• 대한정형외과 초음파학회지
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• 제7권2호
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• pp.127-131
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• 2014

인체에서 가장 큰 기관인 골격근은 통증과 기능장애를 초래할 수 있는데, 통증 유발점이라는 특징적인 병변을 가지는 근막 통증 증후군이 골격근의 가장 흔한 병적 상황 중의 하나이다. 통증 유발점은 골격근 내의 taut band라고 불리는 띠안에 존재하는 과민한 통증성 국소 병변으로 국소 통증 뿐만 아니라 연관통 및 만성적인 관절운동 제한과도 동반된다. 다양한 치료법들이 시도되었으나 통증 유발점 주사법이 가장 효율적인 치료법으로 사용되고 있으며 이 종설에서는 근막 통증 증후군의 일반적 병인과 통증 유발 주사의 방법에 대하여 소개하고자 한다.

• The Korean Journal of Pain
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• 제8권2호
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• pp.272-278
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• 1995

Headache is a common disease of the general population. But the main problem in any study of headache has been that of defining the disease entities. In 1988, the Headache Classification committee of the International Headache Society introduced operational diagnostic criteria for all headache disorders into 13 major group; migraine, tension-type headache, cluster headache and chronic paroxysmal hemicrania etc. Sjaastad was the first to describe "cervicogenic headache", one of various head pain syndromes that probably originate in the cervical spine. Between March 1995 and June 1995, we studied 78 out-patients of the Department of Neuro pain clinic, Sanggye Paik Hospital, Inje university. We divided the patients into three study group: Fifty-three patients with tension-type headache, 13 with cervicogenic headache, and 12 with migraine headache. The reponse of trigger point injection and $C_2$-ganglion block in patients was investigated. We paid particular attention to the response of trigger point injection in patients of the three group. The effect of trigger point injection was more marked in tension-type headache group than in the other categories. The pain reduction after $C_2$-ganglion block was more marked in cervicogenic headache group than in the others.

• Clinics in Shoulder and Elbow
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• 제6권2호
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• pp.108-114
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• 2003

The shoulder is a complex area which makes it vulnerable to painful pathologic processes. Chronic shoulder pain has become more common recently due to increased use of computers and a ,generally more sedentary life style among most people . Trigger point injection and neural blockade are useful for the management of chronic shoulder pain which has not improved with conservative treatment. Published articles concerning trigger point injection or neural blockade for chronic shoulder pain were reviewed to evaluate promising methods. If we are careful to remain aware of the details and complications in addition to adhering to effective treatments, these should be good armamentarium for doctors enthusiastic about the management of chronic shoulder pain.

• The Korean Journal of Pain
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• 제20권1호
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• pp.74-77
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• 2007

The trigger point injection technique is widely used in pain clinics for the treatment of acute and chronic pain. Yet it has a variety of complications such asvasovagal syncope, total spinal anesthesia, paralysis, root block, pneumothorax, needle breakage, skin infection, and hematoma formation. Among them, the simultaneous occurrence of psoas and epidural abscesses is extremely rare. We report here on a patient who was diagnosed with epidural and psoas abscesses after paravertebral trigger point injection.

• The Korean Journal of Pain
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• 제12권2호
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• pp.263-267
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• 1999

We have observed retroperitoneal hematoma after trigger point injections of quadratus lumborum in a patient with chronic low back pain. Severe flank pain and dyspnea was observed three hours after injection of local anesthetic and steroid to the trigger point of quadratus lumborum muscle. There was fuge hematoma in abdominal CT image around the right kidney, which displaced and compressed the kidney anteriorly. Following infusion of contrast media, extravasation through renal vein and IVC was notified. Patient had a past history of having been treated with platelet aggregation inhibitor and lower dose aspirin treatment after cerebral ischemia for a year, but coagulative function was within normal range. Patient was admitted 12 days for bed rest, pain control and transfusion. We need to take greater care with a frequent aspiration and exact direction of needle, during trigger point injection of quadratus lumborum, particu right side, to avoid vascular injury.

• The Korean Journal of Pain
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• 제12권1호
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• pp.75-80
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• 1999

Background: Despite tension type headache is popular, the exact mechanism and method of treatment are not certain yet. So, we supposed the basic mechanism of tension type headache is myogenic, and did Tienchu acupoint block, occipital nerve block, and trigger point injection in tension type headache patients. Methods: Fifty-seven tension type headache patients were treated with local anesthetics and small dose of steroid. The intensity of pain and effect of every treatment was evaluated as Verbal Rating Score (VRS; 0~10) before and after every treatment. Evaluation of treatment was based on the time of treatment (1,2 times, 3 times, 4,5 times). Goal of treatment was VRS reaching below two point and it was considered as treated state. Results: Symptom improvement rates of each treatment were 90% (1, 2 times), 91% (3 times), 70% (4, 5 times) respectively. VRS reduction more than 50% rates were 60%, 64%, 60% respectively. Treated state (VRS<2) rates were 33%, 27%, 30% respectively. Conclusion: Tienchu acupoint block, occipital nerve block, trigger point injection were sorts of most effective and simply applicable modalities of treatment in tension type headache.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.193-197
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• 1998

Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)

• 대한물리치료과학회지
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• 제2권3호
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• pp.727-738
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• 1995

Myofascial pain syndrome is one of the major cause of chronic pain and trigger point injection, stretching, spray and electrical therapy are often used in clinical situation for treatment of myofascial pain syndrome. Myofascial pain syndrome is characterzied by the existence of a hypersensitive region, called the trigger point in a muscle or in the connective tissue, together with palpable noble, stiffness, limitation of motion and referred pain when trigger point is stimulated. Physiologically, they represent a self-sustaining vicious cycle of pain-spasm-pain. The purpose of this study is to illustrate mechanisms of pain by stimulation of acupuncture and trigger point, to introduce clinic application of orient and western stimulative point (acupuncture, trigger point)for treatment of MPS(myofascial pain syndrome), to make physiotherapist use both stimulative points for treatment of MPS.

• The Korean Journal of Pain
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• 제25권1호
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• pp.52-54
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• 2012

Trigger point injection treatment is an effective and widely applied treatment for myofascial pain syndrome. The trapezius muscle frequently causes myofascial pain in neck area. We herein report a case in which direct pulsed radiofrequency (RF) treatment was applied to the trapezius muscle. We observed that the RF treatment produced continuous pain relief when the effective duration of trigger point injection was temporary in myofascial pain.

• 대한물리치료과학회지
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• 제4권2호
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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.