A new insight into the management of myofascial pain syndrome

Abstract

Myofascial pain syndrome (MPS) is a musculoskeletal disorder which is characterized by pain, muscle spasms, and muscle tenderness, as well as a limited range of motion, weakness, and rarely, autonomous dysfunction. Management includes exercise programs in particular, and many other invasive and non-invasive therapies, depending on the clinical status of the patient. The main options include medical therapies with analgesics, myorelaxants and antidepressants, hot pack therapy, exercise, stretch and spray therapy, ischemic compression, therapeutic massage, biofeedback, transcutaneous electrical nerve stimulation (TENS), ultrasound (US), interferential (IFA) current, low-energy light amplification by stimulated emission of radiation (LASER), extracorporeal shock wave therapy (ESWT), trigger point injections, dry needling, and acupuncture. There is growing evidence that trigger point injections and dry needling, as well as stretching exercises, are effective alternatives in the management of MPS. Management success is primarily based on the cooperation of the patient and the treating physician and the elimination of predisposing factors.

Comparison of the Effectiveness of Transcutaneous Electrical Nerve Stimulation and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome

“…7,32 Participants were then provided with advice on correct posture (standing, sitting, sleeping, working) and treatment exercises (AROM, stretching, strengthening and scapular stability exercises for upper trapezius) to carry out at home each day until the completion of final measurement. [33][34][35] For each exercise, the participants were asked to perform one set of 10 reps three times a day. The patients were trained on correct posture and how to undertake exercises by the principal investigator at the end of the first treatment session.…”

Myofascial Pain Syndrome: A Concise Update on Clinical, Diagnostic and Integrative and Alternative Therapeutic Perspectives

“…Other effective methods are manual therapies such as post-isometric relaxation, trigger point compression, muscle energy technique, myotherapy, and myofascial massage therapy [1][2][3]20,42]. Furthermore, extracorporeal shock wave (ESWT) and low energy laser therapy significantly reduce pain in patients with MPS [1][2][3]43].…”

“…However in a RCT, when TENS is combined with ultrasound phonophoresis (and compared with diclofenac phonophoresis, phonophoresis alone, and Sham ultrasound) three of them rapidly deactivated tender MTrPs and reduced pain intensity (by increasing pain threshold) but range of motion remained unaffected [45]. Besides local anesthetic injection into MTrPs (such as, procaine, lidocaine, bupivacaine, prilocaine etc), dry needling (or needling with saline used earlier) is a useful technique (but reportedly painful) in which a small needle is effectively used to release MTrPs and associated symptoms including pain and referred pain [43]. The injections of local anesthetics are reported to have severe adverse effects such as muscle necrosis, fatal anaphylactic shock (in a susceptible person), and dose-related toxic effects.…”

“…Fluoromethane spray is not used because it is highly inflammable linked with accidental death and toxic effects on the ozone layer [1]. Currently, medical acupuncture needles associated with minimal pain and tissue injury are frequently used effectively in the treatment of patients with MTrP and MPS [43,47]. Surprisingly, needling of surrounding zone of MTrP or directly into it has similar therapeutic effect [1].…”

Effectiveness of mobilization practices for patients with neck pain due to myofascial pain syndrome: a randomized clinical trial

“…Myofascial pain syndrome (MPS) is a regional pain syndrome characterized by taut bands inside muscles or myofascial structures which are known as trigger points and sensory (hyperalgesia, dysesthesia, hypersensitivity, referred pain), motor (local twitching response, muscle spasm, decreased muscular coordination and weakness, limitations of joint movements) and autonomic (changes in skin temperature, erythema, piloerection, diaphoresis, salivation, lacrimation, proprioceptive disturbances) symptoms when these points are stimulated. [1,2] Its etiology is not known exactly. Postural or ergonomic disturbances, overuse of the muscles or mechanical causes like recurrent micro traumas, hormonal disturbances, vitamin and mineral imbalances and stress may cause a predisposition to this disease.…”