Desai Mehul J, Bean Matthew C, Heckman Thomas W, Jayaseelan Dhinu, Moats Nick, Nava Andrew
George Washington University Medical Center, The GW Spine & Pain Center, 2131 K Street, NW Suite 600, Washington, DC, USA.
Pain Manag. 2013 Jan;3(1):67-79. doi: 10.2217/pmt.12.78.
SUMMARY The objective of this article was to perform a narrative review regarding the treatment of myofascial pain syndrome and to provide clinicians with treatment recommendations. This paper reviews the efficacy of various myofascial pain syndrome treatment modalities, including pharmacological therapy, injection-based therapies and physical therapy interventions. Outcomes evaluated included pain (visual analog scale), pain pressure threshold and range of motion. The evidence found significant benefit with multiple treatments, including diclofenac patch, thiocolchicoside and lidocaine patches. Trigger point injections, ischemic compression therapy, transcutaneous electrical nerve stimulation, spray and stretch, and myofascial release were also efficacious. The authors recommend focusing on treating underlying pathologies, including spinal conditions, postural abnormalities and underlying behavioral issues. To achieve maximum pain reduction and improve function, we recommend physicians approach myofascial pain syndrome with a multimodal plan, which includes a combination of pharmacologic therapies, various physical therapeutic modalities and injection therapies.
摘要 本文的目的是对肌筋膜疼痛综合征的治疗进行叙述性综述,并为临床医生提供治疗建议。本文回顾了各种肌筋膜疼痛综合征治疗方式的疗效,包括药物治疗、注射疗法和物理治疗干预措施。评估的结果包括疼痛(视觉模拟量表)、疼痛压力阈值和活动范围。证据表明多种治疗方法有显著益处,包括双氯芬酸贴剂、秋水仙碱硫代糖苷和利多卡因贴剂。触发点注射、缺血性按压疗法、经皮电刺激神经疗法、喷雾与伸展以及肌筋膜松解术也有效。作者建议着重治疗潜在病因,包括脊柱疾病、姿势异常和潜在行为问题。为实现最大程度的疼痛减轻和功能改善,我们建议医生采用多模式方案治疗肌筋膜疼痛综合征,该方案包括药物治疗、各种物理治疗方式和注射疗法的联合应用。