A New Muscle Pain Detection Device to Diagnose Muscles as a Source of Back and/or Neck Pain

Abstract

Using the MPDD appears to be more valid and potentially more reliable than palpation to identify muscles causing regional pain that could benefit from injections.

A Comprehensive Protocol to Diagnose and Treat Pain of Muscular Origin May Successfully and Reliably Decrease or Eliminate Pain in a Chronic Pain Population

“…It is estimated that 70–85% [21,47] of patients with low back pain have nonspecific low back pain. We suggest that a large percentage of these patients with not only low back pain, but upper back and shoulder pain as well, have a muscular component to their pain [28,29,48]. Although we only specifically address those patients with MPAI as a cause of pain, many of the patients had pain also from weakness stiffness, and tension, which we did not specifically analyze.…”

“…An important aspect of the examination is the production of pain along the entire course of suspected muscle from origin to insertion in order to unambiguously identify a muscle as a source of pain. A partially blinded randomized controlled validation study has been completed demonstrating that the MPDD is significantly better than palpation in determining a muscle thought to be the source of pain in a region of the body [28]. For MPAI to be diagnosed in a muscle the entire course of the muscle from the origin to insertion must be experienced as painful (tender, aching, or soreness).…”

“…We also note that the diagnostic and treatment protocol incorporates multiple variables, each of which should be investigated for their individual contributions to the overall outcome: The electrical detection device to identify MP and to determine possible etiologies of such pain (MPAI, TrPs, tension, stiffness, and/or spasm as the cause of pain. [We have noted above a successful RCT comparing MPDD to palpation in identifying MPAI]) [28], injections only of muscles identified as containing trigger points vs tension, stiffness or spasm through the use of the electrical device, the muscle injection procedure itself (entire muscle including the origin and insertion down to the bony attachment) and the injectate, 0.5% Lidocaine. The post-injection protocol variables that should be studied for their role in the total outcome are: use of a neuromuscular electrical stimulation to provide a rhythmic contraction and use of a specific structured exercise protocol.…”

“…Most functional muscle pain is experienced with muscle activity vs rest. Therefore, an examination of a resting muscle is likely to be less accurate in determining the source of the muscle pain, frequently identifying a referred pain pattern, compared with an examination utilizing movement of discrete muscles [28,29].…”

Reliability and validity of manual palpation for the assessment of patients with low back pain: a systematic and critical review

“…In stage 1 screening, 1976 citations were ineligible. Forty-seven papers were reviewed in stage 2, and 31 were excluded: ineligible study population (n = 11) [41][42][43][44][45][46][47][48][49][50][51], inappropriate outcome measure (n = 6) [52][53][54][55][56][57], ineligible publication type (n = 4) [58][59][60][61], ineligible sample size (n = 3) [62][63][64], study design (n = 3) [65][66][67] and did not investigate manual palpation (n = 4) [68][69][70][71]. Two authors were contacted for publication type and age range, both responded [27,59].…”