In recent years,the treatment of myofascial pain trigger point is a relatively popular technology,many people regard it as"Ashi point"in meridian theory,but compared with the traditional meridian theory,the ...In recent years,the treatment of myofascial pain trigger point is a relatively popular technology,many people regard it as"Ashi point"in meridian theory,but compared with the traditional meridian theory,the description of myofascial pain trigger point is more intuitive and easier to master.This paper expounds the similarities and differences between myofascial pain trigger point and traditional meridian theory from the aspects of theory,basic research and clinical application,in order to provide a specific idea for the scientific interpretation of meridian phenomenon in traditional Chinese medicine.展开更多
BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs an...BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.展开更多
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...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.展开更多
Objective:To observe the clinical efficacy of acupotomology in the treatment of cervical and shoulder myofascial pain trigger point for cervical radiculopathy,and to detect its effect on COX-2,PGE2,5-HT,TNF-α and oth...Objective:To observe the clinical efficacy of acupotomology in the treatment of cervical and shoulder myofascial pain trigger point for cervical radiculopathy,and to detect its effect on COX-2,PGE2,5-HT,TNF-α and other inflammatory factors.Methods:A total of 110 CSR patients were selected as the research objects and divided into observation group(Acupotomology to release the trigger points of myofascial pain in neck and shoulder combined with"three-stage"dialectical traction method)and control group(conventional acupuncture combined with"Stage 3"dialectical traction)with 55 cases.Before and after treatment,the two groups were compared by improving the efficacy of MacNab,simplifying the SCORE of Mc Gill Pain Scale,measuring cervical curvature and serum levels of inflammatory factors such as COX-2,PGE2,5-HT and TNF-α.Results:After two weeks of treatment,the total effective rate of the observation group was 96.36%,higher than that of the control group(83.63%),and the difference was statistically significant(P<0.05).After the treatment,PRI,VAS,PPI and other scores of the two groups were all lower than those before the treatment,with statistical significance(P<0.05).However,there was no statistically significant difference in PRI,VAS and PPI scores between the two groups after treatment(P>0.05).The serum inflammatory factors of coX-2,PGE2,5-HT and TNF-αin the two groups were significantly lower after treatment than before treatment(P<0.05).However,the comparison of cox-2,PGE2,5-ht and TNF-αbetween the two groups showed no statistical significance(P>0.05).The cervical curvature values measured after treatment were significantly increased compared with those before treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups(P>0.05).Conclusion:The combination of acumotomology and"three-stage"dialectical traction method can significantly improve the pain and discomfort of patients with cervical radiculopathy,significantly reduce the symptoms,restore the physiological curvature of cervical vertebra,and reduce the inflammatory factors in serum.展开更多
Objective To investigate the current practice of myofascial pain syndrome (MPS) including current epidemiology, pathology, diagnosis and treatment. Data sources The data analyzed in this review were mainly from rele...Objective To investigate the current practice of myofascial pain syndrome (MPS) including current epidemiology, pathology, diagnosis and treatment. Data sources The data analyzed in this review were mainly from relevant articles without restriction on the publication date reported in PubMed, MedSci, Google scholar. The terms "myofasial trigger points" and "myofacial pain syndrome" were used for the literature search. Study selection Original articles with no limitation of research design and critical reviews containing data relevant to myofascial trigger points (MTrPs) and MPS were retrieved, reviewed, analyzed and summarized. Results Myofascial pain syndrome (MPS) is characterized by painful taut band, referred pain, and local response twitch with a prevalence of 85% to 95% of incidence. Several factors link to the etiology of MTrPs, such as the chronic injury and overload of muscles. Other factors, such as certain nutrient and hormone insufficiency, comorbidities, and muscle imbalance may also maintain the MTrP in an active status and induce recurrent pain. The current pathology is that an extra leakage acetylcholine at the neuromuscular junction induces persistent contracture knots, relative to some hypotheses of integration, muscle spindle discharges, spinal segment sensitization, ect. MTrPs can be diagnosed and localized based on a few subjective criteria. Several approaches, including both direct and supplementary treatments, can inactivate MTrPs. Direct treatments are categorized into invasive and conservative. Conclusion This review provides a clear understanding of MTrP pain and introduces the most useful treatment approaches in China.展开更多
Aim:The study aimed at the painful trigger points(TrPs)for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range o...Aim:The study aimed at the painful trigger points(TrPs)for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction.Methods:We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction.Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain.We used mean and standard deviation values.The Mann–Whitney U-test was used to compare the two groups.The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores.The Student’s t-test was used to compare maximum mouth opening(MMO)groups.Then paired t-test was also used to study the changes of time in an MMO.Results:The results showed that pulsed electromagnetic field(PEMF)therapy is the most effective treatment modality regarding for pain relief.Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods,and a statistically significant increase in mean MMO.Conclusion:The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.展开更多
In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic...In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding(1) acupuncture as dry needling and(2) acupuncture points as trigger points(dry needling points). Dry needling simply using English biomedical terms(especially using "fascia" hypothesis) in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain(dry needling promoters redefined it as "myofascial pain"). Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy(a surgical procedure) instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture's local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients' safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.展开更多
基金Natural Science Foundation of Hainan Province(2017)
文摘In recent years,the treatment of myofascial pain trigger point is a relatively popular technology,many people regard it as"Ashi point"in meridian theory,but compared with the traditional meridian theory,the description of myofascial pain trigger point is more intuitive and easier to master.This paper expounds the similarities and differences between myofascial pain trigger point and traditional meridian theory from the aspects of theory,basic research and clinical application,in order to provide a specific idea for the scientific interpretation of meridian phenomenon in traditional Chinese medicine.
