Case Report: Myofascial Pain Syndrome
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- เผยแพร่เมื่อ 13 มี.ค. 2021
- In this week's episode of the Spine & Nerve podcast Drs. Nicolas Karvelas and Brian Joves conclude the discussion regarding Myofascial Pain Syndromes through a case presentation. The doctors present a common clinical scenario where myofascial pain is causing significant negative impact on a patient's function, quality of life, and health.
In the prior background and journal club episodes, the pathophysiology of myofascial pain was discussed in detail (see anchor.fm/spine/episodes/Back... and anchor.fm/spine/episodes/Jour....
This episode’s discussion brings things a little more clinical than the prior two. The doctors present a clinical picture of a young woman with chronic neck pain. Listen as they walk through the process of identifying pathology and initiating a treatment protocol that focuses on physical modalities, topical ointments and trigger point therapy.
This podcast/youtube video is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, the may not represent the views of Spine & Nerve.
References:
1. Ting et al. Review of Trigger Point Therapy for the Treatment of Myofascial Pain Syndromes. J Anesthesiol & Pain. 2020;1 (3):22-29.
I wish I could just talk to you guys. I suffer from permanent cervical myofascial pain syndrome. As long as you have myofascial pain syndrome in your title, I'm not offended. You both were spot on. I currently do lidocaine injections in the cervical area. I wish they had something for the neck but can't use those injections there. I also focus mostly on my posture and take it as it comes as far as treatment goes. (There is a change in lifestyle dealing with the syndrome. Many treatment options just have no long term effects. Short term great.)
So is the trigger point just like their forever and you just can do stuff to damp down the spazzing out in pain from it
Trigger points can be treated with multiple modalities as discussed in the video
I go to a physio that specializes in fascia release. Also starting to use tens machine which is working wonders. Also making sure I have enough minerals. In my case I need more salt so I get finger wet and put it in pink salt.
Can mayofacial pain from the back shoulder cause imbalance, nausea and other sensory symptoms?
Hi..i have myofascial pain for 6 months now,i feel out of balance specially noon time..how are you feeling now
It has recently been the culprit of 3falls in two weeks time. The trigger points can affect posture and balance! Have a good Dr. and try to treat before or right after a flare-upof the condition,
After couple of sittings with a myofascial therapist, i have fatigue, and now its more than 2 weeks. The reason for therapy- shoulder and neck pain has gone though. What could be the reason?
Possibly fibromyalgia because of the shoulder and neck pain?
Cervical instability through arthritis or degenerative disk, fibromyalgia caused it in me. A rheumatologist or neurologist can diagnose and treat it if you find a good one (university or research-based physicians know more in this field. Early detection and treatment is essential! Good luck.
Bla bla. Sorry but theory doesn't help. I take 1 piroxicam when I feel that I can't manage the pain, it helps a lot. Sometimes I have 4 to 7 knots on me and it's painful and when it hurts now one touches me piroxicam helps keep everything under control. 1 tablet 40 mg in 24h are times when I don't even have to take more 1 is enough
Trigger point injection are the most useless procedure for myofascial trigger points. Its nothing more than a temporary relief.
Dry needling on the other hand is am extremely effective and low cost procedure for treating myofascial trigger points. Its actually the needling effect or the mechanical disruption of the trigger point that brings relief and not the injection of any chemical substance.
Patient complaint, experienced Examiner with an ability to identify and palpate for taut bands, good anatomy and needling skills, some estim and an exercise program is all that is needed.
Trigger point injections and pharmaceuticals are useless and have a retarding effect on myofascial pain syndrpme
thanks for the feedback. you are correct, the dry needling/ mechanical disruption is a key component to TPIs
@@SpineNerve There are several advantages associated with this dry needling technique when compared
with Fischer’s injection technique. First, affected segments may be treated without concern for the possible side effects associated with injection of local anaesthetics. In addition, more segments may be treated in one visit with dry needling because the number of injections is limited by the total dosage of anaesthetic that may be administered at one time. Furthermore, acupuncture needles are minimally invasive and better tolerated by patients because they have rounded-tips, designed to painlessly pass around cells, blood vessels and other tissues. On the other hand, hypodermic needles are bevel-edged and sharp, designed to cut through blood vessels (thereby damaging to cells and tissues); this attribute results in more inflammation, bleeding and pain. Due to its fine construction and smaller diameter, an acupuncture needle provides the practitioner superior kinesthetic feedback when compared to a hypodermic needle. This permits more accurate manipulation and easier placement of the needle at desired tissue depth
@@SpineNerve hello Doctor, i have myofascial pain syndrome in my lower back and legs, i am going through dry needling treatment. Already been through 5 sessions. I got relief from the pain, but the pain does come back if you are doing daily routine work. What could be done ?
Try kinesiology tape! It's immediate relief in the neck and shoulder areas.
If anyone is interested
www.ncbi.nlm.nih.gov/pmc/articles/PMC4285362/
Mechanisms of Myofascial Pain
M. Saleet Jafri
Injections of substances such as lidocaine and capsaicin block the activation of the nociceptive neurons. Capsaicin blocks activation of the TRPV1 channels while lidocaine blocks neuron depolarization (Figure 1). These however do not seem to disrupt the positive-feedback loop that sustains the myofascial trigger point. As mentioned previously, this could be because lidocaine's block of the sodium channel does not impair the CGRP-mediated acetylcholine leak into the neuromuscular junction that might contribute to the persistence of the trigger point
great article!!!