Physical Medicine and Rehabilitation for Myofascial Pain Follow-up

  • Author: Jennifer E Finley, MD, FAAPMR; Chief Editor: Consuelo T Lorenzo, MD   more...
 
Updated: Oct 28, 2011
 

Further Outpatient Care

  • For patients with myofascial pain, periodic physician visits should continue until the individual's symptoms have resolved or have stabilized at maximum medical improvement (MMI).
Next

Deterrence

  • The deterrence and prevention of myofascial pain focus on removing perpetuating factors. Using appropriate body mechanics, avoiding prolonged static positioning, and properly fitting furniture and workstations all are important. Full ROM of all muscles on a daily basis is extremely helpful.
Previous
Next

Prognosis

  • The prognosis for the resolution of myofascial pain is good if treatment is started in the acute phase and aggravating factors are eliminated. Treatment becomes more difficult as chronicity increases.
Previous
Next

Patient Education

Previous
 
Contributor Information and Disclosures
Author

Jennifer E Finley, MD, FAAPMR  Consulting Physiatrist

Jennifer E Finley, MD, FAAPMR is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Physical Medicine and Rehabilitation, and American College of Sports Medicine

Disclosure: Allergan Honoraria Speaking and teaching

Specialty Editor Board

Martin K Childers, DO, PhD  Professor, Department of Neurology, Wake Forest University School of Medicine; Professor, Rehabilitation Program, Institute for Regenerative Medicine, Wake Forest Baptist Medical Center

Martin K Childers, DO, PhD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Congress of Rehabilitation Medicine, American Osteopathic Association, Christian Medical & Dental Society, and Federation of American Societies for Experimental Biology

Disclosure: Allergan pharma Consulting fee Consulting

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Patrick M Foye, MD  Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society

Disclosure: Nothing to disclose.

Kelly L Allen, MD  Medical Director, Medevals

Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD  Physiatrist, Department of Physical Medicine and Rehabilitation, Alegent Health, Immanuel Rehabilitation Center

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

References

  1. Dorsher PT. Myofascial referred-pain data provide physiologic evidence of acupuncture meridians. J Pain. Jul 2009;10(7):723-31. [Medline].

  2. Ge HY, Wang Y, Danneskiold-Samsoe B, et al. The Predetermined Sites of Examination for Tender Points in Fibromyalgia Syndrome Are Frequently Associated With Myofascial Trigger Points. J Pain. Nov 13 2009;[Medline].

  3. McPartland JM. Travell trigger points--molecular and osteopathic perspectives. J Am Osteopath Assoc. Jun 2004;104(6):244-9. [Medline]. [Full Text].

  4. Hong CZ, Simons DG. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points. Arch Phys Med Rehabil. Jul 1998;79(7):863-72. [Medline].

  5. Alonso-Blanco C, Fernández-de-Las-Peñas C, Morales-Cabezas M, Zarco-Moreno P, Ge HY, Florez-García M. Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. Clin J Pain. Jun 2011;27(5):405-13. [Medline].

  6. Gerwin RD. A review of myofascial pain and fibromyalgia--factors that promote their persistence. Acupunct Med. Sep 2005;23(3):121-34. [Medline].

  7. Graff-Radford SB. Myofascial pain: diagnosis and management. Curr Pain Headache Rep. Dec 2004;8(6):463-7. [Medline].

  8. Simons DG, Travell JG, Simons LS. Travell and Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore, Md: Williams & Wilkins; 1999.

  9. Gerwin RD, Dommerholt J, Shah JP. An expansion of Simons' integrated hypothesis of trigger point formation. Curr Pain Headache Rep. Dec 2004;8(6):468-75. [Medline].

  10. Myburgh C, Larsen AH, Hartvigsen J. A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance. Arch Phys Med Rehabil. Jun 2008;89(6):1169-76. [Medline].

  11. Hameroff SR, Crago BR, Blitt CD, et al. Comparison of bupivacaine, etidocaine, and saline for trigger-point therapy. Anesth Analg. Oct 1981;60(10):752-5. [Medline].

  12. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. Jul-Aug 1994;73(4):256-63. [Medline].

  13. Venâncio Rde A, Alencar FG, Zamperini C. Different substances and dry-needling injections in patients with myofascial pain and headaches. Cranio. Apr 2008;26(2):96-103. [Medline].

  14. Wreje U, Brorsson B. A multicenter randomized controlled trial of injections of sterile water and saline for chronic myofascial pain syndromes. Pain. Jun 1995;61(3):441-4. [Medline].

