Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain.

Authors:
Diego Turo
Diego Turo
George Mason University
United States
Paul Otto
Paul Otto
George Mason University
United States
Murad Hossain
Murad Hossain
Niigata University of Pharmacy and Applied Life Sciences
Tadesse Gebreab
Tadesse Gebreab
H.S.) and Center for the Study of Chronic Illness and Disability (K.A.
Katherine Armstrong
Katherine Armstrong
Stanford University School of Medicine
William F Rosenberger
William F Rosenberger
University of Maryland
United States
Hui Shao
Hui Shao
Kentucky Lions Eye Center
Louisville | United States
Jay P Shah
Jay P Shah
Mayo Clinic
United States

J Ultrasound Med 2015 Dec 21;34(12):2149-61. Epub 2015 Oct 21.

Departments of Bioengineering (D.T., T.G., S.S.), Electrical and Computer Engineering (P.O., M.H.), and Statistics (W.F.R., H.S.) and Center for the Study of Chronic Illness and Disability (K.A., L.H.G.), George Mason University, Fairfax, Virginia USA; and Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, Maryland USA (J.P.S.).

Objectives: To compare a mechanical heterogeneity index derived from ultrasound vibration elastography with physical findings before and after dry-needling treatment of spontaneously painful active myofascial trigger points in the upper trapezius muscle.

Methods: Forty-eight patients with chronic myofascial pain enrolled in a prospective interventional trial of 3 weekly dry-needling treatments for active myofascial trigger points. Trigger points were evaluated at baseline and at treatment completion using palpation, the pressure-pain threshold, and the mechanical heterogeneity index. Thirty patients were reevaluated at 8 weeks. Trigger points that "responded" changed to tissue that was no longer spontaneously painful, with or without the presence of a palpable nodule. Trigger points that "resolved" changed to tissue without a palpable nodule. The mechanical heterogeneity index was defined as the proportion of the upper trapezius muscle that appeared mechanically stiffer on elastography. Statistical significance for comparisons was determined at P < .05.

Results: Following 3 dry needle treatments, the mechanical heterogeneity index decreased significantly for the 38 myofascial trigger points (79% of 48) that responded to treatment. Among these, the baseline mechanical heterogeneity index was significantly lower for the 13 trigger points (27% of 38) that resolved, but the decrease after 3 dry needle treatments did not reach significance. The pressure-pain threshold improved significantly for both groups. At 8 weeks, the mechanical heterogeneity index decreased significantly for the 22 trigger points (73% of 30) that responded and for the 10 (45% of 22) that resolved. The pressure-pain threshold improvement was significant for trigger points that responded but did not reach significance for resolved trigger points.

Conclusions: The mechanical heterogeneity index identifies changes in muscle tissue properties that correlate with changes in the myofascial trigger point status after dry needling.

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http://www.jultrasoundmed.org/content/34/12/2149.full.pdf
Web Search
http://www.jultrasoundmed.org//cgi/doi/10.7863/ultra.14.0803
Publisher Site
http://dx.doi.org/10.7863/ultra.14.08033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555767PMC

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December 2015
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