Treatment of Myofascial Pain

Desai, Mehul; Bean, Matthew C; Heckman, Thomas; Jayaseelan, Dhinakar J.; Moats, Nick; Nava, Andrew

doi:10.2217/pmt.12.78

Cited by 12 publications

(8 citation statements)

References 56 publications

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“…At each session, ~30 min is dedicated to these manual techniques to increase flexibility, decrease TrP-related pain and tension, and increase balance and stability. Other pain management strategies, including general and specific respiratory and relaxation exercises, aim to enhance patient’s self-management and self-empowerment skills [ 11 , 42 ]. Aredo et al reported: “this dual approach addresses physiological and psychological components of chronic myofascial pain, alleviates MTrP-related pain, and furnishes patients with coping strategies to redirect their focus during a painful episode” [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource

Berghmans

2018

Int Urogynecol J

102

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Introduction and hypothesisChronic pelvic pain (CPP) in women is a complex syndrome. Pain sensation and intensity often do not correspond with the identified lesion location but are felt elsewhere, leading to muskuloskeletal and myofascial disorders and sexual dysfunction (SD). Although physical aspects are prevalent, they are often underdiagnosed and undertreated due to lack of understanding regarding its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints, leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms, often with insufficient results. Because pelvic floor muscle disorders contribute significantly to CPP and SD, there is rationale for physiotherapy. However, physiotherapy is a widely underused and untapped resource, which has its place in the multidisciplinary approach to these health problems.MethodsComputer-aided and manual searches and methodological quality assessment were carried out for meta-analyses, systematic reviews, and randomized controlled trials (RCTs) published between 1990 and 2017 investigating classification, assessment, and (physiotherapeutic) treatment of pelvic pain and/or female SD defined by the keywords below. Expert opinions were sought via interviews.ResultsDue to a lack of sufficient relevant medical information, referral data, and test results, focused physiotherapy is difficult to administer adequately. However, recent quality studies indicate significant clinical effects of physiotherapy for CPP and female SD, and experts advocate a multidisciplinary approach that includes physiotherapy.ConclusionsBecause of its holistic approach, physiotherapy can contribute significantly to the multidisciplinary assessment and treatment of CPP and female SD.

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Section: Resultsmentioning

confidence: 99%

Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource

Berghmans

2018

Int Urogynecol J

102

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“…Therefore, it is necessary to conduct further studies with a larger number of patients so that analyses can examine different subgroups of patients and determine if the interventions might help to treat underlying pathologies, including spinal conditions, postural abnormalities, and underlying behavioral issues. Furthermore, it is important to include patients on a waiting list or in a sham treatment placebo group in order to assess the superiority of one intervention over another in this patient population [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of myofascial pain syndrome with lidocaine injection and physical therapy, alone or in combination: a single blind, randomized, controlled clinical trial

