Characteristics of Myofascial Pain Syndrome of the Infraspinatus Muscle

Overview

Journal Ann Rehabil Med

Specialty Rehabilitation Medicine

Date 2017 Oct 4

PMID 28971041

Authors

Junbeom Kwon

Hyoung Seop Kim

Won Hyuk Chang

Chunung Park

Sang Chul Lee

Affiliations

Soon will be listed here.

Abstract

Objective: To report the characteristics of myofascial trigger points (MTrPs) in the infraspinatus muscle and evaluate the therapeutic effect of trigger-point injections.

Methods: Medical records of 297 patients (221 women; age, 53.9±11.3 years) with MTrPs in the infraspinatus muscle were reviewed retrospectively. Because there were 83 patients with MTrPs in both infraspinatus muscles, the characteristics of total 380 infraspinatus muscles with MTrPs (214 one side, 83 both sides) were investigated. Specific characteristics collected included chief complaint area, referred pain pattern, the number of local twitch responses, and distribution of MTrPs in the muscle. For statistical analysis, the paired t-test was used to compare a visual analogue scale (VAS) before and 2 weeks after the first injection.

Results: The most common chief complaint area of MTrPs in the infraspinatus muscle was the scapular area. The most common pattern of referred pain was the anterolateral aspect of the arm (above the elbow). Active MTrPs were multiple rather than single in the infraspinatus muscle. MTrPs were frequently in the center of the muscle. Trigger-point injection of the infraspinatus muscle significantly decreased the pain intensity. Mean VAS score decreased significantly after the first injection compared to the baseline (7.11 vs. 3.74; p<0.001).

Conclusion: Characteristics of MTrPs and the therapeutic effects of trigger-point injections of the infraspinatus muscle were assessed. These findings could provide clinicians with useful information in diagnosing and treating myofascial pain syndrome of the infraspinatus muscle.

References

Kimura Y, Ge H, Zhang Y, Kimura M, Sumikura H, Arendt-Nielsen L . Evaluation of sympathetic vasoconstrictor response following nociceptive stimulation of latent myofascial trigger points in humans. Acta Physiol (Oxf). 2009; 196(4):411-7. DOI: 10.1111/j.1748-1716.2009.01960.x. View

Rubin D . Myofascial trigger point syndromes: an approach to management. Arch Phys Med Rehabil. 1981; 62(3):107-10. View

SOLA A, RODENBERGER M, GETTYS B . Incidence of hypersensitive areas in posterior shoulder muscles; a survey of two hundred young adults. Am J Phys Med. 1955; 34(6):585-90. View

Ge H, Fernandez-de-Las-Penas C, Arendt-Nielsen L . Sympathetic facilitation of hyperalgesia evoked from myofascial tender and trigger points in patients with unilateral shoulder pain. Clin Neurophysiol. 2006; 117(7):1545-50. DOI: 10.1016/j.clinph.2006.03.026. View

Long 2nd C . Myofascial pain syndromes. II. Syndromes of the head, neck and shoulder girdle. Henry Ford Hosp Med Bull. 1956; 4(1):22-8. View

Hong C . Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994; 73(4):256-63. DOI: 10.1097/00002060-199407000-00006. View

TRAVELL J, RINZLER S . Pain syndromes of the chest muscles; resemblance to effort angina and myocardial infarction, and relief by local block. Can Med Assoc J. 1948; 59(4):333-8. PMC: 1591163. View

Zhang Y, Ge H, Yue S, Kimura Y, Arendt-Nielsen L . Attenuated skin blood flow response to nociceptive stimulation of latent myofascial trigger points. Arch Phys Med Rehabil. 2009; 90(2):325-32. DOI: 10.1016/j.apmr.2008.06.037. View

SOLA A, KUITERT J . Myofascial trigger point pain in the neck and shoulder girdle; report of 100 cases treated by injection of normal saline. Northwest Med. 1955; 54(9):980-4. View

10.

Hong C . Pathophysiology of myofascial trigger point. J Formos Med Assoc. 1996; 95(2):93-104. View

11.

Kelly M . Some rules for the employment of local analgesia in the treatment of somatic pain. Med J Aust. 2010; 1(8):235-9. DOI: 10.5694/j.1326-5377.1947.tb73088.x. View

12.

Simons D . Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol. 2004; 14(1):95-107. DOI: 10.1016/j.jelekin.2003.09.018. View

13.

Rivner M . The neurophysiology of myofascial pain syndrome. Curr Pain Headache Rep. 2001; 5(5):432-40. DOI: 10.1007/s11916-001-0054-6. View

14.

Reynolds M . Myofascial trigger point syndromes in the practice of rheumatology. Arch Phys Med Rehabil. 1981; 62(3):111-4. View

15.

SOLA A, Williams R . Myofascial pain syndromes. Neurology. 1956; 6(2):91-5. DOI: 10.1212/wnl.6.2.91. View

16.

Zhuang X, Tan S, Huang Q . Understanding of myofascial trigger points. Chin Med J (Engl). 2014; 127(24):4271-7. View

17.

Suh M, Chang W, Choi H, Lee S . Ultrasound-guided myofascial trigger point injection into brachialis muscle for rotator cuff disease patients with upper arm pain: a pilot study. Ann Rehabil Med. 2014; 38(5):673-81. PMC: 4221396. DOI: 10.5535/arm.2014.38.5.673. View

18.

TRAVELL J, RINZLER S . The myofascial genesis of pain. Postgrad Med. 1952; 11(5):425-34. DOI: 10.1080/00325481.1952.11694280. View

19.

Criscuolo C . Interventional approaches to the management of myofascial pain syndrome. Curr Pain Headache Rep. 2001; 5(5):407-11. DOI: 10.1007/s11916-001-0051-9. View

20.

Rha D, Shin J, Kim Y, Jung J, Kim Y, Lee S . Detecting local twitch responses of myofascial trigger points in the lower-back muscles using ultrasonography. Arch Phys Med Rehabil. 2011; 92(10):1576-1580.e1. DOI: 10.1016/j.apmr.2011.05.005. View