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A Comprehensive Review of the Treatment and Management of Myofascial Pain Syndrome

  • Other Pain (AD Kaye and N Vadivelu, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Myofascial pain syndrome (MPS) is a musculoskeletal pain condition that stems from localized, taut regions of skeletal muscle and fascia, termed trigger points. The purpose of this comprehensive review is to provide updated information on prevalence, pathophysiology, and treatment modalities with a focus on interventional modalities in managing MPS.

Recent Findings

Though MPS can present acutely, it frequently presents as a chronic condition, affecting up to 85% of adults during their lifetime. MPS is an often-overlooked component of pain with overarching effects on society, including patient quality of life, physical and social functioning, emotional well-being, energy, and costs on health care. The prevalence of MPS is generally increased among patients with other chronic pain disorders and has been associated with various other conditions such as bladder pain syndrome, endometriosis, and anxiety.

Summary

MPS is poorly understood and remains a challenging condition to treat. Non-pharmacologic treatment modalities such as acupuncture, massage, transcutaneous electrical stimulation, and interferential current therapy may offer relief to some patients with MPS. Additional studies are warranted to get a better understanding of managing myofascial pain.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Dieleman JL, Baral R, Birger M, Bui AL, Bulchis A, Chapin A, et al. US spending on personal health care and public health, 1996-2013. JAMA. 2016;316:2627.

    PubMed  PubMed Central  Google Scholar 

  2. Manchikanti L, Soin A, Mann DP, Bakshi S, Pampati V, Hirsch JA. Reversal of growth of utilization of interventional techniques in managing chronic pain in Medicare population post Affordable Care Act. Pain Physician. American Society of Interventional Pain Physicians. 2017;20:551–67.

    Google Scholar 

  3. Manchikanti L, Soin A, Mann DP, Bakshi S, Pampati V, Hirsch JA. Comparative analysis of utilization of epidural procedures in managing chronic pain in the Medicare population. Spine (Phila Pa 1976). 2019;44:220–32.

  4. Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M. Benyamin JAH. Declining utilization of percutaneous epidural adhesiolysis in Medicare population: evidence-based or over-regulated? Interv Pain Manag Reports. 2018;2:9–17.

  5. Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M. Benyamin JAH. Cost calculation methodology exacerbates site-of-service differentials by 10- to 18-fold for soft tissue and joint injections in hospital outpatient departments. Interv Pain Manag Reports 2017;1:183–189.

  6. Manchikanti M, Manchikanti L, Kaye AD, Pampati V, Hirsch JA. Usage patterns of sacroiliac joint injections - a comparative evaluation of pre and post affordable care act in Medicare population B. Interv Pain Manag Reports. 2018;2:157–66.

    Google Scholar 

  7. Garza-Villarreal EA, Pando V, Vuust P, Parsons C. Music-induced analgesia in chronic pain conditions: a systematic review and meta-analysis. Pain Physician. American Society of Interventional Pain Physicians; 2017;20:597–610.

  8. Romman A, Salama-Hanna J, Dwivedi S. Mexiletine usage in a chronic pain clinic: indications, tolerability, and side effects. Pain Physician American Society of Interventional Pain Physicians. 2018;21:E573–9.

    Google Scholar 

  9. Provenzano DA, Kamal KM, Giannetti V. Evaluation of primary care physician chronic pain management practice patterns. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:E593–602.

    Google Scholar 

  10. Li X, Wang R, Xing X, Shi X, Tian J, Zhang J, et al. Acupuncture for myofascial pain syndrome: a network meta-analysis of 33 randomized controlled trials. Pain Physician. American Society of Interventional Pain Physicians; 2017;20:E883–E902.

  11. Manchikanti L, Kaye AM, Knezevic NN, McAnally H, Trescot AM, Blank S, et al. Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American Society of Interventional Pain Physicians (ASIPP) guidelines. Pain Physician. American Society of Interventional Pain Physicians. 2017;20:S3–92.

