Myofascial Trigger Points in the Ipsilateral Gluteal Muscles Associated with Pyogenic Sacroiliitis: A Case Report

Tsai, Wen–Chung; Wang, Tyng-Guey; Hong, Chang‐Zern

doi:10.1300/j094v07n03_06

Cited by 11 publications

(8 citation statements)

References 14 publications

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“…This question stems from the fact that trigger points often have been found in the absence of precipitating mechanical injury. Indeed, trigger points have been observed with nonmusculoskeletal pathologies such as pelvic/urogenital syndromes [17], herpes zoster infection [18], and pyogenic sacroiliitis [19] in the absence of local trauma. In the latter case, the resolution of the primary pathology (infection) with antibiotic therapy led to the long-term remission of the trigger points, suggesting a causal relationship between the underlying infectious pathology and trigger point expression.…”

Section: Physiologic Mechanisms Of Myofascial Trigger Points and Myofmentioning

confidence: 99%

New Trends in the Treatment and Management of Myofascial Pain Syndrome

Srbely

2010

Curr Pain Headache Rep

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Myofascial pain syndrome presents a significant physical and financial burden to society. In view of the aging demographics, myofascial pain promises to be an even greater challenge to health care in the future. Myofascial trigger points have been identified as important anatomic and physiologic phenomena in the pathophysiology of myofascial pain. While their pathophysiologic mechanisms are still unclear, emerging research suggests that trigger points may be initiated by neurogenic mechanisms secondary to central sensitization, and not necessarily by local injury. A variety of treatments are employed in the management of trigger points, including manual therapy, electrotherapy, exercise, and needle therapy. Therapeutic ultrasound demonstrates significant potential as a safe, cost-effective, and relatively noninvasive therapeutic alternative in the treatment and management of this modern day medical enigma.

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Section: Physiologic Mechanisms Of Myofascial Trigger Points and Myofmentioning

confidence: 99%

New Trends in the Treatment and Management of Myofascial Pain Syndrome

Srbely

2010

Curr Pain Headache Rep

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“…Gluteal pain is commonly (10%-25% of the general population with increased prevalence in women) associated with low back pain or as a single complaint related to other lesions such as sacroiliac joint lesion, ischial tuberosities bursitis, or subtrochanteric bursitis. [1][2][3][4][5][6] Subtrochanteric bursitis is a commonly diagnosed inflammatory condition that presents with pain in the gluteal region, including the greater trochanter, often with radiation down the lateral aspect of the thigh, [1][2][3][4][5][6] exacerbated by lying on the affected side, with prolonged standing or transitioning to a standing position, sitting with the affected leg crossed and with climbing stairs, running or other high-impact activities. 6 In addition to the localized pain in the greater trochanter region, it can also cause myofascial pain in the gluteal muscles.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Fascia Release for Treating Chronic Recurrent Gluteal Myofascial Pain—A Pilot Study of a New Technique

Chen

Lin

Hong³

et al. 2015

Rehabilitation Process and Outcome

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OBJECTIVE:To investigate the therapeutic effectiveness of percutaneous fascia release to treat chronic recurrent gluteal myofascial pain related to recurrent tendonitis or bursitis at the attachment sites. METHODS: Five patients (three males, two females; aged 48.6 ± 8.9 years) with myofascial trigger points in the gluteus medius muscle were treated. Outcome measures, including pain intensity, pressure pain threshold, and the relative strength of hip abduction, were assessed before, immediately after, and six months after the treatment. The data measured before and after treatment (different times) on visual analog scale, pressure pain threshold, and relative hip abduction strength were analyzed by Wilcoxon signed-rank test and paired t-test, respectively, for the comparisons between time points. RESULTS: Reduction in pain intensity and increase in the pressure pain threshold and the relative hip abduction strength were found in all five patients after treatment when compared with those of before treatment (P , 0.05). Moreover, all of these improvements existed for at least six months (P . 0.05). CONCLUSIONS: Percutaneous fascia release of gluteal muscle insertion sites can be used to treat chronic gluteal pain related to subtrochanteric bursitis to avoid recurrence, if other treatment cannot control the recurrence, although this was demonstrated only on a small sample size without control and blind assessment in the pilot study.

