ABSTRACT
There are several causes of otalgia, specifically primary otalgia, which originates inside the ear, and referred otalgia, which originates outside the ear. In a rare case, otalgia may result from myofascial pain syndrome (MPS) due to a contraction of cervical muscles. The author of this study reports a case in which otalgia caused by MPS due to contraction of the trapezius muscle was treated with intramuscular stimulation (IMS). A 48-year-old female patient with otalgia for two weeks was otolaryngologically tested and no anomaly was found. A pain clinic consultation was requested and severe contraction of the trapezius muscle was observed by history taking, visual inspections and palpation. She was successfully returned to the normal state with two sessions of IMS.
Subject(s)
Female , Humans , Middle Aged , Ear , Earache , Muscles , Myofascial Pain Syndromes , Pain Clinics , Palpation , Superficial Back MusclesABSTRACT
Intramuscular stimulation (IMS) is widely used to treat myofascial pain syndrome. IMS is a safe procedure but several complications have been described. To our knowledge, spinal subarachnoid hematoma has never been reported as a complication of an IMS. The authors have experienced a case of spinal subarachnoid hematoma occurring after an IMS, which was tentatively diagnosed as intracranial subarachnoid hemorrhage because of severe headache. Patient was successfully treated with surgery. Here, we report our case with a review of literature.
Subject(s)
Humans , Headache , Hematoma , Myofascial Pain Syndromes , Subarachnoid HemorrhageABSTRACT
Intramuscular stimulation (IMS) therapy has been used widely ever since Gunn introduced the effect of IMS in his study in 1980. Usually IMS has been based on Cannon's radiculopathic model, known for its effectiveness in chronic pain relief. In this study we systematically review the effectiveness and safety of IMS. In order to accomplish a systematic review, we searched for IMS-related studies through 12 bibliographical databases and 19 studies were included (4 randomized controlled trials (RCTs), 2 non-RCTs and 13 case reports/studies). Study selection was conducted independently by two researchers based on title and abstract. As a result, most included studies of 16 showed significant improvement in range of motion, decrease of drug consumption as well as pain relief after IMS treatment; the other 3 studies reported adverse events. In terms of the effectiveness of IMS, the results of intervention were good, so we concluded that IMS therapy is a useful method of pain treatment; with respect of safety, few adverse events that could have been caused by IMS were observed. However, it is not certain that there was a causal relationship between IMS and the adverse events that were reported due to a lack of evidence. Therefore, clinicians who have sufficient knowledge and experience of IMS will have to perform the procedure after thorough clinical examinations to determine its appropriateness for target patients. This study provided meaningful data on the current state of IMS treatment. We expect that the result of this study will stimulate further more extensive research on IMS.
Subject(s)
Humans , Chronic Pain , Range of Motion, ArticularABSTRACT
Spasmodic dysphonia is a voice disorder that's characterized by intermittent, involuntary tightening or constriction of the larynx during phonation.This paper describes the case of a 45-yr-old female who suffered from phonation difficulties along with posterior and anterior neck pain.She was diagnosed with adductor type spasmodic dysphonia, which is a chronic disorder involving hyperadduction of the vocal mechanism and a resultant vocal arrest.The neural innervation of the intrinsic laryngeal musculature and the cervical nerves too may well be amenable to intramuscular stimulation therapy.
Subject(s)
Female , Humans , Constriction , Dysphonia , Larynx , Neck , Phonation , Voice DisordersABSTRACT
Spasmodic dysphonia is a voice disorder that's characterized by intermittent, involuntary tightening or constriction of the larynx during phonation.This paper describes the case of a 45-yr-old female who suffered from phonation difficulties along with posterior and anterior neck pain.She was diagnosed with adductor type spasmodic dysphonia, which is a chronic disorder involving hyperadduction of the vocal mechanism and a resultant vocal arrest.The neural innervation of the intrinsic laryngeal musculature and the cervical nerves too may well be amenable to intramuscular stimulation therapy.
