Abstract
Myofascial pain syndrome (MPS) is a common musculoskeletal disorder associated with myofascial trigger points. Injection of steroid and local anaesthetic at the site is commonly used minimally invasive treatment procedure. Different parameters are used to assess improvement patterns in patients with myofascial pain syndrome, like pain, activity, global assessment score, pain free range of motion and composite scoring systems like University of California, Los Angeles (UCLA) score and Constant Murley (CM) score. This prospective study has been designed to correlate the improvement in pain free range of motion (ROM) of shoulder with other functional scores like activity score, University of California, Los Angeles (UCLA) score and Constant Murley (CM) score after local injection with steroid and local anaesthetic in management of Myofascial Pain Syndrome (MPS) involving upper back. Forty five patients with diagnosed MPS of upper back region were included in the study and were given combination of steroid and local anaesthetic injection. Other noninvasive treatments were same across the groups. Forty patients completed the study. Patients were assessed once before intervention and after 2 weeks and 6 weeks of intervention. The parameters assessed were pain score, patient’s global score, physician’s global score, activity score, pain free range of motion of shoulder abduction, UCLA score and Constant Murley score. Results were analysed and interpreted using appropriate statistical tests. All parameters demonstrated significant improvement over time. We also found good correlation of ROM with UCLA and Constant Murley score and moderate correlation with activity score.
Keywords: Myofascial Pain Syndrome, Trigger Point Injection, Pain free ROM, UCLA score, Constant Murley score.
References
- H C Chandolaand Arunangshu Chakraborty. Fibromyalgia and Myofascial Pain Syndrome-A Dilemma Indian J Anaesth. 2009; 53(5): 575–581.
- Rachlin ES. Myofascial Pain and Fibromyalgia Trigger Point Management. In History and physical examination for regional myofascial pain syndrome; St Louis, Mosby- Yearbook: 1994..
- Simmons D, Travell J, Simmons Y. Trigger Point Manual. 2nd edition. vol-1. Williams & Wilkins; 1999.
- Hong CZ. Considerations & recommendations regarding myofascial trigger point injection. J Mus Pain. 1994(2):29–59
- Fricton JR, Steenks MH. Diagnosis and treatment of myofascial pain Ned Tijdschr Tandheelkd.1996 ;103(7):249-53.
- Wheeler AH. Myofascial pain disorders: theory to therapy. 2004;64(1):45-62.
- Bron C, Gast A, Dommerholt J, Boudewijn Stegenga B, Wensing M, Rob AB Oostendorp RA. Treatment of myofascial trigger points in patientswith chronic shoulder pain: a randomized,controlled trial. BMC Medicine 2011, 9(8): 1-14.
- Romeo AA, Mazzocca A, David W. Hang DW, Shott S, Bernard R. Bach BR. Shoulder Scoring Scales for the Evaluation of Rotator Clinical Orthopaedics and Related Research 2004; 42(7):107–114
- Pérez-Palomares S, Oliván-Blázquez B, Pérez-Palomares A, Gaspar-Calvo E, Pérez-Benito M, López-Lapeña E, Torre-Beldarraín Mr, Magallón-Botaya R. Contribution of Dry Needling to Individualized Physical Therapy Treatment of Shoulder Pain: A Randomized Clinical Trial. J Orthop Sports Phys Ther.2017;47(1):11-20
- Khalil SS, Abdulla MM (2018) The Effect of Extra Corporeal Shock Wave Therapy versus Ultrasound Therapy in Patients with Myofascial Pain Syndrome in Trapezius Muscle. JSM Physical Med Rehabil 2(1): 1008.
- Lee J, Park S, Na S. The Effect of Proprioceptive Neuromuscular Facilitation Therapy on Pain and Function. . Phys. Ther. Sci.2013;25( 6):713-716.
- Itoh K, Saito S, Sahara S, Naitoh Y, Imai K, Kitakoji H. Randomized Trial of Trigger Point Acupuncture Treatment for Chronic Shoulder Pain: A Preliminary Study. J Acupunct Meridian Stud 2014;7(2):59-64
- Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points Anesthesiol Clin.2007;25(4):841-51.
- Robert Bennett Myofascial pain syndromes and their evaluation Best Practice & Research Clinical Rheumatology. 2007;21( 3):427–445.
- Jaeger B. Myofascial trigger point pain. Alpha Omegan.2013;106(1-2):14-22.
- Brodsky M, Spritzer K, Hays RD , Hui K. Change in Health-Related Quality-of-Life at Group and Individual Levels Over Time in Patients Treated for Chronic Myofascial Neck Pain. Journal of Evidence-Based Complementary & Alternative Medicine 22(3): 1-4.
- Jaiswal M, Sanyal RP, Goswami S. Revalidation of Trigger Point Injection in Myofascial Pain Syndrome, Assessed by Pain Disability Score. International Journal of Scientifific Study. 2017; 5(1):172-175
- Lugo LH, García HI, Rogers HL, Alberto Plata JA. Treatment of myofascial pain syndrome with lidocaine injection and physical therapy, alone or in combination: a single blind, randomized, controlled clinical trial. BMC Musculoskeletal Disorders (2016) 17:101
- Hong C, Hsueh T. Difference in Pain Relief After Trigger Point Injections inMyofascial Pain Patients With and Without Fibromyalgia. Arch Phys Med Rehabil. 1996; 77: 1171-6.
- Mohammed AM, Zaki LA, Abdelraouf OR, Rashad GM. Dry Needling Versus Trigger Point Release In Treatment Of Myofascial Low Back Pain. International Journal of ChemTech Research. 2016; 9(10): 276-285.
- Lee J, Han E. A Comparison of the Effects of PNF, ESWT, and TPI on Pain and Function of Patients with Myofascial Pain Syndrome. . Phys. Ther. Sci.2013; 25( 3):341-344.
- Razmjou H, Bean A, MacDermid JC, Osnabrugge V, Travers N, Holtby R. Convergent Validity of the Constant-Murley Outcome Measure in Patients with Rotator Cuff Disease. Physiother Can. 2008;60:72-79.
- Simons DC, Travell JC, Simons LS. Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore, Md: Lippincott Williams & Wilkins; 1999.
Corresponding Author
Dr Kshetra Madhab Das
Associate Professor, Dept of P.M.&R, NRS Medical College & Hospital, Kolkata, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mo: 9830790414
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.100
