JORR
Journal of Orthopedics Research and Rehabilitation

The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers inorthopaedic surgery, physical therapy and rehabilitation, neurosurgery, neurology and clinic anesthesiology and reanimation. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-0560
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Effects of myofascial trigger point injection on the disease activity in patients with comorbidity of fibromyalgia and cervical myofascial pain syndrome
Abstract
Aims: To investigate the effect of myofascial trigger point injection on the disease activity of FS in patients with myofascial trigger points in the coexistence of fibromyalgia syndrome (FS) and chronic cervical myofascial pain syndrome (MAS).
Methods: 30 consenting patients between the ages of 18-60 who has had FS for at least for 3 months and also MPS in trapezius, levator skapula, splenius capitis, and multifidus muscles in cervical region and 15 patients with FS but without MPS were included in the present study. Patients newly diagnosed with FS, were evaluted for the presence of MPS and FS, disease activity was evaluated before administering treatment and after administration of trigger point injection tretament for cervical MPS. In the group with only FS, cervical region tender point injection was carried out. Patients were evaluated before injection and one month after injection. Severity of pain was evaluated with VAS (visual analog scale), pressure pain threshold was measured with algometer, total myalgic score (TMS) , fibromiyalgia impact questionnaire (FIQ), Pittsburgh sleep quality index (PSQI) , Beck depression inventory (BDI), Beck anxiety inventory (BAI), fatique severity scale (FSS) results were evaluated prior to and after treatment.
Results: When patients were evaluted at 1st month after myofacial trigger point and cervical tender point injections statistically significant decrease was found in VAS, TMS, PSQI, FIQ, FSS, BAI and BAI scores and the number of trigger points in both FS and FS+MAS groups. (for all parameters p<;0,005). However, this decrease was more evident in FS+MPS group.
Conclusion: In conclusion, in the concomitance of MPS and FS, which is one of the most common causes of widespread musculoskletal pain, the treatment of MPS with trigger point injection has been shown to exert positive effects on the severity of FS, affective disorders, sleep and fatique. In the treatment of FS, thetreatment of MPS, which is one of the periheral pain generators, should be given priority.

Keywords : Fibromyalgia syndrome, myofascial pain syndrome, peripheral pain generators, trigger and tender points