    Google Scholar 

  12. Kaye AD, Jones MR, Kaye AM, Ripoll JG, Galan V, Beakley BD, et al. Prescription opioid abuse in chronic pain: an updated review of opioid abuse predictors and strategies to curb opioid abuse: part 1. Pain Physician [Internet]. 2017 [cited 2018 Mar 14];20:S93–109. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28226333.

  13. Kaye AD, Jones MR, Kaye AM, Ripoll JG, Jones DE, Galan V, et al. Prescription opioid abuse in chronic pain: an updated review of opioid abuse predictors and strategies to curb opioid abuse (part 2). Pain Physician [Internet]. 2017 [cited 2018 mar 14];20:S111–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28226334.

  14. Manchikanti L, Sanapati J, Benyamin RM, Atluri S, Kaye AD, Hirsch JA. Reframing the prevention strategies of the opioid crisis: focusing on prescription opioids, fentanyl, and heroin epidemic. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:309–26.

    Google Scholar 

  15. • Wheeler AH, Carolina N. Myofascial pain disorders theory to therapy. Drugs. Springer International Publishing; 2004;64:45–62. A review of the management of myofascial pain syndrome.

  16. Fleckenstein J, Zaps D, Rüger LJ, Lehmeyer L, Freiberg F, Lang PM, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey. BMC Musculoskelet Disord. BioMed Central; 2010;11:32.

  17. • Jafri MS. Mechanisms of myofascial pain. Int Sch Res Not. Hindawi Limited; 2014;2014. A systematic review of the current evidence regarding the racial, ethnic, and cultural alterations and differences in pain beliefs, cognitions, and behaviors in patients with chronic musculoskeletal pain.

  18. Pain: a forgotten aspect of idiopathic scoliosis [Internet]. [cited 2020 Mar 31]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2484866/

  19. • Tantanatip A, Chang K-V. Myofascial syndrome. Encycl Pain. Springer Berlin Heidelberg; 2013. p. 2009–2009. A review of functional connectivity in 4 common pain syndromes: chronic back pain, fibromyalgia, diabetic neuropathy, and complex regional pain syndrome.

  20. Orhan C, Van Looveren E, Cagnie B, Mukhtar NB, Lenoir D, Meeus M. Are pain beliefs, cognitions, and behaviors influenced by race, ethnicity, and culture in patients with chronic musculoskeletal pain: a systematic review. Pain Physician. American Society of Interventional Pain Physicians; 2018;21:541–558.

  21. Clark J, Nijs J, Yeowell G, Goodwin PC. What are the predictors of altered central pain modulation in chronic musculoskeletal pain populations? A systematic review. Pain Physician. American Society of Interventional Pain Physicians; 2017;20:487–500.

  22. Thorp SL, Suchy T, Vadivelu N, Helander EM, Urman RD, Kaye AD. Functional connectivity alterations: novel therapy and future implications in chronic pain management. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:E207–14.

    Google Scholar 

  23. Coppieters I, De Pauw R, Caeyenberghs K, Danneels L, Kregel J, Pattyn A, et al. Decreased regional grey matter volume in women with chronic whiplash-associated disorders: relationships with cognitive deficits and disturbed pain processing. Pain Physician. American Society of Interventional Pain Physicians; 2017;20:E1025–E1051.

  24. Bansal D, Boya CS, Vatte R, Ghai B. High prevalence of hypovitaminosis D in patients with low back pain: evidence from meta-analysis. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:E389–99.

    Google Scholar 

  25. •• Kregel J, Coppieters I, Depauw R, Malfliet A, Danneels L, Nijs J, et al. Does conservative treatment change the brain in patients with chronic musculoskeletal pain? A systematic review. Pain Physician. American Society of Interventional Pain Physicians; 2017;20:139–54. A systematic review concerning the prevalence, diagnostic criteria, and treatment of myofascial trigger points.

