Abstract
We compared the feasibility of ultrasound (US)-guided myofascial trigger point (MTrP) injection with that of a blind injection technique following the use of shear wave elastography (SWE) for the measurement of stiffness at the MTrPs in patients with trapezius myofascial pain syndrome (MPS). A total of 41 patients (n = 41) were randomized to either the trial group (n = 21, SWE combined with US-guided injection) or the control group (n = 20, SWE combined with blind injection). At baseline and four weeks, they were evaluated for the manual muscle test (MMT), the range of motion (ROM), pain visual analogue scale (VAS) scores, Shoulder Pain and Disability Index (SPADI) scores and Neck Disability Index (NDI) scores during the abduction, adduction, flexion, extension, external rotation and internal rotation of the shoulder joint. Differences in changes in pain VAS scores, NDI scores and SPADI scores at four weeks from baseline between the two groups reached statistical significance (p = 0.003, 0.012, and 0.018, respectively). US-guided MTrP injection is a more useful modality as compared with a blind injection in patients with MPS.
Highlights
Myofascial pain syndrome (MPS) is referred to as regional pain that arises from hyperirritable spots located within taut bands of the skeletal muscle, termed as myofascial trigger points (MTrPs)
MTrPs are often present in the upper trapezius muscle, which accounts for approximately 85% of patients with MPS presenting with pain [10]
MTrPs, injections of lidocaine nodule on physical examination followed by shear wave elastography (SWE) assessing the stiffness at the MTrPs, injections of diluted with saline were performed at theperformed same dose at using blinddose technique, by Travell lidocaine diluted with saline were the asame using as a proposed blind technique, as and proposed by Travell and Simons [20]
Summary
Myofascial pain syndrome (MPS) is referred to as regional pain that arises from hyperirritable spots located within taut bands of the skeletal muscle, termed as myofascial trigger points (MTrPs). MTrPs are often present in the upper trapezius muscle, which accounts for approximately 85% of patients with MPS presenting with pain [10]. They can be either active or latent, active ones cause spontaneous pain and motor symptoms with nerve stimulation, whereas latent ones do not cause painful symptoms. Lin et al used a multi-scale wavelet model for the interpretation of surface electromyography (SEMG) signals, attempting to validate its usefulness in characterizing changes in neuromuscular activation in patients with MPS via machine learning [18]. We conducted this preliminary pilot study to compare the feasibility of US-guided MTrP injection with that of a blind injection technique following the use of shear wave elastography (SWE) for the assessment of stiffness at the MTrPs in patients with MPS
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