Muscle Pain Syndromes

Hong, Chang‐Zern

doi:10.1016/b978-1-4377-0884-4.10043-6

Cited by 30 publications

(37 citation statements)

References 140 publications

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“…Pain sensations may indicate that a sensitized nociceptor was encountered by the needle tip 22,25,31. All patients tolerated the procedure well with no side effects after the procedure.…”

Section: Methodsmentioning

confidence: 87%

“…However, the pain due to MTrP of piriformis may be suppressed temporarily, but frequently recurs if the underlying etiological lesion is not treated appropriately. The cause of PMPS can be related to or due to lumbar spinal lesions, sacral spinal lesions, sacroiliac lesions, pelvic lesions, or hip joint lesions, and so on, and the most common cause is a lumbar facet lesion at the level of L5–S1 6,14,25. Lumbar facet lesions can cause MTrP pain in gluteal muscles including piriformis muscle 14,24,25,32.…”

Section: Discussionmentioning

confidence: 99%

“…The reason for the multiple needle insertion technique is to attempt to reach multiple sensitive loci (nociceptors) in the pain region as much as possible 14,25,29. When sensitive nociceptors are encountered, the strong needle stimulation (high pressure) can cause impulses (action potentials) transmitted to the spinal cord via sensory pathways to turn on the descending pain inhibitory system 14,25,31. The descending pain inhibitory system is the most important intrinsic pain control mechanism 37–42.…”

Section: Discussionmentioning

confidence: 99%

“…An anesthetic solution containing 1 mL triamcinaline acetonide (40 mg/mL) and 2 mL lidocaine (1%) in a 5 cc syringe connected to a 23 gauge needle with a length of 23/4 inches was used for the injection. After sterilization, the syringe was held by the dominant hand gently with the thumb and middle finger in the anterior position and the index finger controlling the end portion of syringe, similar to Hong’s technique for MTrP injection 14,21,25. Mapping the depth of bony structures at and near the facet joint was important.…”

Section: Methodsmentioning

confidence: 99%

“…In such cases, the pain can be reproduced during performance of a lumbar facet test,23,24 and the pain can be relieved by appropriate treatment of the lumbar facet lesion 10,14. In clinical practice, pain involving the MTrP in the piriformis muscle is frequently caused by a degenerative disc at the L5–S1 level 25. The first choice of treatment for lumbar degenerative disc disease is physical therapy including pelvic traction.…”

Section: Introductionmentioning

confidence: 99%

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Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies

Huang¹,

Chen²,

Hong³

et al. 2014

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Background and aimsThe aim of this study was to demonstrate the effectiveness of lumbar facet joint injection for piriformis myofascial pain syndrome.MethodsFifty-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.ResultsImmediately 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 (P<0.01). This effectiveness lasted for 2 weeks in 49 patients (94.2%), and lasted for approximately 6 months in 35 (97.2%) of 36 patients. The mean range of motion increased from 13.4±6.8 degrees to 22.1±6.0 degrees immediately after injection, and further increased 2 weeks and 6 months later. Immediately after injection, 45 patients (86.5%) had no facet sign. In addition, 90.4% and 94.4% of patients had no facet sign after 2 weeks and after 6 months, respectively.ConclusionsIt is important to identify the possible cause of piriformis myofascial 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.

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“…Pain sensations may indicate that a sensitized nociceptor was encountered by the needle tip 22,25,31. All patients tolerated the procedure well with no side effects after the procedure.…”

Section: Methodsmentioning

confidence: 87%