  26. Chen JH, Chen HJ, Kao CH, Tseng CH, Tsai CH. Is fibromyalgia risk higher among male and young inflammatory bowel disease patients? Evidence from a Taiwan cohort of one million. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:E257–64.

    Google Scholar 

  27. Batistaki C, Mavrocordatos P, Smyrnioti ME, Lyrakos G, Kitsou MC, Stamatiou G, et al. Patients’ perceptions of chronic pain during the economic crisis: lessons learned from Greece. Pain Physician. American Society of Interventional Pain Physicians; 2018;21:E533–E543.

  28. Simons DG. Understanding effective treatments of myofascial trigger points. J Bodyw Mov Ther Churchill Livingstone. 2002;6:81–8.

    Google Scholar 

  29. Ge HY, Fernández-de-las-Peñas C, Yue SW. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation. Chin Med. 2011;6:13.

    PubMed  PubMed Central  Google Scholar 

  30. Simons DG, Dexter JR. Comparison of local twitch responses elicited by palpitation and needling of myofascial trigger points. J Musculoskelet Pain Informa Healthcare. 1995;3:49–61.

    Google Scholar 

  31. Thibaut A, Zeng D, Caumo W, Liu J, Fregni F. Corticospinal excitability as a biomarker of myofascial pain syndrome. PAIN Reports. 2017;2:e594.

    PubMed  PubMed Central  Google Scholar 

  32. Chen Q, Basford J, An K-N. Ability of magnetic resonance elastography to assess taut bands. Clin Biomech (Bristol, Avon). 2008/02/21. 2008;23:623–9.

  33. Bonder JH, Chi M, Rispoli L. Myofascial pelvic pain and related disorders. Phys Med Rehabil Clin N Am. Elsevier Inc; 2017;28:501–515.

  34. Do TP, Heldarskard GF, Kolding LT, Hvedstrup J, Schytz HW. Myofascial trigger points in migraine and tension-type headache. J Headache Pain. BioMed Central; 2018;19:84.

  35. Palacios-Ceña M, Ferracini GN, Florencio LL, Ruíz M, Guerrero ÁL, Arendt-Nielsen L, et al. The number of active but not latent trigger points associated with widespread pressure pain hypersensitivity in women with episodic migraines. Pain Med [Internet]. 2017 [cited 2020 Mar 31];18:2485–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29016874.

  36. Bajaj P, Bajaj P, Graven-Nielsen T, Arendt-Nielsen L. Trigger points in patients with lower limb osteoarthritis. J Musculoskelet Pain Taylor & Francis. 2001;9:17–33.

    Google Scholar 

  37. Henry R, Cahill CM, Wood G, Hroch J, Wilson R, Cupido T, et al. Myofascial pain in patients waitlisted for total knee arthroplasty. Pain Res Manag. 17:321–7.

  38. Peral-Cagigal B, Pérez-Villar Á, Redondo-González L-M, García-Sierra C, Morante-Silva M, Madrigal-Rubiales B, et al. Temporal headache and jaw claudication may be the key for the diagnosis of giant cell arteritis. Med Oral Patol Oral Cir Bucal. Medicina Oral S.L; 2018;23:e290–4.

  39. Chiarotto A, Clijsen R, Fernandez-De-Las-Penas C, Barbero M. Prevalence of myofascial trigger points in spinal disorders: a systematic review and meta-analysis. Arch Phys Med Rehabil WB Saunders. 2016;97:316–37.

    Google Scholar 

  40. Rainsford K. Profile and mechanisms of gastrointestinal and other side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). Am J Med Elsevier. 1999;107:27–35.

    Google Scholar 

  41. Hsieh LF, Hong CZ, Chern SH, Chen CC. Efficacy and side effects of diclofenac patch in treatment of patients with myofascial pain syndrome of the upper trapezius. J Pain Symptom Manag. 2010;39:116–25.