Subject(s)
Female , Humans , Constriction , Dysphonia , Larynx , Neck , Phonation , Voice DisordersABSTRACT
Acupuncture therapy has been widely performed by staffs of oriental medicine in Korea, and intramuscular stimulation (IMS) therapy has been introduced recently and used for controlling myofascial pain in the field of orthopedics, rehabilitation, and pain clinics. To penetrate human tissues, relatively long needles are used in both procedures and these these may have some risks to puncture blood vessels. However, there were few reports about sequelae or complications after such procedures in Korean literatures. Recently, we experienced two cases of perirenal hematoma in patients without blood coagulation abnormalities (one case induced by acupuncture in oriental medicine clinic, and the other case induced by IMS in orthopedic clinic and was also accompanied by perirenal abscess).
Subject(s)
Humans , Acupuncture , Acupuncture Therapy , Blood Coagulation , Blood Vessels , Hematoma , Kidney , Korea , Medicine, East Asian Traditional , Needles , Orthopedics , Pain Clinics , PuncturesABSTRACT
BACKGROUND: The presence of pain during interventional pain management such as prolotherapy and intramuscular stimulation is stressful to patients and can affect the treatment outcome. We studied the safety and efficacy of two drug regimens: midazolam alone and midazolam/alfentanil for sedation anesthesia during prolotherapy and intramuscular stimulation. METHODS: Fifty three patients received either midazolam 0.04-0.08 mg/kg (Group M) or midazolam 0.01-0.02 mg/kg with alfentanil 4-8microgram/kg (Group A) for prolotherapy or intramuscular stimulation. We recorded the pain response, sedation score and side effects during the procedure, as well as amnesia, satisfaction and time to discharge after the procedure. RESULTS: Both drug regimens had significant sedation scores, amnesia and overall provided patient satisfaction. The treatment of pain was superior in Group A. Respiratory depression of three patients occurred in Group A. The time to discharge was longer in Group M. CONCLUSIONS: Midazolam and midazolam/alfentanil used for sedation anesthesia during prolotherapy and intramuscular stimulation were both effective; however, midazolam alone was the safer approach.
Subject(s)
Humans , Alfentanil , Amnesia , Anesthesia , Midazolam , Pain Management , Patient Satisfaction , Respiratory Insufficiency , Treatment OutcomeABSTRACT
BACKGROUND: Painful experiences during procedures such as prolotherapy and intramuscular stimulation are stressful to patients and can affect the treatment outcome. We present a method for relieving pain and increasing the level of patient comfort during the procedure. METHODS: Twenty six patients who requested sedation anesthesia during the procedure were examined. All patients were injected with 500 ml of 0.9% normal saline and were monitored by electrocardiography, blood pressure and pulse oximetry. The patients were supplied with oxygen (3 L/min) through a nasal cannula. Midazolam (0.02 mg/kg) and alfentanil (8 microgram/kg) was injected before the procedure and a bolus injection was administered during the procedure if patients felt any pain. The duration of the procedure, the total amount of drugs, the changes in the systolic blood pressure, heart rate, pulse oxygen saturation, sedation and pain level during procedure, satisfaction scale after the procedure, complications and the incidence of amnesia were evaluated. RESULTS: Twenty one patients had a moderate level of sedation, 15 patients did not feel any pain during the procedure, 17 patients had high level of satisfaction (8-10). No patient experienced complications after the procedure, or unstable vital signs, and 6 patients could not remember the procedure. CONCLUSIONS: Sedation anesthesia is a safe method for relieving pain during the procedure, and most patients had a high level of satisfaction.
Subject(s)
Humans , Alfentanil , Amnesia , Anesthesia , Blood Pressure , Catheters , Electrocardiography , Heart Rate , Incidence , Midazolam , Oximetry , Oxygen , Treatment Outcome , Vital SignsABSTRACT
Cervicogenic headache (CGH) is not universally accepted as terminology used to discuss headaches associated with disorders of the cervical spine. Sjaastad was the first to describe CGH that its definition and diagnosis relied entirely on clinical features. Pain is often triggered by irritation of nociceptors from structures in the cervical spine, and so diagnostic criteria of CGH have been established with agreement that these headaches start in the neck or occipital region and are associated with tenderness of cervical paraspinal tissues. Past history and clinical features are important to detect and diagnose the disease because the significance of radiological findings and advanced diagnostic testing is unclear. Gunn's intramuscular stimulation (IMS) is a treatment modality of CGH upon radiculopathic model. We tried IMS for treatment of 3 patients with CGH. After IMS, the patients were well respond the therapy and the results were satisfactory. Therefore we recommend the IMS for the treatment of CGH.
