta, Dipanwita; Jha, Vishwajeet; Kumar, Vineet; Mohanty, Ajit Kumar; Pant, Lalit Mohan; Shukla, Prashant; Topkar, Anita; Aziz, Tariq; Banerjee, Sudeshna; Bhowmik, Sandeep; Chatterjee, Rajdeep Mohan; Dewanjee, Ram Krishna; Dugad, Shashikant; Ganguly, Sanmay; Ghosh, Saranya; Guchait, Monoranjan; Gurtu, Atul; Kole, Gouranga; Kumar, Sanjeev; Mahakud, Bibhuprasad; Maity, Manas; Majumder, Gobinda; Mazumdar, Kajari; Mitra, Soureek; Mohanty, Gagan Bihari; Parida, Bibhuti; Sarkar, Tanmay; Sur, Nairit; Sutar, Bajrang; Wickramage, Nadeesha; Chauhan, Shubhanshu; Dube, Sourabh; Kothekar, Kunal; Sharma, Seema; Bakhshiansohi, Hamed; Behnamian, Hadi; Etesami, Seyed Mohsen; Fahim, Ali; Goldouzian, Reza; Khakzad, Mohsen; Mohammadi Najafabadi, Mojtaba; Naseri, Mohsen; Paktinat Mehdiabadi, Saeid; Rezaei Hosseinabadi, Ferdos; Safarzadeh, Batool; Zeinali, Maryam; Felcini, Marta; Grunewald, Martin; Abbrescia, Marcello; Calabria, Cesare; Caputo, Claudio; Colaleo, Anna; Creanza, Donato; Cristella, Leonardo; De Filippis, Nicola; De Palma, Mauro; Fiore, Luigi; Iaselli, Giuseppe; Maggi, Giorgio; Maggi, Marcello; Miniello, Giorgia; My, Salvatore; Nuzzo, Salvatore; Pompili, Alexis; Pugliese, Gabriella; Radogna, Raffaella; Ranieri, Antonio; Selvaggi, Giovanna; Silvestris, Lucia; Venditti, Rosamaria; Verwilligen, Piet; Abbiendi, Giovanni; Battilana, Carlo; Benvenuti, Alberto; Bonacorsi, Daniele; Braibant-Giacomelli, Sylvie; Brigliadori, Luca; Campanini, Renato; Capiluppi, Paolo; Castro, Andrea; Cavallo, Francesca Romana; Chhibra, Simranjit Singh; Codispoti, Giuseppe; Cuffiani, Marco; Dallavalle, Gaetano-Marco; Fabbri, Fabrizio; Fanfani, Alessandra; Fasanella, Daniele; Giacomelli, Paolo; Grandi, Claudio; Guiducci, Luigi; Marcellini, Stefano; Masetti, Gianni; Montanari, Alessandro; Navarria, Francesco; Perrotta, Andrea; Rossi, Antonio; Rovelli, Tiziano; Siroli, Gian Piero; Tosi, Nicolò; Travaglini, Riccardo; Cappello, Gigi; Chiorboli, Massimiliano; Costa, Salvatore; Di Mattia, Alessandro; Giordano, Ferdinando; Potenza, Renato; Tricomi, Alessia; Tuve, Cristina; Barbagli, Giuseppe; Ciulli, Vitaliano; Civinini, Carlo; D'Alessandro, Raffaello; Focardi, Ettore; Gonzi, Sandro; Gori, Valentina; Lenzi, Piergiulio; Meschini, Marco; Paoletti, Simone; Sguazzoni, Giacomo; Tropiano, Antonio; Viliani, Lorenzo; Benussi, Luigi; Bianco, Stefano; Fabbri, Franco; Piccolo, Davide; Primavera, Federica; Calvelli, Valerio; Ferro, Fabrizio; Lo Vetere, Maurizio; Monge, Maria Roberta; Robutti, Enrico; Tosi, Silvano; Brianza, Luca; Dinardo, Mauro Emanuele; Fiorendi, Sara; Gennai, Simone; Gerosa, Raffaele; Ghezzi, Alessio; Govoni, Pietro; Malvezzi, Sandra; Manzoni, Riccardo Andrea; Marzocchi, Badder; Menasce, Dario; Moroni, Luigi; Paganoni, Marco; Pedrini, Daniele; Ragazzi, Stefano; Redaelli, Nicola; Tabarelli de Fatis, Tommaso; Buontempo, Salvatore; Cavallo, Nicola; Di Guida, Salvatore; Esposito, Marco; Fabozzi, Francesco; Iorio, Alberto Orso Maria; Lanza, Giuseppe; Lista, Luca; Meola, Sabino; Merola, Mario; Paolucci, Pierluigi; Sciacca, Crisostomo; Thyssen, Filip; Bacchetta, Nicola; Bellato, Marco; Benato, Lisa; Bisello, Dario; Boletti, Alessio; Carlin, Roberto; Checchia, Paolo; Dall'Osso, Martino; Dosselli, Umberto; Gasparini, Fabrizio; Gasparini, Ugo; Gozzelino, Andrea; Lacaprara, Stefano; Margoni, Martino; Meneguzzo, Anna