Myofascial pain syndrome belongs to a group of chronic pain conditions. It characteristically impacts your musculoskeletal system. Typically, patients experience localized muscular pain for a few weeks. On the contrary, others may suffer from a persistent episode of muscle pain. The pain sensation can be easily compared to the feeling of a knot stiff spinal muscle - unable to move or relax at all.
For patients experiencing myofascial pain syndrome (MPS), the sensitive spots in their bodies are generally referred to as trigger points. When touched, the pain often spreads pain to your shoulders, neck, and even upper back. While pressure is applied to these sensitive trigger points, patients experience pain (referred pain) in a different part of the body. Contrary to common belief, trigger points aren’t only found near your neck. You can find them in muscles all over your body.
What Are the Symptoms of Myofascial Pain Syndrome ?
Some of the very common symptoms experienced in MPS include:
What Are the Most Critical Risk Factors and Causes?
The majority of the trigger points develop due to muscle trauma (injury), muscle overuse, or even psychological stress. Such sensitive trigger points most probably arise from repetitive and sustained activities. These can include working on a computer all day or even lifting heavy objects. No single factor can be ruled out as the definitive cause for the development of trigger points. In patients suffering from myofascial pain syndrome, a combination of risk factors can include the following:
What Do We Offer? Trigger Point Injections as A Treatment Option.
Myofascial pain syndrome can be a very daunting condition to experience. If you are someone who is still experiencing recurrent myofascial trigger points despite trying out all home remedies and other massage therapies, we are offering Trigger point injections (TPIs).
Trigger point injections are a straightforward treatment option extensively used to relieve myofascial pain. TPIs are like dry needling, but only a solution is injected into the affected. Generally, doctors have two options - inject saline or a local anesthetic.
Trigger point injections are able to treat muscle pain all over your body. These can handle both; general muscle knots as well as their consequences like migraine, myofascial pain, or even tension headaches. Doctors are able to use these TPIs wherever the trigger points exist. Health experts consider them safe to use in all areas of your body.
Here at Global Medical Clinic, we offer lidocaine (local anesthetic) injections as a later-stage therapy for your trigger points - that is, when you have already gone through less invasive treatments, like massage, before opting for injection therapy. Depending on your particular condition, our expert doctors may prescribe the injections in conjunction with a physical therapy program or an exercise plan for optimal results and facilitating better rehabilitation.
What Does a Trigger Point Injection Appointment Looks Like?
The whole TPIs procedure is a short and in-office appointment. It is a very simple process. Initially, your healthcare provider will palpate the potential trigger point to accurately identify the exact region where the myofascial knots are located. A fine needle will be utilized to deliver the lidocaine via injection directly into the target tissue area. During this phase, you may be lying down or sitting up depending on the location of the target trigger point(s). You may likely end up receiving more than one injection—everything depends on your particular condition and the number of trigger points you have. Our healthcare will share all relevant details with you prior to the procedure.
Knee pain can be debilitating in many circumstances and requires a proper diagnosis to improve knee function. The most common causes of knee pain are the following: • Repeated stress on the knee • Aging • Injuries • Cartilage tears • Arthritis • Tendonitis • Strained or sprained ligaments [1]
The severity and location of knee pain also depend on the underlying cause of knee pain. Symptoms indicative of knee pain include: • Inability to fully straighten the knee. • Weakness and instability of the knee • Swelling and stiffness in the knee joint • Crunching or popping noises • Redness and warmth to touch
What Are Ultrasound Guided Injections? Ultrasound-guided injections have become a reliable and immediate solution to provide pain relief in the knee. Ultrasound is a popular technology that has eliminated the need for surgery by targeting knee pain and providing quick relief. In patients with knee pain due to arthritis or tendonitis, ultrasound-guided injections can pinpoint the exact location of pain with maximum accuracy. The ultrasound technique allows the physician to administer the injection with safety and accuracy, leaving no room for any type of error [2].
How Are Ultrasound Guided Injections Administered? For administering injections in the knee, ultrasound technology is a safe and non-invasive technology that utilizes high-frequency sound waves to capture live images of the internal structures of the knee. Guided injections work in similar ways to conventional injections, but ultrasound makes it possible for the doctor to have an “X-ray vision.” The physician determines the optimal injection placement by using a probe on the joint instead of relying on experience and touch. The physician then uses the detailed, clear images guide to insert the needle and administer the medicine into the knee joint [3].
Types Of Ultrasound-Guided Injections: There are three types of injectable products used in ultrasound-guided injections:
1. Ultrasound-Guided Corticosteroid Injection: Corticosteroid is a strong anti-inflammatory medication commonly used for the treatment of knee osteoarthritis. This injectable steroid is mixed with a local anesthetic to alleviate pain [4]. In most cases, corticosteroids are an effective option, but if your knee pain worsens, there are still two evidence-based alternatives to ultrasound-guided corticosteroid injections.
2. Ultrasound-Guided Hyaluronic Acid Injection: Hyaluronic acid is naturally present in the joints to provide lubrication for allowing movement and reducing friction. The ultrasound-guided hyaluronic injection has been reported to alleviate knee pain and increase knee function for up to 180 days [5].
3. Ultrasound-Guided PRP Injection: For ultrasound-guided platelet-rich plasma (PRP) injections, a small amount of blood is extracted and centrifuged to separate the plasma. The plasma is rich in growth factors, which have regenerating and tissue healing properties. The concentrated plasma injections are then re-administered to trigger the natural healing process.
Conclusion: Ultrasound-guided injections have become a modern solution for quick relief from knee pain. Unlike conventional injections, guided injections are less painful and preserve the knee function to get back to normal life activities.
References:
1. Dulay GS, Cooper C, Dennison EM. Knee pain, knee injury, knee osteoarthritis & work. Best Pract Res Clin Rheumatol 2015;29:454–61. https://doi.org/10.1016/j.berh.2015.05.005.
2. Wu T, Dong Y, Song H xin, Fu Y, Li J hua. Ultrasound-guided versus landmark in knee arthrocentesis: A systematic review. Semin Arthritis Rheum 2016;45:627–32. https://doi.org/10.1016/j.semarthrit.2015.10.011.
3. Bruyn GAW, Schmidt WA. How to perform ultrasound-guided injections. Best Pract Res Clin Rheumatol 2009;23:269–79.https://doi.org/10.1016/j.berh.2008.11.001.
4. Law TY, Nguyen C, Frank RM, Rosas S, McCormick F. Current concepts on the use of corticosteroid injections for knee osteoarthritis. Phys Sportsmed 2015;43:269–73. https://doi.org/10.1080/00913847.2015.1017440.
5. Callegari L, Spanò E, Bini A, Valli F, Genovese E, Fugazzola C. Ultrasound-Guided Injection of a Corticosteroid and Hyaluronic Acid. Drugs R D 2011;11:137–45. https://doi.org/10.2165/11591220-000000000-00000.
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