Is early diagnosis of myofascial pain syndrome possible with the detection of latent trigger points by shear wave elastography?

Ersen Ertekin, Zehra S Kasar, Figen Tunali Turkdogan, Ersen Ertekin, Zehra S Kasar, Figen Tunali Turkdogan

Abstract

Purpose: The aim of the study was to investigate the contribution of shear wave elastography to the diagnosis of myo-fascial pain syndrome (MPS) of the upper part of the trapezius.

Material and methods: Ethical committee approval was obtained for the study. Thirty volunteer women with trigger points in the upper part of the trapezius muscle and 30 healthy women with a similar age distribution were included in the study. The patient group performed a self-stretching exercise program for 4 weeks. No intervention was applied to the control group. Muscle stiffness values of both groups were evaluated with shear wave elastography (SWE), and pain levels of all volunteers were evaluated by the Visual Analogue Scale at the beginning and the end of the study. The statistical analyses were performed using SPSS version 18.0.

Results: There was a significant decrease after the treatment in terms of upper trapezius muscle stiffness and the pain levels in the patient group (p < 0.001 and p < 0.001). In the patient group, there was a moderate correlation between the decrease in the pain level and the reductions in muscle stiffness (r = 0.595). In control group, there was no significant difference in terms of both muscle stiffness and pain levels before and after treatment (p > 0.05).

Conclusions: SWE is a reliable method for detecting latent trigger points in MPS, and it can be used for evaluating the response to treatment.

Keywords: latent trigger point; myofascial pain syndrome; shear wave elastography.

Conflict of interest statement

The authors report no conflict of interest.

© Pol J Radiol 2021.

Figures

Figure 1
Figure 1
Box-plot graphic of the first and last shear wave elastography (SWE) measurements of 2 radiologists in the latent trigger point and the control groups. It shows the compatibility of SWE measurements of the 2 radiologists
Figure 2
Figure 2
22-year-old female case with latent trigger point. Shear wave elastography measurements of both radiologists (R1 and R2) showed a significant decrease in (a) pre-treatment (b) measurements
Figure 3
Figure 3
Shear wave elastography (SWE) measurements of 21-year-old female volunteers in the control group. No significant change was observed in the first (a) and last (b) SWE measurements of both radiologists (R1 and R2)

References

    1. Cummings M, Baldry P. Regional myofascial pain: diagnosis and management. Best Pract Res Clin Rheumatol 2007; 21: 367-387.
    1. Borg-Stein J, Simons DG. Focused review: myofascial pain. Arch Phys Med Rehabil 2002; 83: 40-49.
    1. Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol 2011; 25: 185-198.
    1. Nicol AL, Crooks M, Hsu ES, Ferrante FM. Mysofascial pain syndrome. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP (eds.). Essentials of Pain Medicine. 4th ed. Elsevier, Philadelphia: 2018. p. 207-12.e1.
    1. Simons, DG. Travell JG. Simons PT. Trapezius muscle. In: Johnson EP, Napora LS, Myers JS (eds.). Travell and Simons’ Myofascial Pain and Dysfunction: the Trigger Point Manual. Vol I. Upper half of body. 2nd ed. Williams and Wilkins, Baltimore: 1999. p. 278-307.
    1. Martin BI, Deyo RA, Mirza SK, et al. . Expenditures and health status among adults with back and neck problems. JAMA 2008; 299: 656-664.
    1. Ichihashi N, Umegaki H, Ikezoe T, et al. . The effects of a 4-week static stretching programme on the individual muscles comprising the hamstrings. J Sports Sci 2016; 34: 2155-2159.
    1. Sigrist RMS, Liau J, Kaffas AE, et al. . Ultrasound elastography: review of techniques and clinical applications. Theranostics 2017; 7: 1303-1329.
    1. Yuan S, Magarik M, Lex AM, Fleischer AC. Clinical applications of sonoelastography. Expert Rev Med Devices 2016; 13: 1107-1117.
    1. Schmalzl J, Fenwick A, Boehm D, Gilbert F. The application of ultra-sound elastography in the shoulder. J Shoulder Elbow Surg 2017; 26: 2236-2246.
    1. Taljanovic MS, Gimber LH, Becker GW, et al. . Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics 2017; 37: 855-870.
    1. Heizelmann A, Tasdemir S, Schmidberger J, et al. . Measurements of the trapezius and erector spinae muscles using virtual touch imaging quantification ultrasound-elastography: a cross section study. BMC Musculoskelet Disord 2017; 18: 370.
    1. Gennisson JL, Deffieux T, Fink M, Tanter M. Ultrasound elastography: principles and techniques. Diagn Interv Imaging 2013; 94: 487-495.
    1. Calvo-Lobo C, Diez-Vega I, Martínez-Pascual B, et al. . Tensio-myo-graphy, sonoelastography, and mechanosensitivity differences between active, latent, and control low back myofascial trigger points: a cross-sectional study. Medicine (Baltimore) 2017; 96: e6287.
    1. Grabowski PJ, Slane LC, Thelen DG, et al. . Evidence of generalized muscle stiffness in the presence of latent trigger points within infraspinatus. Arch Phys Med Rehabil 2018; 99: 2257-2262.
    1. Taş S, Korkusuz F, Erden Z. Neck muscle stiffness in participants with and without chronic neck pain: a shear-wave elastography study. J Manipulative Physiol Ther 2018; 41: 580-588.
    1. Jafari M, Bahrpeyma F, Mokhtari-Dizaji M, Nasiri A. Novel me-thod to measure active myofascial trigger point stiffness using ultrasound imaging. J Bodyw Mov Ther 2018; 22: 374-378.
    1. Money S. Pathophysiology of trigger points in myofascial pain syndrome. J Pain Palliat Care Pharmacother 2017; 31: 158-159.
    1. Liu L, Huang QM, Liu QG, et al. . Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil 2015; 96: 944-955.
    1. Nouged E, Dajani J, Ku B, et al. . Local anesthetic injections for the short-term treatment of head and neck myofascial pain syndrome: a systematic review with meta-analysis. J Oral Facial Pain Headache 2019; 33: 183-198.
    1. Khalifeh M, Mehta K, Varguise N, et al. . Botulinum toxin type A for the treatment of head and neck chronic myofascial pain syndrome: a systematic review and meta-analysis. J Am Dent Assoc 2016; 147: 959-73.e1.
    1. Wang R, Li X, Zhou S, et al. . Manual acupuncture for myofascial pain syndrome: a systematic review and meta-analysis. Acupunct Med 2017; 35: 241-250.
    1. Kalichman L, Ben David C. Effect of self-myofascial release on myofascial pain, muscle flexibility, and strength: a narrative review. J Bodyw Mov Ther 2017; 21: 446-451.
    1. Oliveira-Campelo NM, de Melo CA, Alburquerque-Sendín F, Machado JP. Short-and medium-term effects of manual therapy on cervical active range of motion and pressure pain sensitivity in latent myofascial pain of the upper trapezius muscle: a randomized controlled trial. J Manipulative Physiol Ther 2013; 36: 300-309.
    1. Ahmed S, Khattab S, Haddad C, et al. . Effect of aerobic exercise in the treatment of myofascial pain: a systematic review. J Exerc Rehabil 2018; 14: 902-910.

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