• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.335-343
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• 2022

Objective: This study aimed to investigate the effects of ischemic compression treatment (ICT) or low-level laser therapy (LLLT) applied to the trigger points of the infraspinatus muscle on shoulder pain and function in patients with shoulder pain. Design: A randomized clinical trial Methods: Thirty patients with shoulder pain were randomly allocated into the ICT group (n=15) or LLLT groups (n=15). ICT was performed on three myofascial trigger points (MTrPs) of the infraspinatus muscle twice a week for 4 weeks (eight sessions), with 5 minutes of treatment per trigger point. LLLT was performed similarly. Shoulder pain was assessed using the visual analogue scale (VAS) and pain pressure threshold (PPT), and shoulder function was assessed using the Korean Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, rotator cuff strength, and range of motion (ROM) of shoulder flexion and abduction. Results: Significant changes in VAS score and PPT were found after the intervention in both groups (p<0.05). Significant changes were observed in the Korean DASH score, rotator cuff strength, and ROM of shoulder flexion (p<0.05) but not in the ROM of shoulder abduction (p<0.05). There were no significant differences between the two groups. Conclusions: This study showed that both ICT and LLLT applied on the MTrPs of the infraspinatus muscle were effective for relieving shoulder pain and improving shoulder functions in patients with shoulder pain.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.261-266
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• 2013

Myofascial pain is a condition associated with regional pain and muscle tenderness characterized by the presence of myofascial trigger points. In this case report, a subject complaining of nighttime bruxism was clinically assessed, and a latent trigger point of the anterior temporalis muscle was identified with manual palpation. A surface electromyographic (SEMG) exam of the anterior temporalis muscle harboring the latent trigger point demonstrated several SEMG features, including post-contraction irritability, delayed relaxation following contraction and accelerated muscle fatigue. It was concluded that a SEMG exam may detect abnormal masticatory muscle function and, therefore, assist in the evaluation of myogenous temporomandibular disorders.

• Journal of Oral Medicine and Pain
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• v.42 no.3
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• pp.53-61
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• 2017

Myogenous temporomandibular disorder is a collective term for pathologic conditions of the masticatory muscles, mainly characterized by pain and dysfunction associated with various pathophysiological processes. Among the subtypes of myogenous temporomandibular disorder, myofascial pain is one of the most common muscle disorders, characterized by the presence of trigger points (TrPs). Various modalities, such as ultrasound, manipulative therapy, spray-and-stretch technique, transcutaneous electrical nerve stimulation, injection/dry needling, and low-level laser therapy are used to inactivate TrPs. Needling/injection on the TrPs is one of the most common treatments for myofascial pain. Despite the evidence, there is continued controversy over defining the biological and clinical characteristics of TrPs and the efficacy of injection/dry needling. This review discusses the current concept of injection/needling to relieve TrPs.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.49-61
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• 2005

Summary of Background Data: Myofascial pain syndrome (MPS) is a common painful muscle disorder caused by trigger points occurring in myofascial. MPS is a major cause of chronical pain and is the subject of further clinical examination. Purpose: To uncover effective intramuscular stimulation therapy (IMS), the patients' actively participation stretching exercise and stabilizing around shoulder girdle where trigger point provoking myofascial pain syndrome in usually occurred. Methods: 45 myofascial pain syndrome patients were randomly chosen and divided into 3 groups. The first group (G1) received only IMS therapy, The second group (G2) had both IMS and active stretching exercises administered and the final group (G3) was given IMS therapy and stabilizing exercises. Therapy intervention was given for 3 weeks, 3 times a week and then only stretching exercise for the second group and stabilizing exercise for the third group was given for another 3 weeks. The visual analogue scale was dine before the experiment, 3 weeks after the experiment and 6weeks after the experiment to measure subjective degrees of pain and pressure pain threshold to measure sensitivity improvement of trigger point and functional ability questionnaire to measure daily life performance. Results: There were no significant changes after 3 weeks but after 6 weeks, between GI and G2 and between G1 and G3 showed significant change of pain, pressure pain threshold and daily life performance. There were significant improvement of the measurement of degrees of pain, pressure pain threshold and improvement of daily life performance at different times for G1 showed change 3 weeks after the experiment, but there were no changes 6 weeks after the experiment. There were significant improvement of the measurement at different times for G2 and G3 showed change 3 weeks after the experiment and 6 weeks after the experiment. Conclusions: IMS therapy proved to be effective in inactivation of trigger points of the myofascial pain syndrome patients and stretching and stabilizing exercises beside it keep remedial value longer by improvement of pain and dysfunction that occurred by the trigger point.

• 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.

• Korean Journal of Acupuncture
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• v.20 no.1
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• pp.71-90
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• 2003

The shoulder is the most flexible joint in human body, so many people suffer from the shoulder pain. In order to improve medical care about shoulder muscle disease, Myofascial Pain Syndrome(M.P.S) is compared with the oriental medical theory. The findings of this study are as follows; 1. Myofascial Pain Syndrome(M.P.S) is the sensory, motor, and autonomic symptoms caused by myofascial trigger points. For the objectivity of the oriental medical theory, practical application is necessary. 2. The meridian and meridian-muscle of the shoulder is su-sam-yang(手三陽), su-sam-um(手三陰). Meridian-muscle theory is similar to anatomical muscle and myofascia. 3. There is similarity in the trigger point and Ashi(阿是)-point, taut band and palpable tender-point(硬結), referred pain and Hangki(行氣). In this study, myofacial pain syndrome is similar to the oriental medical theory. If myofacial pain syndrome is applicated in treatment, the cure of shoulder pain and objectivity of the oriental medical theory is improved.

• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.294-303
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• 2024

Objective: The objective of this study is to evaluate the effects of radial shock wave therapy (RSWT) targeting multiple myofascial trigger points (MTrPs) along myofascial chains on shoulder pain, function, range of motion, and muscle strength in patients with bicipital tendinopathy. While traditional treatments primarily focus on a single MTrP, this study aims to achieve better clinical improvement by simultaneously treating multiple MTrPs along the myofascial chains. Design: A randomized controlled trial. Methods: Twenty-eight patients with bicipital tendinopathy were randomly assigned to either an experimental group (n=14) or a control group (n=14). The experimental group received RSWT targeting multiple MTrPs along myofascial chains, while the control group received RSWT focused on a single MTrP in the biceps brachii. Both groups underwent three treatment sessions over a nine-day period, with one session every three days. Outcomes, including shoulder pain, function, range of motion, and muscle strength, were measured before and after treatment to assess therapeutic effects. Results: Both groups showed significant improvements in shoulder pain, function, range of motion, and muscle strength (p<0.05). However, the experimental group demonstrated significantly greater improvements in all outcome measures compared to the control group (p<0.05). Conclusions: RSWT targeting multiple MTrPs along myofascial chains showed significantly greater effects in relieving shoulder pain, improving function, enhancing range of motion, and strengthening muscles in patients with bicipital tendinopathy compared to treatment targeting a single MTrP. Therefore, this study proposes that a comprehensive treatment strategy considering the entire myofascial pathway may be more effective in the rehabilitation of patients with bicipital tendinopathy.

• 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.

• 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.