Subject(s)
Humans , Diagnosis , Diagnostic Tests, Routine , Headache , Neck , Nociceptors , Post-Traumatic Headache , SpineABSTRACT
Carpal tunnel syndrome is a common peripheral nerve entrapment syndrome that is characterized by pain, sensory disturbance along the distribution of the median nerve in hands, thenar muscle atrophy, and cervical radiculopathy. Diagnosis mainly depends upon careful examination and symptomatology, because laboratory and radiological tests are unhelpful. Treatments have included wrist immobilization, anti-imflammatory drug, local injection of steroid, nerve block and surgical decompression. Carpal tunnel syndrome is a type of neuropathic pain caused by denervation supersensitivity, and intramuscular stimulation (IMS) is a treatment modality for neuropathic pain. Here, we used IMS for the treatment of 4 patients with carpal tunnel syndrome. After IMS, most patients did not feel numbness or a tingling sensation and results were satisfactory. Therefore, we recommand IMS as a treatment for carpal tunnel syndrome.
Subject(s)
Humans , Carpal Tunnel Syndrome , Decompression, Surgical , Denervation , Diagnosis , Hand , Hypesthesia , Immobilization , Median Nerve , Muscular Atrophy , Nerve Block , Neuralgia , Peripheral Nerves , Radiculopathy , Sensation , WristABSTRACT
objective: This study was conducted to assess effects of intramuscular stimulation (IMS) in comparison with that of dry needling and intramuscular electrical stimulation (IMES) in the patients with myofascial pain syndrome (MPS) of upper trapezius. METHOD: Thirty patients with MPS were assigned randomly to three groups, such as dry needling group (n=10), IMES group (n=10), and IMS group (n=10). In dry needling group, dry needling was applied to the trigger point of upper trapezius muscle. In IMES group, IMES was applied to the trigger point of upper trapezius muscle. In IMS group, IMS was applied to the trigger point of upper trapezius and parcervical muscles. Treatment were done three times a week for 2 weeks. Effects were assessed on 3rd day, 7th day and 14th day after treatment by visual analogue scale (VAS), McGill pain questionnaire (MPQ), and passive range of motion (PROM) of cervical spine. RESULTS: Significant changes of VAS and PROM were noticed in IMS group, compared with other groups. No significant difference of MPQ was noticed in IMS group, compared with other groups. CONCLUSION: IMS may be more effective treatment modality than dry needling and IMES in patients with MPS of upper trapezius muscle.
Subject(s)
Humans , Electric Stimulation , Muscles , Myofascial Pain Syndromes , Pain Measurement , Range of Motion, Articular , Spine , Superficial Back Muscles , Trigger PointsABSTRACT
BACKGROUND: Osteoarthritis(OA) has become one of the most important medical problem among the old age because it causes severe functional disability, but, up to date, the therapeutic methods for OA have not been so satisfactory to the patients with OA. Authors have investigated the effectiveness of intramuscular stimulation(IMS) therapy as an substitutive therapy for the relief of pain and dysfunction in patients with OA of the knee. METHODS: Eighteen patients who had visited the department of family medicine, Korea university anam hospital, with symptomatic OA of the knee during the period from March 1 to May 31. 2001 were included in this study and treated with IMS therapy on the quadriceps and hamstring muscles four times during two weeks. Patients self-scored Korean Western Ontario and McMaster universities Osteoarthritis Index (KWOMAC) at baseline and after the last therapy. The result was analysed by paired t-test and ANOVA. RESULT: Patients improved on KWOMAC scales for pain, stiffness, function and total scores after IMS therapy(p<0.05). The demographic characteristics such as body mass index (BML), duration of disease, affected site, radiologic finding did not have influence on the result of this study. No adverse effects of IMS therapy were reported. CONCLUSION: In this study, the improvement of pain, stiffness, and function of knee joint after treatment was reported. This study suggest that IMS is an effective and safe substitutive therapy for patients with OA of Knee.