Lugo

García

Rogers

et al. 2016

BMC Musculoskelet Disord

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BackgroundMyofascial pain syndrome (MPS) of the shoulder girdle and cervical region is a common musculoskeletal problem that is often chronic or recurrent. Physical therapy (PT) and lidocaine injections (LI) are two treatments with demonstrated effectiveness compared to a control group, however little is known about their combined value. The objective of this study was to determine whether LI into trigger points combined with a PT program would be more effective than each separate treatment alone in improving pain, function, and quality of life in a group of patients with MPS of the shoulder girdle and cervical region.MethodsA single-blind, randomized, controlled clinical trial (RCT) was conducted with three parallel groups in the Departments of Physical Medicine and Rehabilitation of two urban hospitals in Medellin, Colombia. One hundred and twenty seven patients with shoulder girdle MPS for more than 6 weeks and pain greater than 40 mm on the visual analog scale (VAS) were assigned to 1 of 3 intervention groups: PT, LI, or the combination of both (PT + LI). The primary outcome was VAS pain rating at 1-month post-treatment. The secondary outcomes included VAS pain rating at 3 months, and, at both 1 and 3 months post-treatment: (a) function, evaluated by hand-back maneuver and the hand-mouth maneuver, (b) quality of life, as measured by sub-scales of the Short Form – 36 (SF-36), and (c) depressive symptoms, as measured by the Patient Health Questionnaire – 9 (PHQ-9). Independent t-tests were used to compare outcomes between groups at 1 month and 3 months post-treatment.ResultsIn the per protocol analysis, there were no significant intergroup differences in VAS at 1 month PT + LI, 40.8 [25.3] vs. PT, 37.8 [21.9], p = 0.560 and vs. LI, 44.2 [24.9], p = 0.545. There were also no differences between groups on secondary outcomes except that the PT and PT + LI groups had higher right upper limb hand-back maneuver scores compared to the LI alone group at both 1 and 3 months (p = 0.013 and p = 0.016 respectively).ConclusionsThe results of this RCT showed that no differences in pain ratings were observed between the individual treatments (PT or LI) compared to the combined treatment of PT and LI. In general, no difference in primary or secondary outcomes was observed between treatments.Trial registrationNTC01250184 November 27, 2010.

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“…Therefore, TT applications could be a treatment option especially in conditions where a dysfunction in blood flow plays an important role in generation and persistence of pain and dysfunction (i.e., osteoarthrosis, tendinopathies, and myofascial pain syndrome). 1,[3][4][5][15][16][17][18][19][20][21][22] Although tendons are poorly vascularized and tendon nutrition is more reliant on synovial fluid diffusion than vascular perfusion, the role of changed vascularization during healing of tendon healing is still not clear. 23 It remains questionable if TT can affect blood flow in other anatomical structures such as tendons and joint capsules.…”

Section: Discussionmentioning

confidence: 99%

Does the Application of Tecar Therapy Affect Temperature and Perfusion of Skin and Muscle Microcirculation? A Pilot Feasibility Study on Healthy Subjects

Clijsen

Leoni

Schneebeli

et al. 2020

The Journal of Alternative and Complementary Medicine

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Background: Tecar therapy (TT) is an endogenous thermotherapy used to generate warming up of superficial and deep tissues. TT capability to affect the blood flow is commonly considered to be the primary mechanism to promote tissue healing processes. Despite some preliminary evidence about its clinical efficacy, knowledge on the physiologic responses induced by TT is lacking. Objective: The aim of this quantitative randomized pilot study was to determinate if TT, delivered in two modes (resistive and capacitive), affects the perfusion of the skin microcirculation (PSMC) and intramuscular blood flow (IMBF). Design: A randomized controlled pilot feasibility study. Subjects: Ten healthy volunteers (n = 4 females, n = 6 males; mean age 35.9-10.7 years) from a university population were recruited and completed the study. Intervention: All subjects received three different TT applications (resistive, capacitive, and placebo) for a period of 8 min. Outcome measures: PSMC, IMBF, and the skin temperature (ST) were measured pre-and post-TT application using power Doppler sonography, laser speckle contrast imaging (LSCI), and infrared thermography. Results: Compared with placebo application, statistically significant differences in PSMC resulted after both the resistive (p = 0.0001) and the capacitive (p = 0.0001) TT applications, while only the resistive modality compared with the placebo was capable to induce a significant change of IMBF (p = 0.013) and ST (p = 0.0001). Conclusions: The use of power Doppler sonography and LSCI enabled us to evaluate differences in PSMC and IMBF induced by TT application.

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Treatment of Myofascial Pain

Cited by 12 publications

References 56 publications

Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource

Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource

Treatment of myofascial pain syndrome with lidocaine injection and physical therapy, alone or in combination: a single blind, randomized, controlled clinical trial

Does the Application of Tecar Therapy Affect Temperature and Perfusion of Skin and Muscle Microcirculation? A Pilot Feasibility Study on Healthy Subjects

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