    CAS  Google Scholar 

  42. Obata H. Analgesic mechanisms of antidepressants for neuropathic pain. Int J Mol Sci. Multidisciplinary Digital Publishing Institute (MDPI); 2017;18.

  43. Annaswamy TM, De Luigi AJ, O’Neill BJ, Keole N, Berbrayer D. Emerging concepts in the treatment of myofascial pain: a review of medications, modalities, and needle-based interventions. PM&R. 2011;3:940–61.

    Google Scholar 

  44. Haviv Y, Zini A, Sharav Y, Almoznino G, Benoliel R. Nortriptyline compared to amitriptyline for the treatment of persistent masticatory myofascial pain. J Oral Facial Pain Headache. 2018.

  45. Haviv Y, Rettman A, Aframian D, Sharav Y, Benoliel R. Myofascial pain: an open study on the pharmacotherapeutic response to stepped treatment with tricyclic antidepressants and gabapentin. J Oral Facial Pain Headache. 2015;29:144–51.

    PubMed  Google Scholar 

  46. Bendtsen L, Jensen R. Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache. Cephalalgia. 2000;20:603–10.

    CAS  PubMed  Google Scholar 

  47. Huang-Lionnet JH, Hameed H, Cohen SP. Pharmacologic management of myofascial pain. Essentials Pain Med. 4th ed. Elsevier; 2018. p. 475–484.e2.

  48. Heir GM. The efficacy of pharmacologic treatment of Temporomandibular disorders. Oral Maxillofac Surg Clin North Am. 2018;30:279–85.

    PubMed  Google Scholar 

  49. Groves L, Shellenberger M, Davis C. Tizanidine treatment of spasticity: a meta-analysis of controlled, double-blind, comparative studies with baclofen and diazepam. Adv Ther. 1998;15:241–51.

    CAS  PubMed  Google Scholar 

  50. Xie P, Qin B, Yang F, Yu T, Yu J, Wang J, et al. Lidocaine injection in the intramuscular innervation zone can effectively treat chronic neck pain caused by MTrPs in the trapezius muscle. Pain Physician. 2015;18:E815–26.

    PubMed  Google Scholar 

  51. Firmani M, Miralles R, Casassus R. Effect of lidocaine patches on upper trapezius EMG activity and pain intensity in patients with myofascial trigger points: a randomized clinical study. Acta Odontol Scand. 2015;73:210–8.

    CAS  PubMed  Google Scholar 

  52. Affaitati G, Fabrizio A, Savini A, Lerza R, Tafuri E, Costantini R, et al. A randomized, controlled study comparing a lidocaine patch, a placebo patch, and anesthetic injection for treatment of trigger points in patients with myofascial pain syndrome: evaluation of pain and somatic pain thresholds. Clin Ther. 2009;31:705–20.

    CAS  PubMed  Google Scholar 

  53. Affaitati G, Costantini R, Tana C, Lapenna D, Schiavone C, Cipollone F, et al. Effects of topical vs injection treatment of cervical myofascial trigger points on headache symptoms in migraine patients: a retrospective analysis. J Headache Pain. Springer; 2018;19:104.

  54. Sicard JA. Les injections medicamenteuse extraduraqles per voie saracoccygiene. Comptes Renues des Senances la Soc Biolgie ses Fill . Paris: Elsevier Inc.; 1901. p. 396–8.

  55. Shanthanna H, Busse JW, Thabane L, Paul J, Couban R, Choudhary H, et al. Local anesthetic injections with or without steroid for chronic non-cancer pain: a protocol for a systematic review and meta-analysis of randomized controlled trials. Syst Rev. 2016;5:18.

    PubMed  PubMed Central  Google Scholar 

  56. Lewis RA, Williams NH, Sutton AJ, Burton K, Din NU, Matar HE, et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. Spine J. 2015;15:1461–77.

    PubMed  Google Scholar 

  57. Lee JH, Kim DH, Kim DH, Shin KH, Park SJ, Lee GJ, et al. Comparison of clinical efficacy of epidural injection with or without steroid in lumbosacral disc herniation: a systematic review and meta-analysis. Pain Physician. American Society of Interventional Pain Physicians; 2018;21:468.