Download Article


1. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. <em>Arthritis Rheum</em>. 1990;33(2):160-172.
2. Yunus MB. Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. <em>Semin Arthritis Rheum</em>. 2008;37(6):339- 352.
3. Hong CZ, Simons DG. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points. <em>Arch Phys Med Rehabil</em>. 1998;79(7):863-872.
4. Cakit BD, Taskin S, Nacir B, Unlu I, Genc H, Erdem HR. Comorbidity of fibromyalgia and cervical myofascial pain syndrome. <em>Clin Rheumatol</em>. 2010;29(4):405-411.
5. Ge HY, Wang Y, Danneskiold-Sams&oslash;e B, Graven-Nielsen T, Arendt- Nielsen L. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points. <em>J Pain</em>. 2010;11(7):644-651.
6. Chandola HC, Chakraborty A. Fibromyalgia and myofascial pain syndrome-a dilemma. <em>Indian J Anaesth</em>. 2009;53(5):575-581.
7. Borg-Stein J, Simons DG. Focused review: myofascial pain. <em>Arch Phys Med Rehabil</em>. 2002;83(3 Suppl 1):40-49.
8. Affaitati G, Costantini R, Fabrizio A, Lapenna D, Tafuri E, Giamberardino MA. Effects of treatment of peripheral pain generators in fibromyalgia patients. <em>Eur J Pain</em>. 2011;15(1):61-69.
9. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. <em>Am J Phys Med Rehabil</em>. 1994;73(4):256-263.
10. Staud R, Nagel S, Robinson ME, Price DD. Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo-controlled study. <em>Pain</em>. 2009;145(1):96-104.
11. Bennett RM, Friend R, Marcus D, et al. Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria. <em>Arthritis Care Res. </em>2014;66(9):1364-1373.
12. Simons DG, Travell JG, Simons LS. Myofascial pain and dysfunction: the trigger point manual, vol 1. Upper half of body. Williams &amp; Wilkins: 1999:11-89.
13. Duyur Cakit B, Gen&ccedil; H, Altuntaş V, Erdem HR. Disability and related factors in patients with chronic cervical myofascial pain. <em>Clin Rheumatol</em>. 2009;28(6):647-654.
14. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. <em>Pain</em>. 1987;30(1):115- 126.
15. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the fibromyalgia impact questionnaire. <em>Rheumatol Int</em>. 2000;20(1):9-12.
16. Turner JA, Romano JM. Self-report screening measures for depression in chronic pain patients. <em>J Clin Psychol</em>. 1984;40(4):909-913.
17. Ulusoy M. Turkish version of the beck anxiety inventory: psychometric properties. <em>J Cognit Psychother Internat Quart. </em>1998;12(2):163-172.
18. Ağarg&uuml;n MY, Kara H, Anlar &Ouml;. The validity and reliability of the Pittsburgh sleep quality index. <em>Turk Psikiyatri Derg. </em>1996;7(2):107-115.
19. Gencay-Can A, Can SS. Validation of the Turkish version of the fatigue severity scale in patients with fibromyalgia. <em>Rheumatol Int</em>. 2012;32(1):27-31.
20. Harden RN, Bruehl SP, Gass S, Niemiec C, Barbick B. Signs and symptoms of the myofascial pain syndrome: a national survey of pain management providers. <em>Clin J Pain</em>. 2000;16(1):64-72.
21. Borg-Stein J, Stein J. Trigger points and tender points: one and the same? Does injection treatment help? <em>Rheum Dis Clin North Am</em>. 1996;22(2):305-322.
22. Fern&aacute;ndez-de-Las-Pe&ntilde;as C, Arendt-Nielsen L. Myofascial pain and fibromyalgia: two different but overlapping disorders. <em>Pain Manag</em>. 2016;6(4):401-408.
23. Reddy SS, Yunus MB, Inanici F, Aldag JC. Tender point injections are beneficial in fibromyalgia syndrome: a descriptive, open study. <em>J Musculoskelet Pain</em>. 2000;8(4):7-18.
24. Hong CZ, Hsueh TC. Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. <em>Arch Phys Med Rehabil</em>. 1996;77(11):1161-1166.
25. Steiner JL, Bigatti SM, Slaven JE, Ang DC. The complex relationship between pain intensity and physical functioning in fibromyalgia: the mediating role of depression. <em>J Appl Biobehav Res</em>. 2017;22(4):e12079.
26. Andrade A, Vilarino GT, Sieczkowska SM, Coimbra DR, Bevilacqua GG, Steffens RAK. The relationship between sleep quality and fibromyalgia symptoms. <em>J Health Psychol</em>. 2020;25(9):1176-1186.
27. Ulus Y, Akyol Y, Tander B, Durmus D, Bilgici A, Kuru O. Sleep quality in fibromyalgia and rheumatoid arthritis: associations with pain, fatigue, depression, and disease activity. <em>Clin Exp Rheumatol</em>. 2011;29(6 Suppl 61):S92-S96.
Article available in :
Volume 2, Issue 2, 2024
Page : 32-37
https://doi.org/10.51271/JORR-0029
Article Information
Received : 20 Mar 2024
Accepted : 18 Nis 2024
Published : 26 Nis 2024
Corresponding Author :

Burcu Duyur Çakıt: Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, University of Health Sciences Ankara, Turkiye

[email protected]
Citation : Çelik ÖF, Duyur Çakıt B, Çakıt MO, Genç H. Effects of myofascial trigger point injection on the disease activity in patients with comorbidity of fibromyalgia and cervical myofascial pain syndrome. J Orthop Res Rehabil. 2024;2(2):32-37.

Read: 1213
Cited: 0
Download : 265
_Footer