Trigger Point Injections for Chronic Non-Malignant Musculoskeletal Pain: A Systematic Review

Scott, N. Ann; Guo, Bing; Barton, Pamela M.; Gerwin, Robert D.

doi:10.1111/j.1526-4637.2008.00526.x

Cited by 140 publications

(85 citation statements)

References 58 publications

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“…35,46 TrP dry needling (TrPDN) is one proposed treatment method 15 that has been shown to reduce TrP-associated pain. 38,43 A recent meta-analysis concluded that there is grade A (high-level) evidence to support the use of TrPDN in patients with upperquarter myofascial pain, particularly chronic neck and shoulder pain. 27 However, additional well-designed studies are needed to further examine treatment effectiveness.…”

Section: T T Conclusionmentioning

confidence: 99%

Short-Term Changes in Neck Pain, Widespread Pressure Pain Sensitivity, and Cervical Range of Motion After the Application of Trigger Point Dry Needling in Patients With Acute Mechanical Neck Pain: A Randomized Clinical Trial

Mejuto-Vázquez¹,

Salom‐Moreno²,

Ortega‐Santiago³

et al. 2014

J Orthop Sports Phys Ther

136

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Mechanical neck pain has a lifetime and point pre valence almost as high as low back pain 31 and results in substantial disability and economic burden for society. 29 The authors of a recent study 16 found that the prevalence of mechanical neck pain has decreased in the last few years in Spain, potentially attributed to a better understanding and management of the condition. Physical therapy is usually the first management option for individuals with insidious-onset mechanical neck pain. T T METHODS: Seventeen patients (53% female)were randomly assigned to 1 of 2 groups: a single session of TrPDN or no intervention (waiting list). Pressure pain thresholds over the C5-6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle; neck pain intensity; and cervical spine range-of-motion data were collected at baseline (pretreatment) and 10 minutes and 1 week after the intervention by an assessor blinded to the treatment allocation of the patient. Mixed-model analyses of variance were used to examine the effects of treatment on each outcome variable. T T RESULTS: Patients treated with 1 session ofTrPDN experienced greater decreases in neck pain, greater increases in pressure pain threshold, and higher increases in cervical range of motion than those who did not receive an intervention at both 10 minutes and 1 week after the intervention (P<.01 for all comparisons). Between-group effect sizes were medium to large immediately after the TrPDN session (standardized mean score differences greater than 0.56) and large at the 1-week follow-up (standardized mean score differences greater than 1.34). T T CONCLUSION:The results of the current randomized clinical trial suggest that a single session of TrPDN may decrease neck pain intensity and widespread pressure pain sensitivity, and also increase active cervical range of motion, in patients with acute mechanical neck pain. Changes in pain, pressure pain threshold, and cervical range of motion surpassed their respective minimal detectable change values, supporting clinically relevant treatment effects. Therapy, level 1b-. J Orthop Sports Phys Ther 2014;44(4):252-260. Epub T T LEVEL OF EVIDENCE:

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Section: T T Conclusionmentioning

confidence: 99%

Short-Term Changes in Neck Pain, Widespread Pressure Pain Sensitivity, and Cervical Range of Motion After the Application of Trigger Point Dry Needling in Patients With Acute Mechanical Neck Pain: A Randomized Clinical Trial

Mejuto-Vázquez¹,

Salom‐Moreno²,

Ortega‐Santiago³

et al. 2014

J Orthop Sports Phys Ther

136

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“…13 Ischemic compression has the advantage of being a noninvasive and inexpensive therapy that should not increase anxiety levels of patients. 22 However, although it is a relatively simple technique, if it is performed improperly-for example, without adequate analgesia-ischemic compression can exacerbate the patient's pain and perpetuate the pain cycle.…”

Section: Mitidieri Et Almentioning

confidence: 99%

“…3 Treatment of AMPS requires a multidisciplinary approach, with the goals of interrupting the pain cycle, abolishing the myofascial trigger points, and restoring muscle flexibility by eliminating predisposing factors and perpetuation of the pain. 18 In addition to symptomatic treatment with analgesics, muscle relaxants, antidepressants, and nonsteroidal anti-inflammatory drugs (NSAIDs), 13 specific treatments, such as local anesthetic blockade in trigger points, [19][20][21][22] ischemic compression, 13,23,24 electrotherapy, 25 and Botulinum toxin [26][27][28][29][30] may be tried. Alternative or complementary therapies have also been used increasingly for musculoskeletal pain.…”

Section: Introduction Cmentioning

confidence: 99%

Effect of Acupuncture on Chronic Pelvic Pain Secondary to Abdominal Myofascial Syndrome Not Responsive to Local Anesthetic Block: A Pilot Study

Mitidieri

Gurian

Silva

et al. 2017

Medical Acupuncture

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Objective: Strong evidence shows that 85% of women with chronic pelvic pain (CPP) have musculoskeletal disorders, such as abdominal myofascial pain syndrome (AMPS). The aim of this research was to assess the efficacy of local acupuncture treatment for women with CPP secondary to AMPS unresponsive to treatment with trigger-point injection. Materials and Methods: This pilot study involved 17 women with moderate-to-severe AMPS-related CPP. Acupuncture treatments were given at abdominal-wall trigger points once per week for 10 consecutive weeks. Pain relief was assessed with a visual analogue scale (VAS), the McGill questionnaire, and pressure dynamometer. Quality of life and psychosocial function (risk for anxiety and depression) were evaluated using the Short-Form-36 questionnaire and the Hospital Anxiety and Depression scale. Assessments were performed at baseline and after 1, 3, and 6 months of treatment. Results: Both the VAS and McGill pain questionnaire showed significantly decreased pain intensity (VAS, P < 0.001; and McGill, P 0.049), and the effects were sustained even at 6 months after treatment. Conclusions: Acupuncture treatment was effective for the women who participated in this study, and the current authors believe that these preliminary results suffice to recommend performing randomized controlled trials.

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“…Nevertheless, a common finding of different studies in different pain syndromes is an average improvement, irrespective of the technique or the injectate. 31,38 Because of the lack of high-quality randomized controlled trials, it is unclear whether the improvement is the result of a specific effect of the trigger point treatments or a placebo effect and regression to the mean. Because trigger point treatments are associated with minimal risks, I pragmatically propose to offer them to patients who display trigger points, in the hope of facilitating spontaneous recovery or rehabilitation strategies to reduce pain and improve function.…”

Section: Therapeutic Proceduresmentioning

confidence: 99%

Pharmacological and Interventional Management of Pain After Whiplash Injury

Curatolo¹

2016

J Orthop Sports Phys Ther

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Trigger Point Injections for Chronic Non-Malignant Musculoskeletal Pain: A Systematic Review

Cited by 140 publications

References 58 publications

Short-Term Changes in Neck Pain, Widespread Pressure Pain Sensitivity, and Cervical Range of Motion After the Application of Trigger Point Dry Needling in Patients With Acute Mechanical Neck Pain: A Randomized Clinical Trial

Short-Term Changes in Neck Pain, Widespread Pressure Pain Sensitivity, and Cervical Range of Motion After the Application of Trigger Point Dry Needling in Patients With Acute Mechanical Neck Pain: A Randomized Clinical Trial

Effect of Acupuncture on Chronic Pelvic Pain Secondary to Abdominal Myofascial Syndrome Not Responsive to Local Anesthetic Block: A Pilot Study

Pharmacological and Interventional Management of Pain After Whiplash Injury

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