Injection of Remote Myofascial Trigger Points for Pain Control: A casereport

Abstract

The purpose of this case report is to demonstrate the remote effect of myofascial trigger point (MTrP) injection for pain control. It describes a patient suffering from chronic pain due to MTrPs in bilateral upper trapezius muscle with poor results to direct MTrP injection to upper trapezius. After injection to the MTrPs in bilateral extensor carpi radialis longus, extensor indicis, and first dorsal interosseous muscles, the effectiveness of MTrP injection to bilateral upper trapezius muscles remarkably enhanced. This patient finally became almost pain free. The reason for poor relief of pain immediately after the first MTrP injection (directly on the upper trapezius muscles) was probably due to low pain threshold as a consequence of superimposed fibromyalgia syndrome. The muscles selected for the subsequent injection were actually satellite MTrPs of the key MTrP in the upper trapezius muscle. The remote effectiveness of MTrP injection is probably related to the neural connection in the spinal cord.