Chu J, Bruyninckx F, Neuhauser D V
Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Physical Medicine and Rehabilitation, Leuven University Hospitals, Leuven, Belgium.
BMJ Case Rep. 2016 Jan 13;2016:bcr2015211816. doi: 10.1136/bcr-2015-211816.
Chronic pain with a 30.3% global prevalence significantly impacts universal health. Low back pain has a 9.4% prevalence worldwide causing the most widespread disability. Neck pain ranks 4th highest regarding years lived with disability with a 4.9% prevalence worldwide. The principal cause of pain in 85% of patients visiting a tertiary pain clinic has a myofascial origin. The root cause is multifocal neuromuscular ischaemia at myofascial trigger points from muscle tightening and shortening following spondylotic radiculopathy induced partial denervation. Chronic refractory myofascial pain (CRMP) is a neuromusculoskeletal disease needing management innovations. Using electrical twitch-obtaining intramuscular stimulation (eToims), we provide objective evidence of denervation supersensitivity in multiple myotomes as cause, aggravation and maintenance of CRMP. This study underscores our previous findings that eToims is safe and efficacious for long-term use in CRMP. eToims aids potential prevention (pre-rehabilitation), simultaneous diagnosis, treatment (rehabilitation) and prognosis in real time for acute and CRMP management.
慢性疼痛在全球的患病率为30.3%，对全民健康有重大影响。腰痛在全球的患病率为9.4%，是导致残疾最普遍的原因。颈部疼痛导致的残疾生存年数在全球患病率中排名第四，为4.9%。在三级疼痛诊所就诊的患者中，85%的疼痛主要病因源自肌筋膜。根本原因是在神经根型颈椎病导致部分失神经支配后，肌肉收紧和缩短，致使肌筋膜触发点出现多灶性神经肌肉缺血。慢性难治性肌筋膜疼痛（CRMP）是一种需要管理创新的神经肌肉骨骼疾病。通过使用电刺激获取肌肉抽搐的肌内刺激（eToims），我们提供了客观证据，证明多个肌节中的失神经超敏反应是CRMP的病因、病情加重及持续存在的原因。本研究强调了我们之前的发现，即eToims在CRMP的长期治疗中安全有效。eToims有助于对急性和CRMP的管理进行潜在预防（康复前）、同步诊断、治疗（康复）以及实时预后评估。
