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1.
Pain Res Manag ; 2022: 8920252, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35845982

RESUMO

Numerous studies have suggested that the myofascial trigger points are responsible for most of the myofascial pain syndrome, so it seems reasonable that its destruction is a good therapeutic solution. The effectiveness of dry needling (DN) has been confirmed in muscles with myofascial trigger points, hypertonicity, and spasticity. The objective of this study is to analyze the need of repetitive punctures on muscles in different situations. The levator auris longus (LAL) muscle and gastrocnemius muscle from adult male Swiss mice were dissected and maintained alive, while being submerged in an oxygenated Ringer's solution. DN was evaluated under four animal models, mimicking the human condition: normal healthy muscles, muscle fibers with contraction knots, muscles submerged in a depolarizing Ringer solution (KCl-CaCl2), and muscles submerged in Ringer solution with formalin. Thereafter, samples were evaluated with optical microscopy (LAL) and scanning electron microscopy (gastrocnemius). Healthy muscles allowed the penetration of needles between fibers with minimal injuries. In muscles with contraction knots, the needle separated many muscle fibers, and several others were injured, while blood vessels and intramuscular nerves were mostly not injured. Muscles submerged in a depolarizing solution inducing sustained contraction showed more injured muscular fibers and several muscle fibers separated by the needle. Finally, the muscles submerged in Ringer solution with formalin showed a few number of injured muscular fibers and abundant muscle fibers separated by the needle. Scanning electron microscopy images confirm the optical analyses. In summary, dry needling is a technique that causes mild injury irrespective of the muscle tone.


Assuntos
Agulhamento Seco , Síndromes da Dor Miofascial , Adulto , Animais , Formaldeído , Humanos , Masculino , Camundongos , Músculo Esquelético , Síndromes da Dor Miofascial/terapia , Agulhas , Solução de Ringer , Pontos-Gatilho
3.
J Acupunct Meridian Stud ; 15(2): 143-151, 2022 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-35770581

RESUMO

Background: Exercise therapy is the first choice non-pharmacotherapeutic approach for musculoskeletal pain; however, it often interferes with the implementation and continuation of exercise due to fear-avoidance behaviors. Trigger point acupuncture (TrPAcp) has been reported to reduce musculoskeletal pain. Objectives: To examine the efficacy of exercise combined with TrPAcp compared to exercise alone for older patients with chronic low back pain (CLBP), the most common subjective symptom reported by old people of both sexes in Japan. Methods: In this single-center randomized controlled trial conducted at Teikyo Heisei University, 15 men and women aged ≥ 65 years with low back pain for at least 3 months who met the eligibility criteria were included. The Ex+TrPAcp group received exercise and trigger point acupuncture, while the Ex group received only exercise for 3 months. The main outcome, pain intensity, was measured using the numerical rating scale (NRS). Improvement was defined as a decrease in NRS of ≥ 2 or less than moderate (NRS < 4). Results: The analysis included 7 of 8 cases in the Ex+TrPAcp group and 7 of 7 cases in the Ex group. NRS improved in 6 of 7 and 1 of 7 patients in the intervention and control groups, respectively, with a significant difference between groups (p = 0.03, ϕ = 0.71). Regarding adverse events due to acupuncture, one patient (14.3%) complained of heaviness after acupuncture. Nothing specific was reported with exercise. Conclusion: Compared with Ex alone, Ex+TrPAcp may be more effective therapy for older people with CLBP who do not have an exercise habit.


Assuntos
Terapia por Acupuntura , Dor Crônica , Dor Lombar , Dor Musculoesquelética , Idoso , Dor Crônica/terapia , Terapia por Exercício , Feminino , Humanos , Dor Lombar/terapia , Masculino , Medição da Dor , Resultado do Tratamento , Pontos-Gatilho
4.
Phys Med Rehabil Clin N Am ; 33(2): 307-333, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35526973

RESUMO

Myofascial pain and myofascial pain syndromes are among some of the most common acute and chronic pain conditions. Many interventional procedures can be performed in both an acute and chronic pain setting to address myofascial pain syndromes. Trigger point injections can be performed with or without imaging guidance such as fluoroscopy and ultrasound; however, the use of imaging in years past has been recommended to improve patient outcome and safety. Injections can be performed using no injectate (dry needling), or can involve the administration of local anesthetics, botulinum toxin, or corticosteroids.


