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通过检查下腰痛患者的肌筋膜触发点,聚焦冲击波在肌筋膜疼痛综合征诊断中的应用及益处

The Use and Benefits of Focused Shockwaves for the Diagnosis of Myofascial Pain Syndrome by Examining Myofascial Trigger Points in Low Back Pain.

作者信息

Müller-Ehrenberg Hannes, Giordani Federico, Müller-Ehrenberg Alessandra, Stange Richard

机构信息

Private Clinic Orthopädische Privatpraxis, 48143 Münster, Germany.

Villa Rosa Rehabilitation Hospital, APSS Trento, 38122 Trento, Italy.

出版信息

Biomedicines. 2024 Dec 20;12(12):2909. doi: 10.3390/biomedicines12122909.

DOI:10.3390/biomedicines12122909
PMID:39767813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11673203/
Abstract

: Low back pain (LBP) is a widespread public health issue, with myofascial pain syndrome (MPS) being a common cause, affecting 67-100% of patients. However, there are significant challenges in the diagnostic process due to the subjective and unreliable nature of manual palpation. Focused Extracorporeal Shockwave Therapy (F-ESWT), traditionally used for MPS treatment, offers a reproducible and non-invasive mechanical stimulus, making it a potential diagnostic tool. This study evaluated F-ESWT's diagnostic efficiency in chronic LBP patients by focusing on "recognition" and "referral" of pain. : twenty-eight participants were screened for myofascial trigger points (MTrPs) in the lumbar, gluteal, and thigh regions. Identified MTrPs were stimulated using F-ESWT, and patient feedback was recorded. : data showed high diagnostic accuracy for muscles such as the quadratus lumborum, gluteus medius, and gluteus minimus muscles, achieving "referral" rates of 96%, 95%, and 92% and "recognition" rates of 84%, 86%, and 85%, respectively. Other structures like adductors, iliopsoas, erector spinae, and biceps femoris muscle showed consistent but lower diagnostic rates. : the study's findings indicate that F-ESWT effectively reproduces pain patterns, offering a precise, reproducible, and non-invasive diagnostic approach for MPS in chronic LBP. However, they also highlight the necessity for detailed diagnostic criteria in managing myofascial pain.

摘要

腰痛(LBP)是一个普遍存在的公共卫生问题,肌筋膜疼痛综合征(MPS)是其常见病因,影响67%-100%的患者。然而,由于手动触诊的主观性和不可靠性,诊断过程面临重大挑战。传统上用于治疗MPS的聚焦式体外冲击波疗法(F-ESWT)提供了一种可重复且无创的机械刺激,使其成为一种潜在的诊断工具。本研究通过关注疼痛的“识别”和“激发”来评估F-ESWT对慢性LBP患者的诊断效率。对28名参与者的腰部、臀部和大腿区域进行肌筋膜触发点(MTrP)筛查。使用F-ESWT刺激识别出的MTrP,并记录患者的反馈。数据显示,腰方肌、臀中肌和臀小肌等肌肉的诊断准确率较高,“激发”率分别为96%、95%和92%,“识别”率分别为84%、86%和85%。内收肌、髂腰肌、竖脊肌和股二头肌等其他结构的诊断率虽一致但较低。该研究结果表明,F-ESWT能有效再现疼痛模式,为慢性LBP中的MPS提供了一种精确、可重复且无创的诊断方法。然而,研究结果也凸显了在管理肌筋膜疼痛时制定详细诊断标准的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/ee01c8aab3fd/biomedicines-12-02909-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/751a3172131b/biomedicines-12-02909-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/9fec1e15286b/biomedicines-12-02909-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/8739b04e35ff/biomedicines-12-02909-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/93d24d162e46/biomedicines-12-02909-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/ee01c8aab3fd/biomedicines-12-02909-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/751a3172131b/biomedicines-12-02909-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/9fec1e15286b/biomedicines-12-02909-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/8739b04e35ff/biomedicines-12-02909-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/93d24d162e46/biomedicines-12-02909-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11673203/ee01c8aab3fd/biomedicines-12-02909-g005.jpg

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