Muscular causes of regional pain syndromes

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Pain Med. 2010 Jan;11(1):25-34. Epub 2009 Dec 9.
A comprehensive protocol to diagnose and treat pain of muscular origin may successfully and reliably decrease or eliminate pain in a chronic pain population.

Marcus NJ, Gracely EJ, Keefe KO.
NYU School of Medicine, Departments of Anesthesiology and Psychiatry, Norman Marcus Pain Institute, New York, New York 10016, USA

Abstract

OBJECTIVE: A comprehensive protocol is presented to identify muscular causes of regional pain syndromes utilizing an electrical stimulus in lieu of palpation, and combining elements of Prolotherapy with trigger point injections.

METHODS: One hundred seventy-six consecutive patients were evaluated for the presence of muscle pain by utilizing an electrical stimulus produced by the Muscle Pain Detection Device. The diagnosis of "Muscle Pain Amenable to Injection" (MPAI), rather than trigger points, was made if pain was produced for the duration of the stimulation. If MPAI was found, muscle tendon injections (MTI) were offered to patients along with post-MTI physical therapy, providing neuromuscular electrical stimulation followed by a validated exercise program [1]. A control group, evaluated 1 month prior to their actual consultation/evaluation when muscle pain was identified but not yet treated, was used for comparison.

RESULTS: Forty-five patients who met criteria completed treatment. Patients' scores on the Brief Pain Inventory decreased an average of 62%; median 70% (P < 0.001) for pain severity and 68%; median 85% (P < 0.001) for pain interference one month following treatment. These changes were significantly greater (P < 0.001) than those observed in the untreated controls.

CONCLUSION: A protocol incorporating an easily reproducible electrical stimulus to diagnose a muscle causing pain in a region of the body followed by an injection technique that involves the entirety of the muscle, and post injection restoration of muscle function, can successfully eliminate or significantly reduce regional pain present for years.

PMID: 20002599 [PubMed - in process]

[DMcU]

Those figures are very promising. But I still think manual physical therapy is the best form of treatment, and perhaps the likes of this for stubborn trigger points, a few of which I have myself.

I feel that inflammation is still a causical factor in my case. My meatus is visibly swollen and inflamed. Apparently many of the organs in my pelvic cavity aren't working 100% and this inflammation in itself causes muscle tension. I'm on a pretty good anti-inflammatory diet which should be helping but this is a hard one to shake off!!

My PT has done a thesis on IC but seems far too underexperienced to do internal treatment and hasn't done anything but check my sphincter for tension, this is typical in Ireland where the health system is a pure joke. I may save up for California.

Could the above treatment kick off in the med practice?

[webslave]

Too early to say. This is a new study. Stay tuned.