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.
IntroductionMyofascial pain syndrome (MPS) is a common cause of musculoskeletal pain characterised by trigger points (MTrPs), that is tender loci in taut bands of skeletal muscle, limited range of motion in joints, referred pain and local twitch responses (LTRs) during mechanical stimulation of the MTrPs. 1 Inactivation of MTrPs is essential in managing MPS and several methods have been recommended. The treatments most commonly used for this purpose are dry needling of the MTrPs, injection treatments with local anaesthetics or saline, sprays, and stretching.
2According to the results of several studies, injection continues to be the most effective choice for treatment. The superiority of local injection or dry needling for the inactivation of MTrPs is controversial, [2][3][4][5][6][7][8] and hollow needles were used for dry needling in these studies. 2;6 Gunn suggests that the 'hollow needle' induces more tissue injury and is more painful than a 'pointed-tip needle '. 9 In this single-blinded randomised trial, we compared the efficacies and adverse events of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome.
Method
ParticipantsWe obtained retrospective ethical approval from the institutional review board of Inha University Hospital. We selected 40 subjects with chronic MPS of the upper trapezius from volunteers at four communitybased facilities; one further subject proved unable to complete the necessary forms. Subjects were selected on the basis of physical examination and interview, and signed informed consent was obtained. Participants were randomised into two groups by coin-toss: 1) ACU (acupuncture needling) group and 2) TPI (trigger point injection with 0.5% lidocaine) group.Inclusion criteria for the trial were 1) aged more than 60 years old; 2) complaining of chronic shoulder
AbstractAim To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients. Methods Thirty nine participants with myofascial pain syndrome of one or both upper trapezius muscles were randomised to treatment with either acupuncture needling (n=18) or 0.5% lidocaine injection (n=21) at all the trigger points on days 0, 7 and 14, in a single-blinded study. Pain scores, range of neck movement, pressure pain intensity and depression were measured up to four weeks from the first treatment. Results Local twitch responses were elicited at least once in 94.9% of all subjects. Both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point up to one month. Overall, the range of cervical movement improved in both groups, apart from extension in the acupuncture needling group. Changes in depression showed only trends. Conclusion There was no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating myofascial pain syndrome in elderly patients.
Although non-scarring diffuse hair loss has been frequently observed in systemic lupus erythematosus (SLE) patients, the pattern of hair loss with regard to its frequency in SLE has been rarely studied. The aim of this cross-sectional study was to evaluate the hair loss patterns in SLE during the course of disease. We evaluated 122 SLE patients (age range, 13-71 years; mean age, 32.7 +/- 10.6; female : male ratio, 12.6:1), by conducting interviews about hair loss patterns before and after a diagnosis of SLE using a questionnaire format. History taking and physical examinations were done at the time of interview, and photographs were taken to discriminate the active LE-specific scarring hair loss from the LE-nonspecific diffuse hair loss. Frequency and correlation analysis were performed on the data from the interviews and photographs for determining their relation with the SLE Disease Activity Index (SLEDAI). We found that 104 patients experienced at least one hair loss event before or during the course of SLE. Eighteen patients experienced patch alopecia, including eight who experienced this malady both before and after the diagnosis; thus, the overall prevalence of patch alopecia was 14.8% (18/122). Eighty-six patients experienced hair loss after diagnosis, of which non-scarring diffuse hair loss was the most common pattern (65.1%, 56/86) followed by non-scarring patch alopecia (15.1%, 13/86). The interview survey failed to identify a statistically significant relationship between the hair loss pattern and the SLEDAI. Our results suggest that non-scarring patch alopecia is also an important pattern in SLE that should be included in the differential diagnosis of alopecia areata and confirmed by histopathological examination.
There is an urgent need for increased awareness about travel-related infectious diseases (especially malaria) among Korean travelers, and they should be encouraged to seek pretravel health information.
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