文摘BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.
文摘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.
基金Heilongjiang Traditional Chinese Medicine Scientific Research Project(No.ZHY19-009)。
文摘Objective:To observe the clinical efficacy of acupotomology in the treatment of cervical and shoulder myofascial pain trigger point for cervical radiculopathy,and to detect its effect on COX-2,PGE2,5-HT,TNF-α and other inflammatory factors.Methods:A total of 110 CSR patients were selected as the research objects and divided into observation group(Acupotomology to release the trigger points of myofascial pain in neck and shoulder combined with"three-stage"dialectical traction method)and control group(conventional acupuncture combined with"Stage 3"dialectical traction)with 55 cases.Before and after treatment,the two groups were compared by improving the efficacy of MacNab,simplifying the SCORE of Mc Gill Pain Scale,measuring cervical curvature and serum levels of inflammatory factors such as COX-2,PGE2,5-HT and TNF-α.Results:After two weeks of treatment,the total effective rate of the observation group was 96.36%,higher than that of the control group(83.63%),and the difference was statistically significant(P<0.05).After the treatment,PRI,VAS,PPI and other scores of the two groups were all lower than those before the treatment,with statistical significance(P<0.05).However,there was no statistically significant difference in PRI,VAS and PPI scores between the two groups after treatment(P>0.05).The serum inflammatory factors of coX-2,PGE2,5-HT and TNF-αin the two groups were significantly lower after treatment than before treatment(P<0.05).However,the comparison of cox-2,PGE2,5-ht and TNF-αbetween the two groups showed no statistical significance(P>0.05).The cervical curvature values measured after treatment were significantly increased compared with those before treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups(P>0.05).Conclusion:The combination of acumotomology and"three-stage"dialectical traction method can significantly improve the pain and discomfort of patients with cervical radiculopathy,significantly reduce the symptoms,restore the physiological curvature of cervical vertebra,and reduce the inflammatory factors in serum.
文摘Objective To investigate the current practice of myofascial pain syndrome (MPS) including current epidemiology, pathology, diagnosis and treatment. Data sources The data analyzed in this review were mainly from relevant articles without restriction on the publication date reported in PubMed, MedSci, Google scholar. The terms "myofasial trigger points" and "myofacial pain syndrome" were used for the literature search. Study selection Original articles with no limitation of research design and critical reviews containing data relevant to myofascial trigger points (MTrPs) and MPS were retrieved, reviewed, analyzed and summarized. Results Myofascial pain syndrome (MPS) is characterized by painful taut band, referred pain, and local response twitch with a prevalence of 85% to 95% of incidence. Several factors link to the etiology of MTrPs, such as the chronic injury and overload of muscles. Other factors, such as certain nutrient and hormone insufficiency, comorbidities, and muscle imbalance may also maintain the MTrP in an active status and induce recurrent pain. The current pathology is that an extra leakage acetylcholine at the neuromuscular junction induces persistent contracture knots, relative to some hypotheses of integration, muscle spindle discharges, spinal segment sensitization, ect. MTrPs can be diagnosed and localized based on a few subjective criteria. Several approaches, including both direct and supplementary treatments, can inactivate MTrPs. Direct treatments are categorized into invasive and conservative. Conclusion This review provides a clear understanding of MTrP pain and introduces the most useful treatment approaches in China.
文摘Aim:The study aimed at the painful trigger points(TrPs)for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction.Methods:We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction.Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain.We used mean and standard deviation values.The Mann–Whitney U-test was used to compare the two groups.The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores.The Student’s t-test was used to compare maximum mouth opening(MMO)groups.Then paired t-test was also used to study the changes of time in an MMO.Results:The results showed that pulsed electromagnetic field(PEMF)therapy is the most effective treatment modality regarding for pain relief.Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods,and a statistically significant increase in mean MMO.Conclusion:The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.
文摘In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding(1) acupuncture as dry needling and(2) acupuncture points as trigger points(dry needling points). Dry needling simply using English biomedical terms(especially using "fascia" hypothesis) in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain(dry needling promoters redefined it as "myofascial pain"). Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy(a surgical procedure) instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture's local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients' safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.