Assuntos
Dor Crônica , Síndromes da Dor Miofascial , Anestésicos Locais , Dor Crônica/tratamento farmacológico , Humanos , Síndromes da Dor Miofascial/tratamento farmacológico , Resultado do Tratamento , Pontos-Gatilho
5.
J Bodyw Mov Ther ; 30: 23-29, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35500976

RESUMO

BACKGROUND: One of the most common knee problems is patellofemoral pain syndrome (PFPS). It is of great importance to pay attention to the muscles of the hip area in people with PFPS, especially to the presence of trigger points within the gluteus medius (GM). Accordingly, using therapeutic interventions to eliminate trigger points is required. Therefore, the aim of the present study was to evaluate the effect of GM active trigger point dry needling (TrP-DN) on pain and physical function of non-athlete women with unilateral PFPS. METHODS: 29 young non-athlete women aged between 17 and 40 years old with unilateral PFPS were randomly divided into two groups of experimental (n = 15) and control (n = 14) through the simple and convenience sampling method. Both groups received conventional physiotherapy twice a week up to 6 sessions. The experimental group also received GM active TrP-DN once a week for 3 sessions in addition to the conventional physiotherapy. Pain intensity and physical function of women with PFPS were measured in both groups in three stages of before, immediately after and one week after performing the treatment sessions. FINDINGS: The six-session physiotherapy treatment led to a significant reduction in pain intensity as well as an improvement in physical function in both groups (p < 0.001). In addition, the intergroup comparison showed a significant improvement in physical function of the experimental group after one week from the GM active TrP-DN, compared to the control group (p = 0.048). CONCLUSION: The present study indicated that conventional physiotherapy with or without GM active TrP-DN can reduce pain and improve physical function in non-athlete women with unilateral PFPS. This study also revealed that conventional physiotherapy combined with dry needling can lead to further reduction in pain and a greater improvement in physical function of this group of patients.


Assuntos
Agulhamento Seco , Síndrome da Dor Patelofemoral , Adolescente , Adulto , Feminino , Humanos , Dor , Medição da Dor , Síndrome da Dor Patelofemoral/terapia , Pontos-Gatilho , Adulto Jovem
6.
PLoS One ; 17(4): e0266244, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35390021

RESUMO

Many endangered species exist in only a single population, and almost all species that go extinct will do so from their last remaining population. Understanding how to best conserve these single population threatened species (SPTS) is therefore a distinct and important task for threatened species conservation science. As a last resort, managers of SPTS may consider taking the entire population into captivity-ex situ, in toto conservation. In the past, this choice has been taken to the great benefit of the SPTS, but it has also lead to catastrophe. Here, we develop a decision-support tool for planning when to trigger this difficult action. Our method considers the uncertain and ongoing decline of the SPTS, the possibility that drastic ex situ action will fail, and the opportunities offered by delaying the decision. Specifically, these benefits are additional time for ongoing in situ actions to succeed, and opportunities for the managers to learn about the system. To illustrate its utility, we apply the decision tool to four retrospective case-studies of declining SPTS. As well as offering support to this particular decision, our tool illustrates why trigger points for difficult conservation decisions should be formulated in advance, but must also be adaptive. A trigger-point for the ex situ, in toto conservation of a SPTS, for example, will not take the form of a simple threshold abundance.


Assuntos
Conservação dos Recursos Naturais , Espécies em Perigo de Extinção , Animais , Conservação dos Recursos Naturais/métodos , Estudos Retrospectivos , Pontos-Gatilho
7.
Medicina (Kaunas) ; 58(4)2022 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-35454318

RESUMO

Background and Objectives: This study tested the hypothesis that treatment of myofascial trigger points (MTrPs) in the upper trapezius muscle (UTM) with repeated injection of 1% lidocaine results in better alleviation of muscular stiffness and soreness as well as improved metabolism in the hypercontracted MTrP area than treatment with radial extracorporeal shock wave therapy (rESWT). Materials and Methods: A single-blinded, prospective, randomized controlled trial was conducted on patients suffering from MTrPs in the UTM. Thirty patients were treated with repeated injection of 2 mL of 1% lidocaine (three injections; one injection per week). Another 30 patients were treated with rESWT (three treatment sessions; one treatment session per week; 2000 radial extracorporeal shock waves per treatment session; positive energy flux density = 0.10 mJ/mm2). The primary outcome measure was pain severity using the VAS score. The secondary outcome measures included muscle elasticity index, pressure pain threshold and neck disability index. Evaluation was performed at baseline (T1), 15-30 min after the first treatment in order to register immediate treatment effects (T2), before the second treatment (i.e., one week after baseline) (T3) and one week after the third treatment (i.e., four weeks after baseline) (T4). Results: There were no statistically significant differences in the primary and secondary outcome measures between the patients in the lidocaine arm and the patients in the rESWT arm at T1 and T4. Within the arms, the mean differences of all outcomes were statistically significant (p < 0.001) when comparing the data obtained at T1 with the data obtained at T3 and the data obtained at T4. Conclusions: The results of this pilot study suggest that the use of rESWT in patients with MTrPs in the UTM is safe and leads to reduced pain and improved muscle elasticity, pressure pain threshold and neck disability index, without adverse effects. Larger trials are necessary to verify this. Clinicians should consider rESWT instead of injections of lidocaine in the treatment of MTrPs in the UTM.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Tratamento por Ondas de Choque Extracorpóreas/métodos , Humanos , Lidocaína/uso terapêutico , Projetos Piloto , Estudos Prospectivos , Resultado do Tratamento , Pontos-Gatilho
9.
Rev Assoc Med Bras (1992) ; 68(1): 56-60, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35239938

