Physical Medicine and Rehabilitation for Myofascial Pain Guidelines

1. Bordoni B, Varacallo M. Myofascial Pain. StatPearls. 2018 Jan. [QxMD MEDLINE Link]. [Full Text].

2. Dorsher PT. Myofascial referred-pain data provide physiologic evidence of acupuncture meridians. J Pain. 2009 Jul. 10(7):723-31. [QxMD MEDLINE Link].

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

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

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. 2011 Jun. 27(5):405-13. [QxMD MEDLINE Link].

6. Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil. 2008 Jan. 89(1):16-23. [QxMD MEDLINE Link].

7. Sanchez-Romero EA, Pecos-Martín D, Calvo-Lobo C, et al. Clinical features and myofascial pain syndrome in older adults with knee osteoarthritis by sex and age distribution: A cross-sectional study. Knee. 2018 Dec 6. [QxMD MEDLINE Link].

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

9. Moustafa IM, Diab AA, Hegazy F, Harrison DE. Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial. BMC Musculoskelet Disord. 2018 Nov 12. 19 (1):396. [QxMD MEDLINE Link]. [Full Text].

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

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

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

13. 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. 2008 Jun. 89(6):1169-76. [QxMD MEDLINE Link].

14. Kumbhare D, Shaw S, Ahmed S, Noseworthy MD. Quantitative ultrasound of trapezius muscle involvement in myofascial pain: comparison of clinical and healthy population using texture analysis. J Ultrasound. 2018 Nov 9. [QxMD MEDLINE Link].

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

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

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

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

19. Diraçoglu D, Vural M, Karan A, Aksoy C. Effectiveness of dry needling for the treatment of temporomandibular myofascial pain: a double-blind, randomized, placebo controlled study. J Back Musculoskelet Rehabil. 2012 Jan 1. 25(4):285-90. [QxMD MEDLINE Link].

20. Tekin L, Akarsu S, Durmus O, Cakar E, Dinçer U, Kiralp MZ. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol. 2013 Mar. 32(3):309-15. [QxMD MEDLINE Link].

21. 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. 2011 Oct. 92(10):1576-1580.e1. [QxMD MEDLINE Link].

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

23. Lang AM. Botulinum toxin therapy for myofascial pain disorders. Curr Pain Headache Rep. 2002 Oct. 6(5):355-60. [QxMD MEDLINE Link].

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

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

26. Ahmed S, Subramaniam S, Sidhu K, et al. Effect of Local Anesthetic versus Botulinum Toxin-A Injections on Subjective for Myofascial Pain Disorders: A Systematic Review and Meta-analysis. Clin J Pain. 2018 Dec 26. [QxMD MEDLINE Link].

27. Avendano-Coy J, Gomez-Soriano J, Valencia M, et al. Botulinum toxin type A and myofascial pain syndrome: a retrospective study of 301 patients. J Back Musculoskelet Rehabil. 2014. 27(4):485-92. [QxMD MEDLINE Link].

28. 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. 2009 Apr. 31(4):705-20. [QxMD MEDLINE Link].

29. 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. 2010 Feb 11. 11:32. [QxMD MEDLINE Link]. [Full Text].

30. Ay S, Dogan SK, Evcik D, Baser OC. Comparison the efficacy of phonophoresis and ultrasound therapy in myofascial pain syndrome. Rheumatol Int. 2011 Sep. 31(9):1203-8. [QxMD MEDLINE Link].

31. Tabatabaiee A, Ebrahimi-Takamjani I, Ahmadi A, Sarrafzadeh J, Emrani A. Comparison of pressure release, phonophoresis and dry needling in treatment of latent myofascial trigger point of upper trapezius muscle. J Back Musculoskelet Rehabil. 2018 Dec 14. [QxMD MEDLINE Link].

32. 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. 1998 Jul. 77(1):73-9. [QxMD MEDLINE Link].

33. 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. 2008 Apr. 71(4):200-6. [QxMD MEDLINE Link].

34. Botelho L, Angoleri L, Zortea M, et al. Insights About the Neuroplasticity State on the Effect of Intramuscular Electrical Stimulation in Pain and Disability Associated With Chronic Myofascial Pain Syndrome (MPS): A Double-Blind, Randomized, Sham-Controlled Trial. Front Hum Neurosci. 2018. 12:388. [QxMD MEDLINE Link]. [Full Text].

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

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

37. 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. 1993 Aug. 61(4):653-8. [QxMD MEDLINE Link].

38. Rayegani S, Bahrami M, Samadi B, Sedighipour L, Mokhtarirad M, Eliaspoor D. Comparison of the effects of low energy laser and ultrasound in treatment of shoulder myofascial pain syndrome: a randomized single-blinded clinical trial. Eur J Phys Rehabil Med. 2011 Sep. 47(3):381-9. [QxMD MEDLINE Link].

39. Ahmed S, Haddad C, Subramaniam S, Khattab S, Kumbhare D. The Effect of Electric Stimulation Techniques on Pain and Tenderness at the Myofascial Trigger Point: A Systematic Review. Pain Med. 2019 Jan 25. [QxMD MEDLINE Link].

40. Chan YC, Wang TJ, Chang CC, et al. Short-term effects of self-massage combined with home exercise on pain, daily activity, and autonomic function in patients with myofascial pain dysfunction syndrome. J Phys Ther Sci. 2015 Jan. 27(1):217-21. [QxMD MEDLINE Link]. [Full Text].

41. Halder GE, Scott L, Wyman A, et al. Botox combined with myofascial release physical therapy as a treatment for myofascial pelvic pain. Investig Clin Urol. 2017 Mar. 58 (2):134-9. [QxMD MEDLINE Link]. [Full Text].

42. 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. 1998 Sep. 14(3):248-55. [QxMD MEDLINE Link].

43. 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. 2010 Mar-Apr. 26(3):251-7. [QxMD MEDLINE Link].

44. Chou LW, Hsieh YL, Chen HS, Hong CZ, Kao MJ, Han TI. Remote therapeutic effectiveness of acupuncture in treating myofascial trigger point of the upper trapezius muscle. Am J Phys Med Rehabil. 2011 Dec. 90(12):1036-49. [QxMD MEDLINE Link].

45. [Guideline] Jarrell JF, Vilos GA, Allaire C, et al. No. 164-Consensus Guidelines for the Management of Chronic Pelvic Pain. J Obstet Gynaecol Can. 2018 Nov. 40 (11):e747-87. [QxMD MEDLINE Link]. [Full Text].

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

47. Lin YC, Kuan TS, Hsieh PC, Yen WJ, Chang WC, Chen SM. Therapeutic effects of lidocaine patch on myofascial pain syndrome of the upper trapezius: a randomized, double-blind, placebo-controlled study. Am J Phys Med Rehabil. 2012 Oct. 91(10):871-82. [QxMD MEDLINE Link].

Jennifer E Finley, MD, FAAPMR Consulting Physiatrist and Sports Medicine Physician

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

Disclosure: Nothing to disclose.

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Patrick M Foye, MD Director of Coccyx Pain Center, Professor of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School; Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, University Hospital

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Dean H Hommer, MD Chief Medical Officer, Corpus Christi Medical Center

Dean H Hommer, MD is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American Association for Physician Leadership, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Healthcare Executives, Texas Medical Association

Disclosure: Nothing to disclose.

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

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