• Journal of Korean Physical Therapy Science
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• v.4 no.2
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• pp.383-390
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• 1997

The purpose of this study is the evaluation of the degree of post injection soreness, symptom duration, factor and autonomic symptoms after trigger point injection in patients with trigger points. We devided the subjects of the study into four groups Such as, only dry needling, needle-TENS, with massage-stretch, massage-stretch only, including 100 patients, and measured the visual analog scale before treatment and after treatment. Before treatment, The VAS mean scores were $6.2{\pm}1.03$ in needle-TENS with massage-stretch group ; $6.2{\pm}1.75$ in needdle-TENS group, and $6.3{\pm}1.85$ in dry needling group, and $6.8{\pm}1.03$ in massage-stretch group. In post injection 3rd day, The VAS mean score were $0.9{\pm}1.78$ in needling-TENS with massage-stretch group, $1.1{\pm}1.52$ in needling-TENS group, $1.7{\pm}1.10$ in dry needling group, and $3.9{\pm}3.01$ in massage-stretch group. As for a causative factor of activities for trigger were overload with 37.0%, overwork with 35.0% and fatigue with 13.0%. Symptoms for trigger were tenderness with 28.0%, numbness and tingling with 24.0%. ROM limit with 17.0% and tightness with 17.0%. As a result, needling-TENS with massage-stretch group showed less soreness and effect than other group.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.105-108
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• 1996

Localized or radiating pain in the arm and shoulder joint may result after faulty alignment causing compression or tension on nerves, blood vessels, or supporting soft tissues. The critical site of faulty alignment is the quadrangular space in the axilla bounded by the teres major, teres minor, long head of triceps, and humerus. The axillary nerve emerges through this space to supply the deltoid and teres minor. The activity of the trigger point on teres minor compressing the axillary nerve causes pain to develop through the area of sensory distribution of cutaneous branch of the axillary nerve. Relieving compression on the axillary nerve and suprascapular nerve is the key point to relieving the pain. Spasm of the supraspinatus and infraspinatus compressing the suprascapular nerve caused pain to develop in the shoulder joint and scapular area. We treated those patients experiencing such pain with local anesthetic infiltration or I-R laser stimulation on the identified trigger points.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.195-199
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• 1999

Background: At present, there is no reliable objective test for the diagnosis of myofascial trigger points (MFTP). We evaluated the usefulness of skin resistance point finder for the diagnosis of MFTP. Methods: 40 subjects with clinical MFTPs at the upper trapezius muscle were included in this study. Using skin resistance point finder (UNIQUE S-2010$^{(R)}$, Seik medical, Korea), we tried to find out the point of low skin resistance. At three different current level, sensitivity and specificity of this method for the diagnosis of clinically identified MFTP was evaluated. Pressure threshold for pain of low skin resistance point was measured using Pressure Threshold Meter$^{(R)}$ (Pain Diagnostics and Thermography, U.S.A.). 3 groups of point detected at different current were compared in mean pressure threshold. Results: Fixed single current of skin resistance point finder showed variable sensitivity and specificity. But, by adjusting current level, skin resistance point finder detected all of 40 clinically identified MFTPs. Although it is partially statistically significant, the mean pressure threshold of points detected at high current was high. Conclusion: Skin resistance finder can be used as objective diagnostic tool of MFTPs. There is possibility that it can be useful in evaluating treatment effect. However, more investigation is necessary.

• Journal of Korean Physical Therapy Science
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• v.9 no.2
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• pp.123-131
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• 2002

The purpose of this study is to compare Ultra Sound(U-S), Silver Spike Point(SSP) and Electro-Acupuncture(E-A) with each other and to objectively analyze their concrete validities and their effects on the deactivation of trigger points in patients with myofascial pain syndrome, and to provide basic necessary principles for clinical therapists. Sixty patients were randomly distributed into three groups of twenty persons each and the U-S, the SSP and the E-A were applied to each group respectively. Tree pain evaluation methods of VAS(Visual Analogue Scale), Electrical Stimulation Scale and Pressure Algometer were adopted to measure the effectiveness of each therapy. The results were as follows: The U-S and E-A groups demonstrated statistically significant decrease on the VAS. The pain thresholds by Electrical Stimulation Scale method was increased for all the groups of U-S, SSP and E-A with no statistical significance. however, Pressure Algometer method was found to increase the pain thresholds for both SSP and E-A groups with statistically significance. Statistically significant improvement was found for all the groups together after the administration of the U-S, the SSP and the E-A. From the above results, three methods of U-S, SSP and E-A are found to be effective tools for the deactivation of trigger points in patients with upper trapezius muscle of Myofascial Pain Syndrome. The E-A method was found to be the most effective among three methods.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.17-21
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• 2010

Purpose: This study was designed to investigate possibilities for quantitative analysis using the electromyography and sonography. For better understanding, we evaluated the correlation between the pressure pain threshold and sonography, spontaneous electrical activity in trigger points located in the upper trapezius muscle. Methods: Thirty three active subjects volunteered to participate in this study (n=33). They had a palpable taut band, exquisite spot tenderness of a nodule in a taut band, spontaneous pain, referred pain, jump sign, local twitch response, and a painful limit to full stretch range of motion. We measured Pressure pain threshold, density, white area index, root mean square, and reaction. Pearson’s correlation coefficient was calculated to estimate the relationship between the pressure pain threshold and other variables including density, white area index, root mean square, and reaction time. Results: There were significant correlations between pressure pain threshold and density (r=-0.75, p<0.01), and between pressure pain threshold and white area index (r=-0.74, p<0.01). A significant correlations between pressure pain threshold and root mean square (r=-0.59, p<0.01). The significant correlation was found between pressure pain threshold and reaction time (r=-0.64, p<0.01). Conclusion: These should indicate whether quantitative analysis can be done using the characteristics of electromyography and sonography.