RESUMO

OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.


Assuntos
Síndromes da Dor Miofascial , Cervicalgia , Músculos Superficiais do Dorso , Pontos-Gatilho , Adolescente , Adulto , Dor Crônica , Feminino , Humanos , Pessoa de Meia-Idade , Síndromes da Dor Miofascial/diagnóstico , Síndromes da Dor Miofascial/fisiopatologia , Cervicalgia/epidemiologia , Reprodutibilidade dos Testes , Músculos Superficiais do Dorso/fisiopatologia , Pontos-Gatilho/fisiopatologia , Adulto Jovem
10.
J Bodyw Mov Ther ; 29: 140-145, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35248262

RESUMO

INTRODUCTION: We hypothesized that latent MTrPs might decrease gluteus medius muscle strength in healthy individuals. This study aimed to investigate the relationship between latent MTrPs and gluteus medius muscle strength in a group of healthy adults. METHODS: Forty-eight healthy men were included in the study. Trigger point examination for the gluteus medius was performed bilaterally. Subjects with one or more trigger points on the dominant side and those without any trigger point were assigned to two groups. Muscle strength for the gluteus medius was assessed with a manual muscle tester using the "break test" technique on both sides. For statistical analysis, the independent sample t-test was used to compare the intergroup differences. RESULTS: The latent MTrP group demonstrated lower abduction muscle strength in the dominant gluteus medius. Moreover, the latent MTrP group showed higher abduction muscle strength in the non-dominant gluteus medius (p < 0.05). Intergroup comparison revealed that gluteus medius abduction muscle strength on the dominant side was higher in the non-latent MTrP group (p < 0.05). CONCLUSION: Latent MTrP may cause joint movement limitation, overload by affecting motor activation patterns and reciprocal inhibition mechanisms. Outcomes of the current study revealed that gluteus medius abduction strength values below 9.7 kg could be associated with latent MTrP with high sensitivity and low specificity. It is imperative to note that the latent MTrP of gluteus medius muscle, which has a critical role in the lumbopelvic junction, should not be ignored in clinical practice, and treatment should be applied when detected.


Assuntos
Força Muscular , Pontos-Gatilho , Adulto , Nádegas , Voluntários Saudáveis , Humanos , Masculino , Força Muscular/fisiologia , Músculo Esquelético/fisiologia
11.
Complement Ther Clin Pract ; 47: 101571, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35272249

RESUMO

AIM: To investigate the effectiveness of dry-needling(DN) together with exercise therapy on pain, ultrasonographic parameters of myofascial trigger points(MTrPs), and upper trapezius(UT) muscles, and neck disability in patients with myofascial pain syndrome. MATERIAL AND METHODS: This was a single-blind, prospective, randomized, and controlled trial. Participants aged 18-45 years with persistent neck pain for >3 months caused by the active MTrPs in the UT muscles were included. The exercise therapy was performed 3 times/week for 3 months. DN therapy was applied once a week, for a total of three sessions. The pain intensity, ultrasonographic measurements of the thickness of the UT muscle, and diameter of the MTrPs in the UT muscle were the primary outcomes. The secondary outcome was the neck disability. RESULTS: Seventy participants were randomized into two groups: the dry-needling together with exercise group(DNG, n = 35) and the exercise-only group(EG, n = 35). A total of 8 participants dropped out of the study, and the study was completed with 62 participants(DNG = 33; EG = 29). There was a significant difference in terms of VAS(at night, at rest, and during activity)(p < 0.001) at post-treatment and after 3 months, the thickness of UT muscle(p = 0.004), and diameter of MTrP(p = 0.021) at post-treatment between the groups. No statistical differences were identified in terms of NDI(p = 0.065). CONCLUSION: This study demonstrated the effects of DN applied together with exercise therapy on reduction of the pain intensity at short(post-treatment) and mid-term(after 3 months), and the ultrasonographic parameters of MTrPs and UT muscles at short-term(post-treatment).


