Myofascial Pain Syndrome: Correlation between the Irritability of Trigger Points and the Prevalence of Local Twitch Responses during Trigger Point Injection

Kuan, Ta Shen; Hong, Chang Zern; Chen, Shu Min; Tsai, Chien Tsung; Yen, Wei Chang; Chen, Jo Tong; Chi, Feng

doi:10.3109/10582452.2012.733804

Cited by 15 publications

(24 citation statements)

References 23 publications

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“…In this narrative review, 6 studies were identified that all investigated the clinical importance of eliciting the LTR with MTrP injection or TrPDN as it pertains to the outcome of pain intensity and they are summarized in Table 1. The studies included two randomized controlled trials (Hong, 1994b;Tekin et al, 2013), one prospective, non-randomized, controlled, interventional clinical study , one case control study (Rha et al, 2011), one single-arm cohort study (Kuan et al, 2012) and one quasiexperimental study (Koppenhaver et al, 2016). Importantly, only a single study assessed the influence of eliciting the LTR on changes in disability in addition to pain intensity (Koppenhaver et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

“…However, although needling (dry or wet) with the production of LTRs has been shown to reduce MTrP related pain in the immediate, short, and medium term, the long-term outcomes remain unknown. Furthermore, and more importantly, whether needling with the elicitation of the LTR leads to superior outcomes for the reduction of pain and disability when compared to needling interventions without the LTR remains largely unexplored (Boyles et al, 2015;Gerber et al, 2015;Hong, 1994b;Kuan et al, 2012;Rha et al, 2011;Tekin et al, 2013). In addition, the physiologic importance of the LTR during TrPDN remains to be elucidated (Kuan et al, 2012), and no systematic reviews to date have provided firm conclusions linking the LTR phenomenon directly to the positive clinical outcomes experienced by patients with MPS following the use of TrPDN (Boyles et al, 2015;Cagnie et al, 2015;Cummings and White, 2001;Kietrys et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, and more importantly, whether needling with the elicitation of the LTR leads to superior outcomes for the reduction of pain and disability when compared to needling interventions without the LTR remains largely unexplored (Boyles et al, 2015;Gerber et al, 2015;Hong, 1994b;Kuan et al, 2012;Rha et al, 2011;Tekin et al, 2013). In addition, the physiologic importance of the LTR during TrPDN remains to be elucidated (Kuan et al, 2012), and no systematic reviews to date have provided firm conclusions linking the LTR phenomenon directly to the positive clinical outcomes experienced by patients with MPS following the use of TrPDN (Boyles et al, 2015;Cagnie et al, 2015;Cummings and White, 2001;Kietrys et al, 2013). Given that other needling techniques and manual therapies have shown efficacy in the management of myofascial pain and do not rely on eliciting the LTR (Cagnie et al, 2012(Cagnie et al, , 2015Kostopoulos et al, 2008;Takano et al, 2012), a more detailed investigation of the clinical relevance of the LTR seems appropriate.…”

Section: Introductionmentioning

confidence: 99%

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The local twitch response during trigger point dry needling: Is it necessary for successful outcomes?

Perreault¹,

Dunning

Butts³

2017

Journal of Bodywork and Movement Therapies

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and Discussion: Several studies show that eliciting a LTR does not correlate with changes in pain and disability, and multiple systematic reviews have failed to conclude whether the LTR is relevant to the outcome of TrPDN. Post needling soreness is consistently reported in studies using repeated in and out needling to elicit LTRs and increases in proportion to the number of needle insertions. In contrast, needle winding without LTRs to MTrPs and connective tissue is well supported in the literature, as it is linked to anti-nociception and factors related to tissue repair and remodeling. Additionally, the positive biochemical changes in the MTrP after needling may simply be a wash out effect related to local vasodilation. While the LTR during TrPDN appears unnecessary for managing myofascial pain and unrelated to many of the positive effects of TrPDN, further investigation is required.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The local twitch response during trigger point dry needling: Is it necessary for successful outcomes?

Perreault¹,

Dunning

Butts³

2017

Journal of Bodywork and Movement Therapies

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show abstract

“…Among all DDN techniques the Hong's fast-in and fast-out technique is used in several previous works 10,20–24. The local twitch responses (LTRs) attained are directly correlated with the speed of needle insertion, the clinical efficacy of DDN, and the sensitivity of the MTrPs 15,20,25…”

Section: Introductionmentioning

confidence: 99%

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

Calvo‐Lobo

Pacheco-da-Costa

Hita-Herranz

2017

Journal of Geriatric Physical Therapy

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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 brevis muscle area immediately following and 1 week after the intervention in older adults with nonspecific shoulder pain.

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“…The lead article for this issue of the Journal of Musculoskeletal Pain [JMP] comes from Tainan, Miao-Li City and Tai-Chung, Taiwan (19). The authors recruited 72 MPS patients who had active TrPs in a trapezius muscle, and moderately severe pain from that source, to evaluate what they referred to as TrP irritability.…”

Section: Local Twitch Response In the Myofascial Pain Syndromementioning

confidence: 99%

Local Twitch Response in the Myofascial Pain Syndrome

Russell¹

2012

Journal of Musculoskeletal Pain

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Myofascial Pain Syndrome: Correlation between the Irritability of Trigger Points and the Prevalence of Local Twitch Responses during Trigger Point Injection

Cited by 15 publications

References 23 publications

The local twitch response during trigger point dry needling: Is it necessary for successful outcomes?

The local twitch response during trigger point dry needling: Is it necessary for successful outcomes?

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

Local Twitch Response in the Myofascial Pain Syndrome

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