  58. Manchikanti L, Singh V, Benyamin RM, Kaye AD, Pampati V, Hirsch JA. Reframing Medicare physician payment policy for 2019: a look at proposed policy. Pain Physician. 2018;21:415–432.

  59. Manchikanti L, Malla Y, Cash KA, Pampati V, Hirsch JA. Comparison of effectiveness for fluoroscopic cervical interlaminar epidural injections with or without steroid in cervical post-surgery syndrome. Korean J Pain Korean Pain Society. 2018;31:277–88.

    Google Scholar 

  60. Manchikanti L, Soin A, Benyamin RM, Singh V, Falco FJE, Calodney AK, et al. An update of the systematic appraisal of the accuracy and utility of discography in chronic spinal pain. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:91–110.

    Google Scholar 

  61. Helm S, Simopoulos TT, Stojanovic M, Abdi S, El Terany MA. Effectiveness of thermal annular procedures in treating discogenic low back pain. Pain Physician. American Society of Interventional Pain Physicians. 2017;20:447–70.

    Google Scholar 

  62. Manchikanti L, Falco FJE, Pampati V, Cash KA, Benyamin RM, Hirsch JA. Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome. Pain Physician. 2013;16.

  63. Manchikanti L, Pampati V, Kaye AD, Hirsch JA. Therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain: cost utility analysis based on a randomized controlled trial. Korean J Pain. Korean Pain Society. 2018;31:27–38.

    Google Scholar 

  64. Lee JH, Shin KH, Park SJ, Lee GJ, Lee CH, Kim DH, et al. Comparison of clinical efficacy between transforaminal and interlaminar epidural injections in lumbosacral disc herniation: a systematic review and meta-analysis. Pain Physician. American Society of Interventional Pain Physicians; 2018;21:448.

  65. Moeen SM, Moeen AM. Usage of intravenous lidocaine infusion with enhanced recovery pathway in patients scheduled for open radical cystectomy: a randomized trial. Pain Physician. American Society of Interventional Pain Physicians; 2019;22:E71–E80.

  66. Ni J, Wang X, Tang Y, Yang L, Zeng Y, Guo Y. Subcutaneous injection of triamcinolone and lidocaine to prevent postherpetic neuralgia. Pain Physician. American Society of Interventional Pain Physicians. 2017;20:397–403.

    Google Scholar 

  67. Terkawi AS, Sharma S, Durieux ME, Thammishetti S, Brenin D, Tiouririne M. Perioperative lidocaine infusion reduces the incidence of post-mastectomy chronic pain: a double-blind, placebo-controlled randomized trial. Pain Physician. American Society of Interventional Pain Physicians; 2015;18:E139–E146.

  68. Hanlan AKL, Mah-Jones D, Mills PB. Early adjunct treatment with topical lidocaine results in improved pain and function in a patient with complex regional pain syndrome. Pain Physician. American Society of Interventional Pain Physicians; 2014;17:E629–E635.

  69. Chakravarthy K, Manchikanti L, Kaye AD, Christo PJ. Reframing the role of neuromodulation therapy in the chronic pain treatment paradigm. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:507–13.

    Google Scholar 

  70. Reeves DJ, Foster AE. Continuous intravenous lidocaine infusion for the management of pain uncontrolled by opioid medications. J Pain Palliat Care Pharmacother. Taylor and Francis Ltd; 2017;31:198–203.

  71. Johansson A, Hao J, Sjölund B. Local corticosteroid application blocks transmission in normal nociceptive C-fibres. Acta Anaesthesiol Scand. 1990;34:335–8.

