Treatment of Myofascial Pain.Treatment of Myofascial Pain Esenyel M, Caglar N, Aldemir T (Department of Physical Medicine and Rehabilitation physical medicine and rehabilitation or physiatry or physical therapy or rehabilitation medicine Medical specialty treating chronic disabilities through physical means to help patients return to a comfortable, productive life despite a medical and the Anesthesiology and Pain Clinic, Vakif Gureba Teaching Hospital, Istanbul, Turkey), Am J Phys Med Rehabil. 2000;79:48-52. The purpose of the study was to determine the effect of ultrasound treatment and trigger point injections combined with neck-stretching exercises on myofascial trigger points in the upper trapezius tra·pe·zi·us n. A muscle with origin from the superior nuchal line, the external occipital protuberance, the nuchal ligament, the spinous processes of the seventh cervical and thoracic vertebrae, with insertion into the lateral third of the posterior muscle versus neck-stretching exercises only. The subjects (N=102) were divided randomly into 3 groups. Group 1 (16 men, 20 women) were treated with ultrasound therapy (1.5 W/[cm.sup.2]) to the trigger point and the pain reference zone. Group 2 (14 men, 22 women) received trigger point injections (1% lidocaine lidocaine /li·do·caine/ (li´do-kan) an anesthetic with sedative, analgesic, and cardiac depressant properties, applied topically in the form of the base or hydrochloride salt as a local anesthetic; also used in the latter form as a ). Both groups 1 and 2 were instructed in neck-stretching exercises. Group 3, the control group, received only the neck-stretching exercise instruction. Pain intensity, pain threshold, and range of motion of cervical lateral bending opposite to the involved upper trapezius muscle were measured at baseline and at 2 weeks and 3 months after completion of the study. At baseline, the Beck Depression Inventory Beck Depression Inventory A trademark for a standardized questionnaire used to diagnose depression. Beck Depression Inventory (BDI BDI Burundi (ISO Country code) BDI Beck Depression Inventory BDI Belief-Desire-Intention (AI agents) BDI Baltic Dry Index BDI Basic Driver Improvement (traffic school) ) and the Taylor Manifest Anxiety Scale manifest anxiety scale, n a true-false questionnaire made up of items believed to indicate anxiety, in which the subject answers verbally the statement that describes him or her. (TMAS TMAS Telephone Medical Advice Services TMAS Tank Main Armament Systems TMAS Temperature and Moisture Acquisition System (NASA) TMAS Thermal Mine Avoidance System TMAS Tank Modular Ammunition System(s) ) were used to assess depression and anxiety, respectively. Data were analyzed using Mann-Whitney U tests, paired t tests, Friedman tests, and Spearman spear·man n. A man, especially a soldier, armed with a spear. correlations. Two weeks after study completion patients in groups 1 and 2 showed statistically significant reductions in pain intensity, an increase in pain threshold, and an increase in range of motion. These improvements continued at the 3-month follow-up. There were no statistically significant differences between groups 1 and 2. The control group did not show any statistically significant improvement at the 2-week and 3-month intervals. At the beginning of this study, scores from the BDI indicated that 23% of the subjects were depressed, with severe depression occurring in 5% of the subjects. According to the TMAS scores, high anxiety occurred in 89% of the subjects. Scores on the BDI were correlated significantly with pain duration before treatment (r=.56), and TMAS scores were also correlated significantly with pain duration before treatment (r=.62). No significant correlations were found between (1) depression and pain intensity or pain threshold levels or (2) anxiety scores and pain intensity or pain threshold levels. According to the authors, the results indicated that either ultrasound or trigger-point therapy combined with neck-stretching exercises are superior to stretching exercises only for treatment of myofascial pain in the upper trapezius muscle. Jennifer Rhodes, PT, MS JD Rhodes Wellness & Fitness Consulting New York, NY |
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