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.
The goal of this double-blinded, randomized, controlled study was to confirm the effectiveness of the cervical facet joint injection in treating shoulder pain with the myofascial trigger point in the upper trapezius muscle secondary to cervical facet lesion. Eighty-nine patients with chronic unilateral shoulder pain due to myofascial trigger points in the upper trapezius muscle received an injection to the C4-5 facet joint in the experimental group and to the corresponding unilateral multifidi muscle in the control group. Subjective pain intensity and pressure pain threshold of the myofascial trigger point were assessed, and the prevalence of endplate noise in the myofascial trigger point region was measured in 28 patients before, immediately after, and 1 month after the injection. Half of the patients in the experimental group, but none of the control patients, reported being completely pain free 1 month after the injection. Both the decrease in the pain intensity and the increase in pressure pain threshold were significantly more in the experimental group than in the control group either immediately or 1 month after the injection. There was no significant difference in the change of endplate noise prevalence between the 2 groups. This study demonstrates that intra-articular or peri-articular injection into the cervical facet joint region can effectively inactivate the upper trapezius myofascial trigger point secondary to the facet lesion.
Cervical traction is a physical therapy procedure frequently used to treat cervical disk lesions, cervical spondylosis, and cervical facet joint lesions. We have observed rare cases of side effects in elderly patients, but not in women younger than 30 years.In this pilot study, 96 young women were randomly divided into 3 groups to study the effect of cervical traction with different traction weights on blood pressure, heart rate, heart rate variability, and correlated autonomic adjustment. Cervical traction weight used was 10% of the patient's body weight in group A (n=32), 20% in group B (n=32), and 30% in group C (n=32). Assessments of blood pressure, heart rate, heart rate variability, percentage of high- and low-frequency signals, and low-frequency/high-frequency ratio were performed before, during, and 20 minutes after traction. We found that systolic blood pressure, diastolic blood pressure, and heart rate variability elevated during cervical traction and returned nearly to original levels immediately after traction in group C, but not in groups A or B. There were no significant changes in heart rate, percentage of high- or low-frequency signals, and low-frequency/high-frequency ratio in all 3 groups during or after cervical traction.Cervical traction with a traction weight approximately 10% to 20% of body weight can be safely provided without significant compromise of cardiovascular function. However, heavy traction weight (30% of body weight) should be avoided, especially for a patient with cardiovascular disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.