    CAS  PubMed  Google Scholar 

  72. Mao J, Chen LL. Systemic lidocaine for neuropathic pain relief. Pain. 2000;87:7–17.

    CAS  PubMed  Google Scholar 

  73. Ferrante FM, Paggioli J, Cherukuri S, Arthur GR. The analgesic response to intravenous lidocaine in the treatment of neuropathic pain. Anesth Analg. 1996;82:91–7.

    CAS  PubMed  Google Scholar 

  74. Lavoie P-A, Khazen T, Filion PR. Mechanisms of the inhibition of fast axonal transport by local anesthetics. Neuropharmacology. 1989;28:175–81.

    CAS  PubMed  Google Scholar 

  75. Bisby MA. Inhibition of axonal transport in nerves chronically treated with local anesthetics. Exp Neurol. 1975;47:481–9.

    CAS  PubMed  Google Scholar 

  76. Pasqualucci A. Experimental and clinical studies about the preemptive analgesia with local anesthetics. Possible reasons of the failure. Minerva Anestesiol. 1998;64:445–57.

    CAS  PubMed  Google Scholar 

  77. Sato C, Sakai A, Ikeda Y, Suzuki H, Sakamoto A. The prolonged analgesic effect of epidural ropivacaine in a rat model of neuropathic pain. Anesth Analg. 2008;106:313–20.

    CAS  PubMed  Google Scholar 

  78. Tachihara H, Sekiguchi M, Kikuchi S, Konno S. Do corticosteroids produce additional benefit in nerve root infiltration for lumbar disc herniation? Spine (Phila Pa 1976). 2008;33:743–7.

  79. Cappola AR, FitzGerald GA. Confluence, not conflict of interest: name change necessary. JAMA - J Am Med Assoc. American Medical Association; 2015;314:1791–1792.

  80. Rysavy M. Evidence-based medicine: a science of uncertainty and an art of probability. AMA J Ethics American Medical Association. 2013;15:4–8.

    Google Scholar 

  81. Beall DP, Tutton SM, Murphy K, Olan W, Warner C, Test JB. Analysis of reporting bias in vertebral augmentation. Pain Physician. 2017;20:E1081–90.

    PubMed  Google Scholar 

  82. Shen J, Xu S, Xu S, Ye S, Hao J. Fusion or not for degenerative lumbar spinal stenosis: a meta-analysis and systematic review. Pain Physician. American Society of Interventional Pain Physicians; 2018;21:8.

  83. Song D, He A, Xu R, Xiu X, Wei Y. Efficacy of pain relief in different postherpetic neuralgia therapies: a network meta-analysis. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:19–32.

    Google Scholar 

  84. Fu X, Tang L, Wang C, Li M, Wu H, Li J, et al. A network meta-analysis to compare the efficacy of steroid and antiviral medications for facial paralysis from Bell’s palsy. Pain Physician. American Society of Interventional Pain Physicians. 2018;21:559–69.

    Google Scholar 

  85. Da Silva Salazar AP, Stein C, Marchese RR, Della Méa Plentz R, De Souza Pagnussat A. Electric stimulation for pain relief in patients with fibromyalgia: a systematic review and meta-analysis of randomized controlled trials. Pain Physician. American Society of Interventional Pain Physicians; 2017;20:15–25.

  86. Hou S, Huh B, Kim HK, Kim KH, Abdi S. Treatment of chemotherapy-induced peripheral neuropathy: systematic review and recommendations. Pain Physician. American Society of Interventional Pain Physicians; 2018;21:571–592.

  87. Manchikanti L, Boswell MV, Kaye AD, Helm Ii S, Hirsch JA. Therapeutic role of placebo: evolution of a new paradigm in understanding research and clinical practice. Pain Physician. 2017;20:363–86.

    PubMed  Google Scholar 

  88. Khalifeh M, Mehta K, Varguise N, Suarez-Durall P, Enciso R. Botulinum toxin type A for the treatment of head and neck chronic myofascial pain syndrome. J Am Dent Assoc. 2016;147:959–973.e1.

