Long-term Follow-up of Trigger Point Injections for Abdominal Wall Pain

Abstract

This study demonstrates that TPI, in patients who meet criteria for AWP, are effective over the long term.

Carnett’s Legacy: Raising Legs and Raising Awareness of an Often Misdiagnosed Syndrome

“…When 93 (72.1 %) of 129 patients were interviewed by telephone a mean of 4 years after diagnosis, 44 (47.3 %) denied any AWP, whereas the other 49 reported their pain intensity was 64.8 % of the level experienced before consultation [3]. Thus, the long-term outcome was approximately the same in the predominately uninjected Kaiser patients and in the Mayo cases and in other patients who received injection therapy [2,7]. Nonetheless, variation in patient features, specific aspects of care, and outcome measurements complicates comparison.…”

“…AWP accounts for many patients undergoing abdominal computed tomography (CT) [7]. For example, of 137 non-emergent, primary care outpatients who underwent CT for the complaint of abdominal pain, 11 (8.0 %) were diagnosed with AWP during at least 2 years of follow-up.…”

“…Most patients I see with AWP have undergone CT before referral, likely unnecessary in most cases. Fourteen (12.7 %) of 110 Canadian patients underwent exploratory laparotomy [7]. Patients especially predisposed to mismanagement are those with gallstones and right upper abdominal pain, the most common site of AWP in some series [3,7].…”

“…Fourteen (12.7 %) of 110 Canadian patients underwent exploratory laparotomy [7]. Patients especially predisposed to mismanagement are those with gallstones and right upper abdominal pain, the most common site of AWP in some series [3,7]. This common coincidence in patients who are usually female and overweight or obese can culminate in cholecystectomy in patients with nonbiliary pain, incurring cost, and risk, yet not diminishing their AWP [2].…”

“…Ultrasound is possibly of particular efficacy in obese patients. Combining a corticosteroid with an anesthetic may enhance anesthesia, even though a Canadian study reported steroid addition had no effect on pain relief in small numbers of comparison cases [7]. These commonly used agents and others, such as phenol injected by some pain specialists [5], have not been compared in treating AWP.…”