Assuntos
Síndromes da Dor Miofascial , Pontos-Gatilho , Humanos , Síndromes da Dor Miofascial/terapia , Cervicalgia/terapia , Limiar da Dor , Estudos Prospectivos , Método Simples-Cego
12.
Trials ; 23(1): 238, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35346331

RESUMO

BACKGROUND: Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of nonspecific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain. METHODS: This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 6 sessions will be administered once a week for 6 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength and lumbar mobility will be recorded at 6 weeks (post-immediate) and 2 months after the end of treatment. DISCUSSION: We believe that an approach including electrical dry needling to chronic low back pain dysfunction will be more effective in these patients. The results of this study will inform clinicians on which type of treatment is more beneficial for patients with chronic low back pain. TRIAL REGISTRATION: ClinicalTrials.gov NCT04804228. Registered on 14 January 2021.


Assuntos
Agulhamento Seco , Dor Lombar , Agulhamento Seco/efeitos adversos , Humanos , Dor Lombar/diagnóstico , Dor Lombar/terapia , Modalidades de Fisioterapia , Qualidade de Vida , Pontos-Gatilho
15.
PLoS One ; 17(2): e0263087, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35171940

RESUMO

BACKGROUND: Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. METHODS: Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. FINDINGS: 799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. CONCLUSIONS: MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue ("fascial armoring"). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A "global percutaneous needle fasciotomy" that respects tensegrity principles may treat MPS/fibromyalgia more effectively. "Functional-somatic syndromes" can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.


Assuntos
Adaptação Fisiológica , Evolução Biológica , Fibromialgia/patologia , Síndromes da Dor Miofascial/patologia , Humanos , Pontos-Gatilho
16.
Sci Rep ; 12(1): 3188, 2022 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-35210467

RESUMO

The purpose was to determine the efficacy of deep dry needling (DDN) applied on an active myofascial trigger point (MTrP) versus a latent-MTrP versus a non-MTrP location, on pain reduction and cervical disability, in patients with chronic neck pain. A randomized, double-blind clinical trial design was used. A sample of 65 patients was divided into non-MTrP-DDN, active-MTrP-DDN and latent-MTrP-DDN groups. The visual analog scale (VAS), reproduction of the patient's pain, number of local twitch responses, pressure pain threshold (PPT) and Neck Disability Index (NDI) were assessed before, during and after the intervention and up to 1 month post-intervention. The active-MTrP-DDN-group reduced pain intensity more than non-MTrP-DDN-group after a week and a month (P < 0.01), as well as showing the greatest improvement in tibialis muscle PPT. The treatment of both Active and Latent MTrPs was associated with the reproduction of the patient's pain. The application of DDN on an active-MTrP in the upper trapezius muscle shows greater improvements in pain intensity after 1 week and 1 month post-intervention, compared to DDN applied in latent-MTrPs or outside of MTrPs in patients with neck pain.


Assuntos
Agulhamento Seco , Injeções/métodos , Síndromes da Dor Miofascial/terapia , Cervicalgia/terapia , Pontos-Gatilho , Adolescente , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Limiar da Dor , Músculos Superficiais do Dorso , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
17.
Medicine (Baltimore) ; 101(8): e28838, 2022 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-35212282

RESUMO

BACKGROUND: Osteoarthritis of the knee is one of the major disorders leading to social dysfunction, economic loss and social development. This study was conducted to systematically evaluate the efficacy and safety effectiveness of acupuncture inactivation of myofascial pain trigger points in the treatment of osteoarthritis of the knee. METHODS: Randomized Controlled Trials (RCTs) on the treatment of knee pain were searched by computer from PubMed, The Cochrane Library, China journal full-text database (CNKI), Chinese biomedical literature database (CBM), China academic journal database (Wanfang Data) databases from the date of creation to December 2021, and the data were analyzed by Reman 5.3 software for data analysis. RESULTS: A total of 724 patients from 9 RCTs were finally included, and the results of meta-analysis showed that the acupuncture myofascial pain trigger point group was better than the control group in terms of total effective rate, cure rate, VAS score, Lysholm score, and WOMAC score. CONCLUSION: The efficacy and safety of acupuncturing myofascial pain trigger points in the treatment of knee osteoarthritis is positive, but due to the limited number of literature included in this study and the low quality of the included literature, there is still a need for high-quality and large sample size RCTs for the analysis of this treatment option.