  89. Ajimsha MS, Al-Mudahka NR, Al-Madzhar JA. Effectiveness of myofascial release: systematic review of randomized controlled trials. J Bodyw Mov Ther. Churchill Livingstone. 2015;19:102–12.

    CAS  Google Scholar 

  90. Ajimsha MS, Daniel B, Chithra S. Effectiveness of myofascial release in the management of chronic low back pain in nursing professionals. J Bodyw Mov Ther Elsevier Ltd. 2014;18:273–81.

    CAS  Google Scholar 

  91. Kalichman L, Ben DC. Effect of self-myofascial release on myofascial pain, muscle flexibility, and strength: a narrative review. J Bodyw Mov Ther. Elsevier Ltd. 2017;21:446–51.

    Google Scholar 

  92. Espejo-Antúnez L, Tejeda JFH, Albornoz-Cabello M, Rodríguez-Mansilla J, de la Cruz-Torres B, Ribeiro F, et al. Dry needling in the management of myofascial trigger points: a systematic review of randomized controlled trials. Complement Ther Med Elsevier. 2017;33:46–57.

    Google Scholar 

  93. Rodríguez-Mansilla J, González-Sánchez B, De Toro García Á, Valera-Donoso E, Garrido-Ardila EM, Jiménez-Palomares M, et al. Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome: a Meta-analysis. J Tradit Chinese Med = Chung i tsa chih ying wen pan. 2016;36:1–13.

  94. Castro-Sánchez AM, García-López H, Matarán-Peñarrocha GA, Fernández-Sánchez M, Fernández-Sola C, Granero-Molina J, et al. Effects of dry needling on spinal mobility and trigger points in patients with fibromyalgia syndrome. Pain Physician. American Society of Interventional Pain Physicians. 2017;20:37–52.

    Google Scholar 

  95. Liu L, Huang Q-M, Liu Q-G, Thitham N, Li L-H, Ma Y-T, et al. Evidence for dry needling in the management of myofascial trigger points associated with low back pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. W.B. Saunders; 2018;99:144–152.e2.

  96. Gerber LH, Sikdar S, Aredo JV, Armstrong K, Rosenberger WF, Shao H, et al. Beneficial effects of dry needling for treatment of chronic myofascial pain persist for 6 weeks after treatment completion. PM R. 2017;9:105–12.

    PubMed  Google Scholar 

  97. Wang R, Li X, Zhou S, Zhang X, Yang K, Li X. Manual acupuncture for myofascial pain syndrome: a systematic review and meta-analysis. Acupunct Med. 2017;35:241–50.

    PubMed  Google Scholar 

  98. Fan AY, He H. Dry needling is acupuncture. Acupunct Med. BMJ Publishing Group; 2016;34:241.

  99. Gibson W, Wand BM, Meads C, Catley MJ, O’connell NE. Transcutaneous electrical nerve stimulation (TENS) for chronic pain - an overview of Cochrane Reviews. John Wiley and Sons Ltd: Cochrane Database Syst Rev; 2019.

    Google Scholar 

  100. •• Takla MKN. Low-frequency high-intensity versus medium-frequency low-intensity combined therapy in the management of active myofascial trigger points: a randomized controlled trial. Physiother Res Int. 2018;23. A review of ultrasound-guided injection techniques used for treating myofascial trigger points.

  101. Fuentes JP, Olivo SA, Magee DJ, Gross DP. Effectiveness of interferential current therapy in the management of musculoskeletal pain : a systematic review and meta-analysis. Phys Ther. 2010;90:1219–38.

    PubMed  Google Scholar 

  102. •• Cadena de Almeida C, Maldaner de Silva VZ, Cipriano Junior G, Eloin Liebano R, Joao Luiz QD. Transcutaneous electrical nerve stimulation and interferential current demonstrate similar effects in relieving acute and chronic pain: a systematic review with meta-analysis. Brazilian J Phys Ther. Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia; 2018;22:347–54. A review which investigates the criteria adopted by “experts” to diagnose myofascial trigger point pain syndrome.

