Effects of myofascial trigger point injection on the disease activity in patients with comorbidity of fibromyalgia and cervical myofascial pain syndrome

Abstract

Aims: To investigate the effect of myofascial trigger point injection on the disease activity of FS in patients with myofascial trigger points in the coexistence of fibromyalgia syndrome (FS) and chronic cervical myofascial pain syndrome (MAS). Methods: 30 consenting patients between the ages of 18-60 who has had FS for at least for 3 months and also MPS in trapezius, levator skapula, splenius capitis, and multifidus muscles in cervical region and 15 patients with FS but without MPS were included in the present study. Patients newly diagnosed with FS, were evaluted for the presence of MPS and FS, disease activity was evaluated before administering treatment and after administration of trigger point injection tretament for cervical MPS. In the group with only FS, cervical region tender point injection was carried out. Patients were evaluated before injection and one month after injection. Severity of pain was evaluated with VAS (visual analog scale), pressure pain threshold was measured with algometer, total myalgic score (TMS) , fibromiyalgia impact questionnaire (FIQ), Pittsburgh sleep quality index (PSQI) , Beck depression inventory (BDI), Beck anxiety inventory (BAI), fatique severity scale (FSS) results were evaluated prior to and after treatment. Results: When patients were evaluted at 1st month after myofacial trigger point and cervical tender point injections statistically significant decrease was found in VAS, TMS, PSQI, FIQ, FSS, BAI and BAI scores and the number of trigger points in both FS and FS+MAS groups. (for all parameters p<;0,005). However, this decrease was more evident in FS+MPS group. Conclusion: In conclusion, in the concomitance of MPS and FS, which is one of the most common causes of widespread musculoskletal pain, the treatment of MPS with trigger point injection has been shown to exert positive effects on the severity of FS, affective disorders, sleep and fatique. In the treatment of FS, thetreatment of MPS, which is one of the periheral pain generators, should be given priority.