Expert consensus on the diagnosis and treatment of myofascial pain syndrome

Myofascial pain syndrome(MPS)is characterized by myofascial trigger points and fascial constrictions.At present,domestic and foreign scholars have not reached a consensus on the etiology and pathogenesis of MPS.Due to the lack of specific laboratory indicators and imaging evidence,there is no unified diagnostic criteria for MPS,making it easy to confuse with other diseases.The Chinese Association for the Study of Pain organized domestic experts to formulate this Chinese Pain Specialist Consensus on the diagnosis and treatment of MPS.This article reviews relevant domestic and foreign literature on the definition,epidemiology,pathogenesis,clinical manifestation,diagnostic criteria and treatments of MPS.The consensus is intended to normalize the diagnosis and treatment of MPS and be used by first-line doctors,including pain physicians to manage patients with MPS.

Clinical efficacy of ultrasound-guided pulsed radiofrequency combined with ganglion impar block for treatment of perineal pain

BACKGROUND Ganglion impar block alone or pulsed radiofrequency alone are effective options for treating perineal pain.However,ganglion impar block combined with pulsed radiofrequency(GIB-PRF)for treating perineal pain is rare and the puncture is usually performed with X-ray or computed tomography guidance.AIM To evaluate the safety and clinical efficacy of real-time ultrasound-guided GIBPRF in treating perineal pain.METHODS Thirty patients with perineal pain were included and were treated by GIB-PRF guided by real-time ultrasound imaging between January 2015 and December 2016.Complications were recorded to observe the safety of the ultrasound-guided GIB-PRF procedure,and visual analogue scale(VAS)scores at 24 h before and after treatment and 1,3,and 6 mo later were analyzed to evaluate clinical efficacy.RESULTS Ultrasound-guided GIB-PRF was performed successfully in all patients,and no complications occurred.Compared with pretreatment scores,the VAS scores were significantly lower(P<0.05)at the four time points after treatment.The VAS scores at 1 and 3 mo were slightly lower than those at 24 h(P>0.05)and were significantly lower at 6 mo after treatment(P<0.05).There was a tendency toward lower VAS scores at 6 mo after treatment compared with those at 1 and 3 mo(P>0.05).CONCLUSION Ultrasound-guided GIB-PRF was a safe and effective way to treat perineal pain.The 6-mo short-term clinical efficacy was favorable,but the long-term outcomes need future study.