Assuntos
Terapia por Acupuntura , Dor Crônica/terapia , Osteoartrite do Joelho/terapia , Humanos , Articulação do Joelho/fisiopatologia , Síndromes da Dor Miofascial , Dor , Resultado do Tratamento , Pontos-Gatilho
18.
Medicina (Kaunas) ; 58(2)2022 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-35208580

RESUMO

Background and Objectives: The objective of our clinical trial was to determine the effectiveness of the deep dry needling technique (DDN) (neuromuscular deprogramming) as a first step in the treatment of temporomandibular disorders. Methods and Materials: The double-blind randomized clinical trial comprised 36 patients meeting the inclusion criteria who had signed the corresponding informed consent form. The participants were randomly distributed into two groups, the Experimental group (Group E) and the Control group (Group C). Group E received bilateral DDN on the masseter muscle, while Group C received a simulation of the technique (PN). All the participants were evaluated three times: pre-needling, 10 min post-needling, and through a follow-up evaluation after 15 days. These evaluations included, among other tests: pain evaluation using the Visual Analog Scale (VAS) and bilateral muscle palpation with a pressure algometer; evaluation of the opening pattern and range of the mouth, articular sounds and dental occlusion using T-scans; and electromyography, which was used to evaluate the muscle tone of the masseter muscles, in order to control changes in mandibular position. Results: Digital control of occlusion using Tec-Scan (digital occlusion analysis) showed a significant reduction both in the time of posterior disclusion and in the time needed to reach maximum force in an MI position after needling the muscle, which demonstrated that there were variations in the static position and the trajectory of the jaw. The symmetry of the arch while opening and closing the mouth was recovered in a centric relation, with an increase in the opening range of the mouth after the procedure. Conclusions: facial pain is significantly reduced and is accompanied by a notable reduction in muscle activity after needling its trigger points.


Assuntos
Agulhamento Seco , Síndromes da Dor Miofascial , Transtornos da Articulação Temporomandibular , Humanos , Síndromes da Dor Miofascial/terapia , Agulhas , Transtornos da Articulação Temporomandibular/terapia , Pontos-Gatilho
19.
J Med Case Rep ; 16(1): 31, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35039086

RESUMO

INTRODUCTION: Myofascial pain is a complex health condition that affects the majority of the general population. Myalgia has been recognized as a symptom of long COVID syndrome. The treatment for long COVID syndrome-related myalgia lacks research. Dry needling is a technique that involves the insertion of a needle into the tissue of, or overlaying, a pain point. Wet needling is the addition of an injection of an analgesic substance such as lidocaine while performing needling. Both dry and wet needling have are practiced as treatment modalities for myofascial pain. Limited literature exists to define long COVID syndrome-related myalgia and its relation to myofascial pain, or to examine the utility of needling techniques for this pain. We report a case of dry and wet needling as effective treatments for long COVID-related myofascial pain. CASE PRESENTATION: A 59-year-old, previously healthy Hispanic male with no comorbid conditions was diagnosed with COVID-19 pneumonia. The patient suffered moderate disease without hypoxia and was never hospitalized. Three months later, the patient continued to suffer from symptoms such as exertional dyspnea, "brain fog," and myalgia. An extensive multisystem workup revealed normal cardiac, pulmonary, and end organ functions. The patient was then diagnosed with long COVID syndrome. The nature and chronicity of the patient's myalgia meet the criteria for myofascial pain. Both wet and dry needling were used to treat the patient's myofascial pain, with good short- and long-term therapeutic effects. CONCLUSIONS: COVID-19 infection has been shown to exacerbate preexisting myofascial pain syndrome. Our case report indicates that long COVID syndrome-related myalgia is likely a form of new-onset myofascial pain. Additionally, both wet and dry needling can be utilized as an effective treatment modality for this pain syndrome, with short- and long-term benefits.


Assuntos
COVID-19 , Agulhamento Seco , COVID-19/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia , SARS-CoV-2 , Pontos-Gatilho
20.
Rev. Assoc. Med. Bras. (1992) ; 68(1): 56-60, Jan. 2022. tab
Artigo em Inglês | LILACS | ID: biblio-1360702

RESUMO

SUMMARY OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Cervicalgia/epidemiologia , Pontos-Gatilho/fisiopatologia , Músculos Superficiais do Dorso/fisiopatologia , Síndromes da Dor Miofascial/diagnóstico , Síndromes da Dor Miofascial/fisiopatologia , Reprodutibilidade dos Testes , Dor Crônica , Pessoa de Meia-Idade
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