Ultrasound-guided interventional procedures for myofascial trigger points: a systematic review

Abstract

Myofascial pain syndrome (MPS) is characterized by the presence of clinically detected myofascial trigger points (MTrPs). Diagnostic ultrasound (US) has been proposed as a method to strengthen the reliability of MTrP localization, thus potentially improving the efficacy and safety profile of interventional procedures. The objective is to evaluate the benefit and safety profile of any US-guided interventional procedure for MPS. Medline, Embase, PubMed, the Allied and Complementary Medicine Database (AMED), and Web of Science were systematically searched from their inception to May 2020 for any randomized controlled trial that evaluated treatment benefit and safety of any US-guided interventional procedure for MPS. The primary outcome of interest was pain severity. Additional outcomes of interest were function and adverse effects. The risk of bias was assessed using the Risk of Bias V.2.0 tool. eleven studies met all inclusion and exclusion criteria. Two studies (n=174) with a high risk of bias revealed some evidence supporting US guidance over blinded interventions for improvement in pain and function. Eight studies (n=483) with varying risks of bias were of head-to-head comparisons of different US modalities. These studies revealed that US-guided local anesthetic injections were inferior to US-guided pulse radiofrequency and US-guided dry needling (DN). US-guided DN was also found to be superior to US-guided platelet-rich-plasma injections but inferior to US-guided miniscalpel. Meanwhile, one study (n=21) with some concerns of bias found that US-guided local anesthetic injections were superior to non-steroidal anti-inflammatory drugs for pain outcomes and fewer adverse events. All US-guided procedures resulted in zero or minimal self-limited adverse events. Issues with clinical relevance, limited sample sizes, and small point estimates warrant more high-quality research to better characterize the possible value of US-guided injections.

A new ultrasound-guided percutaneous electrolysis and exercise treatment in patellar tendinopathy: three case reports

“…Moreover, there is literature that also strongly recommends its use not only as an evaluation tool due to its low cost, safety and portability, but also because of the possibility of obtaining quantitative measurements of tissue texture (thickness, cross-sectional areas or perimeters) and as a guide for invasive interventions such as dry needling or percutaneous electrolysis in anatomical regions of high risk due to space conflict [10][11][12].…”

Implementation of Objective Structured Clinical Examination on Diagnostic Musculoskeletal Ultrasonography Training in Undergraduate Traditional Korean Medicine Education: An Action Research

“…For ultrasound OSCE, evaluation tools for abdominal ultrasound [ 38 ] and intensive care ultrasound [ 39 ] have been developed. Ultrasound training is necessary because the safety and effectiveness can be improved by checking the anatomical structures through the ultrasound guide and performing the procedure for the acupuncture, pharmacopuncture, and acupotomy used in traditional medicine [ 14 , 40 , 41 , 42 ]. Therefore, training and assessing students’ performance through the OSCE is essential in traditional medicine education for educational purposes.…”

Multi-dimensional study on the treatment of nonspecific neck pain with ultrasound-guided trigger point injection at the myofascial trigger point of upper trapezius muscles

“…The results showed that all three methods were signi cantly effective in MPS treatment during short-term follow-up; however, the OI and LI groups had slightly better results than the DN group, with no remarkable bene t between OI and LI. Because ultrasound guided local anesthetic injections are superior to nonspeci c anti-in ammatory drugs (NSAIDs) in terms of pain outcomes and fewer adverse events were found in a systematic review [39], we chose ultrasound guided injection of 5% lidocaine in the present study, and no adverse events occurred over the course of the experiment. In an early study of the treatment of NNP, Yanuck J et al [40]evaluated whether TPI with 1% lidocaine can improve myofascial back and neck pain compared with conventional therapies (standard care).…”