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“…The term piriformis myofascial pain syndrome (PMPS) has been used for a pain syndrome caused by myofascial trigger points (MTrPs) of piriformis muscle 3,6. PMPS can be caused by various lesions including, for example, herniated lumbar discs, degenerative lumbar disc lesions, lumbar facet syndrome, trochanteric bursitis, sacroiliac joint dysfunction, and endometriosis 1,9–12…”

Section: Introductionmentioning

confidence: 99%

“…An active MTrP is characterized by spontaneous pain or pain during movement, and a latent MTrP is a tender spot with pain only in response to compression. The pathophysiology of MTrP has been clarified and is now widely accepted 12–21. The current definition of MTrP is the accumulation of sensitized nociceptors in the end plate zone of a palpable taut band of skeletal muscle fibers 22.…”

Section: Introductionmentioning

confidence: 99%

Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies

Huang¹,

Chen²,

Hong³

et al. 2014

PPA

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Background and aimsThe aim of this study was to demonstrate the effectiveness of lumbar facet joint injection for piriformis myofascial pain syndrome.MethodsFifty-two patients with chronic myofascial pain in the piriformis muscle each received a lumbar facet injection into the ipsilateral L5–S1 facet joint region, using the multiple insertion technique. Subjective pain intensity, trunk extension range, and lumbar facet signs were measured before, immediately after, and 2 weeks after injection. Thirty-six patients received follow-up for 6 months.ResultsImmediately after the injection, 27 patients (51.9%) had complete pain subsidence, 19 patients (36.5%) had pain reduction to a tolerable level, and only 6 patients (11.5%) had no pain relief to a tolerable level. Mean pain intensity was reduced from 7.4±0.9 to 1.6±2.1 after injection (P<0.01). This effectiveness lasted for 2 weeks in 49 patients (94.2%), and lasted for approximately 6 months in 35 (97.2%) of 36 patients. The mean range of motion increased from 13.4±6.8 degrees to 22.1±6.0 degrees immediately after injection, and further increased 2 weeks and 6 months later. Immediately after injection, 45 patients (86.5%) had no facet sign. In addition, 90.4% and 94.4% of patients had no facet sign after 2 weeks and after 6 months, respectively.ConclusionsIt is important to identify the possible cause of piriformis myofascial pain syndrome. If this pain is related to lumbar facet lesions, lumbar facet joint injection can immediately suppress piriformis myofascial pain symptoms. This effectiveness may last for at least 6 months in most patients. This study further supports the importance of eliminating the underlying etiological lesion for complete and effective relief of myofascial pain syndrome.

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Myofascial Trigger Points in the Ipsilateral Gluteal Muscles Associated with Pyogenic Sacroiliitis: A Case Report

Cited by 11 publications

References 14 publications

New Trends in the Treatment and Management of Myofascial Pain Syndrome

New Trends in the Treatment and Management of Myofascial Pain Syndrome

Percutaneous Fascia Release for Treating Chronic Recurrent Gluteal Myofascial Pain—A Pilot Study of a New Technique

Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies

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Myofascial Trigger Points in the Ipsilateral Gluteal Muscles Associated with Pyogenic Sacroiliitis: A Case Report

Cited by 11 publications

References 14 publications

New Trends in the Treatment and Management of Myofascial Pain Syndrome

New Trends in the Treatment and Management of Myofascial Pain Syndrome

Percutaneous Fascia Release for Treating Chronic Recurrent Gluteal Myofascial Pain—A Pilot Study of a New Technique

Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52&nbsp;case studies

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Lumbar facet injection for the treatment of chronic piriformis myofascial pain syndrome: 52 case studies