Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Ultrasound imaging and guidance in the management of myofascial pain syndrome: a narrative review

  • Wei-Ting Wu (Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch) ;
  • Ke-Vin Chang (Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch) ;
  • Vincenzo Ricci (Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco) ;
  • Levent Ozcakar (Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School)
  • Received : 2024.05.01
  • Accepted : 2024.05.22
  • Published : 2024.07.31
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Abstract

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.

Keywords

Acknowledgement

This study was funded by the National Taiwan University Hospital, Bei-Hu Branch; Ministry of Science and Technology, Taiwan (MOST 106-2314-B-002-180-MY3 and MOST 109-2314-B-002-114-MY3) and National Science and Technology, Taiwan (NSTC 112-2314-B-002-134).

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