Clinical Characteristics and Effects of Pain Trigger Point Injection on Myo-fascial Pain Syndrome Patients Visiting the Emergency Room

ABSTRACT

PURPOSE: Myofascial pain syndrome (MPS) is thought to be, the least understood and most frequently misdiagnosed disease. With appropriate diagnosis, pain trigger point injection has been proven its effectiveness, so I investigated the usefulness of pain trigger point injection for the treatment of MPS. METHODS: Twelve patients with clinical MPS were evaluated. Pain trigger points were identified by using the positive jump response to the operator's finger pressure. After the pain trigger points had been identified, 2 ml of lidocaine (Travel's technique) were injected. RESULTS: Of the total of 12 patients investigated, include self-diagnosis, 6 (50%) were misdiagnosed mainly as neurosis. These 12 patients had 33 pain trigger points. The pain trigger points were distributed mainly in the chest, 8 patients (66%), and 25 points (76%). As to the duration of pain, in 10 patients, the pain dramatically disappeared within 5 minutes. In the remaining two patients improved symptoms were noted within 20 minutes after injection. CONCLUSIONS: The proper diagnosis of MPS, which is frequently misdiagnosed as neurosis, or some other physiologic and psychologic diseases was the first step and the mainstay in the treatment of MPS. This study suggests that in the diagnosis of MPS, the most practically useful method in the emergency room is to confirm the positive jump response, including tout band and referred pain, by using finger pressure. Pain trigger point injection therapy was dramatically effective, so hopefully it will be available allow clinicians as a possible treatment to better care for patients suffering from MPS.