  103. Giggins OM, Persson UM, Caulfield B. Biofeedback in rehabilitation. J Neuroeng Rehabil. Journal of NeuroEngineering and Rehabilitation; 2013;10, 60.

  104. Kumbhare D, Singh D, Rathbone H A, Gunn M, Grosman-Rimon L, Vadasz B, et al. Ultrasound-guided interventional procedures: myofascial trigger points with structured literature review. Reg Anesth Pain Med. Lippincott Williams and Wilkins; 2017;42:407–412.

  105. Robbins MS, Kuruvilla D, Blumenfeld A, Charleston L, Sorrell M, Robertson CE, et al. Trigger point injections for headache disorders: expert consensus methodology and narrative review. Headache. Blackwell Publishing Inc.; 2014;54:1441–59.

  106. Tough EA, White AR, Richards S, Campbell J. Variability of criteria used to diagnose myofascial trigger point pain syndrome - evidence from a review of the literature. Clin J Pain. 2007;23:278–86.

    PubMed  Google Scholar 

  107. Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surgery, Oral Med Oral Pathol. 1985;60:615–23.

    CAS  Google Scholar 

  108. Bubnov R V., Gandurska-Pavlenko OP. The trigger points dry needling and injection technique under ultrasound guidance for shoulder myofascial pain treatment. A comparative study. Eur J Neurol. 2012;

  109. Bubnov R V., Wang J. Clinical comparative study for ultrasound-guided trigger-point needling for myofascial pain. Med Acupunct. Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA ; 2013;25:437–43.

  110. Beecroft PC, Kongelbeck SR. How safe are intramuscular injections? AACN Clin Issues Crit Care Nurs. 1994;5:207–15.

    CAS  PubMed  Google Scholar 

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  1. Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC, USA

    Annemarie Galasso & Daniel An

  2. Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA

    Ivan Urits & Cyrus Yazdi

  3. University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Diep Nguyen

  4. Creighton University School of Medicine-Phoenix Regional Campus, Phoenix, AZ, USA

    Matthew Borchart

  5. Pain Management Centers of America, Paducah, KY, USA

    Laxmaiah Manchikanti

  6. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Rachel J. Kaye & Ken F. Mancuso

  7. LSUHSC School of Medicine, Department of Anesthesiology, Shreveport, LA, USA

    Alan D. Kaye & Omar Viswanath

  8. Valley Anesthesiology and Pain Consultants – Envision Physician Services, Phoenix, AZ, USA

    Omar Viswanath

  9. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

  10. Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Omar Viswanath

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  1. Annemarie Galasso
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  2. Ivan Urits
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  3. Daniel An
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  4. Diep Nguyen
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  5. Matthew Borchart
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  6. Cyrus Yazdi
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  7. Laxmaiah Manchikanti
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  8. Rachel J. Kaye
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  9. Alan D. Kaye
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  10. Ken F. Mancuso
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  11. Omar Viswanath
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Corresponding author

Correspondence to Ivan Urits.

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Conflict of Interest

Annemarie Galasso, Ivan Urits, Vwaire Orhurhu, Mariam Salisu Orhurhu, Diep Nguyen, Matthew Borchart, Cyrus Yazdi, Laxmaiah Manchikanti, Rachel J. Kaye, Ken F. Mancuso, and Omar Viswanath declare no conflict of interest. Alan Kaye is a Section Editor for Current Headache and Pain Reports. He has not been involved in the editorial handling of this manuscript. Dr. Kaye is also a speaker for Merck.

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This article is part of the Topical Collection on Other Pain

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Galasso, A., Urits, I., An, D. et al. A Comprehensive Review of the Treatment and Management of Myofascial Pain Syndrome. Curr Pain Headache Rep 24, 43 (2020). https://doi.org/10.1007/s11916-020-00877-5

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  • DOI: https://doi.org/10.1007/s11916-020-00877-5

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