Fibrositic myofascial pain in intermittent claudication. Effect of anesthetic block of trigger points on exercise tolerance

Abstract

The blocking of trigger points in the calf by the local injection of an anesthetic agent was performed in 15 patients with intermittent claudication. Reactive and exercise hyperemia, work load and duration of exercise were recorded before and after infiltration of the trigger points. Reactive hyperemia does not change, but the exercise tolerance of the leg significantly improves after local blocking of the trigger areas and the exercise hyperemia increases because of the higher work load. The pain pattern of intermittent claudication can be activated by the summation of abnormal input from muscles, due to contraction in the presence of anoxia, with activity from trigger points. Local infiltration of trigger areas blocks theirir activity. The vicious cycle of pain is interrupted and the exercise tolerance of the leg is increased, without improving blood circulation.

Needling therapies in the management of myofascial trigger point pain: A systematic review

“…Table 2 summarizes the details of the 14 trials that investigated direct wet needling. Wet needling with different substances was compared in 10 studies, 8 of which found that the Macdonald et al 22 Not predominantly myofascial pain Petri et al 23 Not predominantly myofascial pain Petri and Langley 24 Not predominantly myofascial pain Berry et al 25 Not predominantly myofascial pain Crockett et al 26 No needling intervention included Dacre et al 27 Not predominantly myofascial pain Dorigo et al 28 Not RCT Fischer 29 Not RCT Fox et al 30 Not predominantly myofascial pain Freund and Schwartz 31 Not RCT Frost et al 32 Same as trial in Frost et al 77 Gallacchi et al 33 Not predominantly myofascial pain Gnatz 34 Not RCT Gunn et al 35 Not predominantly myofascial pain Hay 36 Not RCT Hendler et al 37 Not RCT Heuser 38 Not randomized Hollingworth et al 39 Not predominantly myofascial pain Hong and Hsueh 40 Same intervention in each group Jacob 41 Not RCT Jaeger and…”

Scoping review and interpretation of Myofascial Pain/Fibromyalgia syndrome: an attempt to assemble a medical puzzle

“…225,226,229 Also supporting this modality’s capability of improving perfusion, is a study showing infiltration of TrPs reduces symptoms of intermittent claudication. 230 Symptomatically, a person constantly exerting effort against such forces of a suffocating fascia would likely feel chronic fatigue and soreness, while accumulating nociceptive substances in muscles in a chronically tonic body; and active loci induced “energy crises”. With regards to active loci, it is possible the cell has its own ways to oppose this abnormality.…”

“…220 Also supporting this modality's capability of improving perfusion, is a study showing infiltration of TrPs reduces symptoms of intermittent claudication. 221 Symptomatically, a person constantly exerting effort against such forces of a suffocating fascia would likely feel chronic fatigue and soreness, whilst accumulating nociceptive substances in muscles in a chronically tonic body, and widespread "energy crises". A reader adopting this "biological ethos" should not be surprised, for example, by a study finding that fibromyalgia patients have elevated serum tau and amyloid beta levels, since studies suggest amyloid beta and the cytoskeletal protein tau and are affected by, or compensate for, mechanical stress.…”

“…A reader adopting this "biological ethos" should not be surprised, for example, by a study finding that fibromyalgia patients have elevated serum tau and amyloid beta levels, since studies suggest amyloid beta and the cytoskeletal protein tau and are affected by, or compensate for, mechanical stress. [221][222][223][224][225][226][227][228] At least we might want to exclude an organic fascial cause before perceiving these cases as psycho-functional disorders, even if the mechanism is still unclear, and even if it involves a degree of central sensitization. Is there enough empirical evidence to recognize MPS and fibromyalgia as honorable organic diseases, like any other, rather than psychosomatic?…”

“…Meta-analyses and systematic reviews find that needling improves pain and stiffness in people with fibromyalgia and MPS [245,246,249]. Support for this modality's capability of improving perfusion is found in a study showing infiltration of TrPs reduces symptoms of intermittent claudication [250]. Symptomatically, a person constantly exerting effort against such forces of a suffocating fascia would likely feel chronic fatigue and soreness, while accumulating nociceptive substances in muscles in a chronically tonic body, and active loci induced "energy crises".…”