  15. Rha DW, Shin JC, Kim YK, Jung JH, Kim YU, Lee SC. Detecting local twitch responses of myofascial trigger points in the lower-back muscles using ultrasonography. Arch Phys Med Rehabil. Oct 2011;92(10):1576-1580.e1. [Medline].

  16. Aoki KR. Evidence for antinociceptive activity of botulinum toxin type A in pain management. Headache. Jul-Aug 2003;43 Suppl 1:S9-15. [Medline].

  17. Lang AM. Botulinum toxin therapy for myofascial pain disorders. Curr Pain Headache Rep. Oct 2002;6(5):355-60. [Medline].

  18. Jeynes LC, Gauci CA. Evidence for the use of botulinum toxin in the chronic pain setting--a review of the literature. Pain Pract. Jul-Aug 2008;8(4):269-76. [Medline].

  19. Cheshire WP, Abashian SW, Mann JD. Botulinum toxin in the treatment of myofascial pain syndrome. Pain. Oct 1994;59(1):65-9. [Medline].

  20. Affaitati G, Fabrizio A, Savini A, et al. A randomized, controlled study comparing a lidocaine patch, a placebo patch, and anesthetic injection for treatment of trigger points in patients with myofascial pain syndrome: evaluation of pain and somatic pain thresholds. Clin Ther. Apr 2009;31(4):705-20. [Medline].

  21. Fleckenstein J, Zaps D, Ruger LJ, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey. BMC Musculoskelet Disord. Feb 11 2010;11:32. [Medline]. [Full Text].

  22. Gam AN, Warming S, Larsen LH, et al. Treatment of myofascial trigger-points with ultrasound combined with massage and exercise--a randomised controlled trial. Pain. Jul 1998;77(1):73-9. [Medline].

  23. Lee SH, Chen CC, Lee CS, et al. Effects of needle electrical intramuscular stimulation on shoulder and cervical myofascial pain syndrome and microcirculation. J Chin Med Assoc. Apr 2008;71(4):200-6. [Medline].

  24. Srbely JZ, Dickey JP, Lowerison M, et al. Stimulation of myofascial trigger points with ultrasound induces segmental antinociceptive effects: a randomized controlled study. Pain. May 26 2008;[Medline].

  25. Ay S, Dogan SK, Evcik D, et al. Comparison the efficacy of phonophoresis and ultrasound therapy in myofascial pain syndrome. Rheumatol Int. Mar 31 2010;[Medline].

  26. Flor H, Birbaumer N. Comparison of the efficacy of electromyographic biofeedback, cognitive- behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain. J Consult Clin Psychol. Aug 1993;61(4):653-8. [Medline].

  27. Birch S, Jamison RN. Controlled trial of Japanese acupuncture for chronic myofascial neck pain: assessment of specific and nonspecific effects of treatment. Clin J Pain. Sep 1998;14(3):248-55. [Medline].

  28. Ma C, Wu S, Li G, et al. Comparison of miniscalpel-needle release, acupuncture needling, and stretching exercise to trigger point in myofascial pain syndrome. Clin J Pain. Mar-Apr 2010;26(3):251-7. [Medline].

  29. Leite FM, Atallah AN, El Dib R, et al. Cyclobenzaprine for the treatment of myofascial pain in adults. Cochrane Database Syst Rev. Jul 8 2009;CD006830. [Medline].

  30. Bendtsen L, Jensen R, Olesen J. Qualitatively altered nociception in chronic myofascial pain. Pain. May-Jun 1996;65(2-3):259-64. [Medline].

  31. Danto JB. Review of integrated neuromusculoskeletal release and the novel application of a segmental anterior/posterior approach in the thoracic, lumbar, and sacral regions. J Am Osteopath Assoc. Dec 2003;103(12):583-96. [Medline]. [Full Text].

  32. Facco E, Ceccherelli F. Myofascial pain mimicking radicular syndromes. Acta Neurochir Suppl. 2005;92:147-50. [Medline].

  33. Hsueh TC, Cheng PT, Kuan TS, et al. The immediate effectiveness of electrical nerve stimulation and electrical muscle stimulation on myofascial trigger points. Am J Phys Med Rehabil. Nov-Dec 1997;76(6):471-6. [Medline].

  34. Saggini R, Giamberardino MA, Gatteschi L, et al. Myofascial pain syndrome of the peroneus longus: biomechanical approach. Clin J Pain. Mar 1996;12(1):30-7. [Medline].

  35. Simons DG. Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol. Feb 2004;14(1):95-107. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.