• Clinical Pain
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• v.20 no.2
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• pp.141-144
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• 2021

There are some cases of myofascial pain syndrome (MPS) with chronic upper back pain that does not respond to dry needling or trigger point injection, well-known treatments for MPS. A 67-year-old female developed a stabbing upper back pain with trigger point at left T7~8 levels 10 years ago. She complained of the pain with Numeral Rating Scale (NRS) 8 points. Myofascial release technique and trigger point injection had no effect. Under ultrasound guidance 20 ml of 1% lidocaine was injected into thoracic paravertebral space. Immediately, the pain was reduced to NRS 4 points. One week later, the second block was performed in the same way as the first, and the pain was reduced to NRS 2 points. The stabbing pain disappeared, and oral opioids were discontinued. Ultrasound guided thoracic paravertebral space block is an effective and safe treatment for refractory MPS with chronic upper back pain.

• Journal of Acupuncture Research
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• v.18 no.1
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• pp.14-20
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• 2001

Purpose ; Iension-type headache is the most common headache. The effect of acupuncture for headache is already known, but the methods and technique of acupuncture is varied. Choice of acupuncture points is mostly relied on experience. Moreover, objective evaluation of acupuncture effects is lacking. Objective ; The objective of this study is to assess the difference of effects between dry needling on trigger point and dry needling on remote acupuncture point. The patients who were diagnosed as tension-type headache and administrated herb-medication were divided into two groups: Trigger point dry needling group and remote acupuncture point dry needling group, matching in sex, age. The degree of pain was measured by visual analogue scale(VAS) two times, before and after dry needling. Conclusion ; VAS showed significant decrement after dry needling on tension-type headache in both groups, but there was no statistically significant difference between two groups according to sex, age and duration. In addition, it is not statistically approved that there exists the difference of VAS between two groups about the treatment effects.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.269-278
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• 2022

Objective: The aim of this study was to evaluate the effects on pain and function of patients with rotator cuff tendinopathy when applying trigger point of infraspinatus and teres minor to myofascial trigger point release (MFR) plus mobility exercise and MFR. Design: A randomized controlled trial. Methods: The total participants were 30patients and were separated to MFR plus mobility exercise group(n=15) and MFR group (n=15) according to the randomized treatment method. The MFR was performed at two infraspinatus tampon points and one teres minor tampon point for twice a week for 4 weeks and the treatment time was 6 minutes 20 seconds in each position. The MFR group also carried out the myofascial trigger point release in the same way as the MFR plus mobility exercise group. Results: The MFR plus mobility exercise group significantly reduced objective and subjective pain (p<0.05). The range of motion of the shoulder joint flexion and external rotation, Quick-Disability of the Arm, shoulder and Hand, and Shoulder Pain and Disability Index were significantly improved in the group to which MFR plus mobility exercise was applied (p<0.05). Conclusions: These results confirmed that MRF plus mobility exercise is more effective in relieving shoulder pain and improving function in rotator cuff tendinopathy.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.1
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• pp.58-64
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• 2010

The purpose of this study was to investigate the distribution of trigger points(TrPs) on athletes with various sporting background. To achieve the purpose, a study was carried out through a survey from 180 athletes involved in 6 selected sports at Yong-In University. Selected sports included Judo, Taekwondo, Kendo, Ssi-reum(Korean traditional wrestling), Boxing, and Golf. An interview type survey and physical examination were conducted with each thirty athletes from each of the selected sports groups. Technical statistic(SPSS 15.0) was used to analyze the distribution of TrPs on these athletes. The most common TrPs observed in muscles of Trapezius, Quadratus Lumborum, Quadriceps in Judo. In Taekwondo, it was on the trapezius and triceps surae. Kendo athletes had TrPs at sites of trapezius, brachioradialis and triceps surae. Ssirem athletes were found to have TrPs on trapezius, deltoid and quadrates lumborum. In boxers, TrPs appearing at trapezius and brachioradialis were observed. Finally, Golf players were seen to have TrPs at trapezius, quadrates lumborum and brachioradialis. Hence, the analysis shows that there are significant differences of the distribution of TrPs according to the different sport items of the athlete.

• Physical Therapy Rehabilitation Science
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• v.2 no.1
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• pp.27-30
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• 2013

Objective: Low back pain is a primary of source of dysfunction and economic costs. Gluteus medius muscle co-activation and activity pattern change caused the low back pain. Active release technique (ART) is a patented, non-invasive, soft tissue treatment process that both locates and breaks down the scar tissue and adhesions. The purpose of this study was to assess the effects on chronic low back pain using ART on gluteus medius so that suggest usable treatment method for treating chronic low back pain. Design: One group pretest-posttest design. Methods: Twelve patients with chronic low back pain were participated in this study. Subjects in ART group were received 2 times a week for 3 weeks treatments with either ART on gluteus medius muscle trigger points. Outcome measures were conducted by pain intensity with a pain visual analogue scale and pressure pain threshold on gluteus medius. Results: Completion of the intervention, the visual analogue scale was decreased in ART group (p<0.05). Also pressure pain threshold was decreased in ART group (p<0.05). Conclusions: Our results suggest that the response to ART may be usable to treat low back pain. ART was presented to reduce pain level of low back in people with chronic low back pain. Further study is required to management for low back pain due to gluteus medius and more ART study.