Teresa; Montecassiano, Fabio; Passaseo, Marina; Pazzini, Jacopo; Pegoraro, Matteo; Pozzobon, Nicola; Simonetto, Franco; Torassa, Ezio; Tosi, Mia; Vanini, Sara; Ventura, Sandro; Zanetti, Marco; Zotto, Pierluigi; Zucchetta, Alberto; Zumerle, Gianni; Braghieri, Alessandro; Magnani, Alice; Montagna, Paolo; Ratti, Sergio P; Re, Valerio; Riccardi, Cristina; Salvini, Paola; Vai, Ilaria; Vitulo, Paolo; Alunni Solestizi, Luisa; Biasini, Maurizio; Bilei, Gian Mario; Ciangottini, Diego; Fanò, Livio; Lariccia, Paolo; Mantovani, Giancarlo; Menichelli, Mauro; Saha, Anirban; Santocchia, Attilio; Androsov, Konstantin; Azzurri, Paolo; Bagliesi, Giuseppe; Bernardini, Jacopo; Boccali, Tommaso; Castaldi, Rino; Ciocci, Maria Agnese; Dell'Orso, Roberto; Donato, Silvio; Fedi, Giacomo; Foà, Lorenzo; Giassi, Alessandro; Grippo, Maria Teresa; Ligabue, Franco; Lomtadze, Teimuraz; Martini, Luca; Messineo, Alberto; Palla, Fabrizio; Rizzi, Andrea; Savoy-Navarro, Aurore; Serban, Alin Titus; Spagnolo, Paolo; Tenchini, Roberto; Tonelli, Guido; Venturi, Andrea; Verdini, Piero Giorgio; Barone, Luciano; Cavallari, Francesca; D'imperio, Giulia; Del Re, Daniele; Diemoz, Marcella; Gelli, Simone; Jorda, Clara; Longo, Egidio; Margaroli, Fabrizio; Meridiani, Paolo; Organtini, Giovanni; Paramatti, Riccardo; Preiato, Federico; Rahatlou, Shahram; Rovelli, Chiara; Santanastasio, Francesco; Traczyk, Piotr; Amapane, Nicola; Arcidiacono, Roberta; Argiro, Stefano; Arneodo, Michele; Bellan, Riccardo; Biino, Cristina; Cartiglia, Nicolo; Costa, Marco; Covarelli, Roberto; Degano, Alessandro; Demaria, Natale; Finco, Linda; Kiani, Bilal; Mariotti, Chiara; Maselli, Silvia; Migliore, Ernesto; Monaco, Vincenzo; Monteil, Ennio; Obertino, Maria Margherita; Pacher, Luca; Pastrone, Nadia; Pelliccioni, Mario; Pinna Angioni, Gian Luca; Ravera, Fabio; Romero, Alessandra; Ruspa, Marta; Sacchi, Roberto; Solano, Ada; Staiano, Amedeo; Tamponi, Umberto; Belforte, Stefano; Candelise, Vieri; Casarsa, Massimo; Cossutti, Fabio; Della Ricca, Giuseppe; Gobbo, Benigno; La Licata, Chiara; Marone, Matteo; Schizzi, Andrea; Zanetti, Anna; Kropivnitskaya, Anna; Nam, Soon-Kwon; Kim, Dong Hee; Kim, Gui Nyun; Kim, Min Suk; Kong, Dae Jung; Lee, Sangeun; Oh, Young Do; Sakharov, Alexandre; Son, Dong-Chul; Brochero Cifuentes, Javier Andres; Kim, Hyunsoo; Kim, Tae Jeong; Song, Sanghyeon; Choi, Suyong; Go, Yeonju; Gyun, Dooyeon; Hong, Byung-Sik; Jo, Mihee; Kim, Hyunchul; Kim, Yongsun; Lee, Byounghoon; Lee, Kisoo; Lee, Kyong Sei; Lee, Songkyo; Park, Sung Keun; Roh, Youn; Yoo, Hwi Dong; Choi, Minkyoo; Kim, Hyunyong; Kim, Ji Hyun; Lee, Jason Sang Hun; Park, Inkyu; Ryu, Geonmo; Ryu, Min Sang; Choi, Young-Il; Goh, Junghwan; Kim, Donghyun; Kwon, Eunhyang; Lee, Jongseok; Yu, Intae; Dudenas, Vytautas; Juodagalvis, Andrius; Vaitkus, Juozas; Ahmed, Ijaz; Ibrahim, Zainol Abidin; Komaragiri, Jyothsna Rani; Md Ali, Mohd Adli Bin; Mohamad Idris, Faridah; Wan Abdullah, Wan Ahmad Tajuddin; Yusli, Mohd Nizam; Casimiro Linares, Edgar; Castilla-Valdez, Heriberto; De La Cruz-Burelo, Eduard; Heredia-De La Cruz, Ivan; Hernandez-Almada, Alberto; Lopez-Fernandez, Ricardo; Sánchez Hernández, Alberto; Carrillo Moreno, Salvador; Vazquez Valencia, Fabiola; Pedraza, Isabel; Salazar Ibarguen, Humberto Antonio; Morelos Pineda, Antonio; Krofcheck, David; Butler, Philip H; Ahmad, Ashfaq; Ahmad, Muhammad; Hassan, Qamar; Hoorani, Hafe