Wu Wei-Ting, Chang Ke-Vin, Mezian Kamal, Ricci Vincenzo, Özçakar Levent
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 100233, Taiwan.
Life (Basel). 2025 Mar 31;15(4):563. doi: 10.3390/life15040563.
Myofascial pain syndrome (MPS) is a common musculoskeletal disorder that significantly affects quality of life. Conventional treatment approaches include pharmacological interventions, physical therapy, and procedures such as dry needling. Among these, ultrasound-guided injections (USGIs) have gained recognition for their precision and therapeutic benefits. Additionally, repetitive peripheral magnetic stimulation (rPMS) has emerged as a non-invasive neuromodulatory technique for pain management. This perspective article examines the physiological mechanisms and clinical applications of USGIs and rPMS, particularly in the lumbar multifidus muscle, and explores their potential synergistic effects. MPS is often associated with chronic muscle dysfunction due to energy depletion, leading to persistent pain and motor impairment. USGIs play a crucial role in restoring muscle perfusion, disrupting pain cycles, and providing diagnostic insights in real time. In parallel, rPMS modulates neuromuscular activation, enhances endogenous pain control, and promotes functional recovery. Ultrasound guidance enhances the precision and effectiveness of interventions, such as dry needling, interfascial plane blocks, and fascial hydrodissection, while rPMS complements these strategies by facilitating neuromuscular reconditioning and reducing pain via central and peripheral mechanisms. The preliminary findings suggest that combining multifidus USGIs with rPMS results in significant pain relief and functional improvements in patients with chronic low back pain. Integrating USGIs with rPMS represents a promising multimodal strategy for managing MPS. By combining targeted injections with non-invasive neuromodulation, clinicians may optimize therapeutic outcomes and provide sustained relief for patients with chronic musculoskeletal pain. Further research is needed to refine treatment protocols and assess the long-term efficacy.
肌筋膜疼痛综合征（MPS）是一种常见的肌肉骨骼疾病，严重影响生活质量。传统的治疗方法包括药物干预、物理治疗以及诸如干针疗法等操作。其中，超声引导下注射（USGIs）因其精准性和治疗效果而受到认可。此外，重复经颅磁刺激（rPMS）已成为一种用于疼痛管理的非侵入性神经调节技术。这篇观点文章探讨了USGIs和rPMS的生理机制及临床应用，特别是在腰多裂肌中的应用，并探讨了它们潜在的协同作用。MPS通常与能量消耗导致的慢性肌肉功能障碍相关，从而导致持续性疼痛和运动障碍。USGIs在恢复肌肉灌注、中断疼痛循环以及实时提供诊断见解方面发挥着关键作用。与此同时，rPMS调节神经肌肉激活，增强内源性疼痛控制，并促进功能恢复。超声引导提高了诸如干针疗法、筋膜间平面阻滞和筋膜水分离等干预措施的精准性和有效性，而rPMS通过促进神经肌肉重塑以及通过中枢和外周机制减轻疼痛来补充这些策略。初步研究结果表明，将多裂肌USGIs与rPMS相结合可使慢性下腰痛患者的疼痛显著减轻且功能得到改善。将USGIs与rPMS相结合是一种有前景的用于管理MPS的多模式策略。通过将靶向注射与非侵入性神经调节相结合，临床医生可以优化治疗效果，并为慢性肌肉骨骼疼痛患者提供持续缓解。需要进一步研究来完善治疗方案并评估长期疗效。
