MİYOFASİYAL AĞRI SENDROMUNDA TETİK NOKTA ENJEKSİYONU İLE TETİK NOKTA ENJEKSİYONU BERABERİNDE KİNEZYO BANTLAMANIN ETKİNLİĞİNİN KARŞILAŞTIRILMASI The Comparison of The Effectiveness of Only Trigger Point Injection and Trigger Point Injection Plus Kinesio Taping in Myofascial Pain Syndrome

ÖZETAmaç: Miyofasiyal ağrı sendromunun (MAS) altında yatan periferik ve merkezi nöral mekanizmalarınınkompleks patolojisi nedeniyle, kronik dönemdeki tedavisinde zorluklar yaşanmaktadır. MAS'da en yaygınkullanılan tedavi yöntemi olan tetik nokta enjeksiyonu (TNE) belli bir düzeyde ağrı gidermesine rağmen, buetki kısa sürmektedir. Trapezius kasında MAS tedavisinde kinezyo bantlamanın (KB) faydalı etkisi olduğunudestekleyen birtakım çalışmalar bulunmaktadır. MAS tedavisine multidisipliner bir yaklaşımın daha yararlıolabileceği düşünülmektedir. Bu çalışmanın amacı, trapezius kasında MAS tedavisinde tek başına TNE'nin veTNE ile KB kombinasyonunun etkinliğini karşılaştırmaktır.Gereç ve Yöntemler: MAS olan 40 hasta rastgele iki gruba ayrıldı (grup başına 20 hasta): Grup 1: TNE (1 mlbetametazon dipropionat+3 ml lidokain+1 ml salin); Grup 2: TNE beraberinde KB. Başlangıçta ve tedaviden1-3 ay sonra görsel analog skala (GAS) ve boyun sakatlık indeksi (BSİ) kaydedildi.Bulgular: Grup 1 ve Grup 2'de hastaların yaş ortalaması sırasıyla 45.9±12.49 ve 47.0±14.34 idi. Her iki gruptada 1. ve 3. aylardaki GAS ve BSİ skorları başlangıç değerine göre anlamlı olarak azalmasına rağmen 3. aydaGAS ve BSİ skorları Grup 2'de Grup 1'e kıyasla anlamlı olarak daha düşüktü (p<0.05).Sonuç: Son zamanlarda, MAS'ın yönetimi için en yaygın kabul gören strateji altta yatan etiyolojiyi tedavi et-mektir. Ana neden tedavi edilmezse tetik noktalar yeniden aktifleşebilir ve MAS kronik hale gelebilir. Tedavi-ye multidisipliner bir yaklaşım en yararlı seçenek gibi görünmektedir. TNE beraberinde KB, MAS tedavisindenüks ve kronikleşmenin önlenmesi için alternatif bir tedavi yaklaşımı olarak düşünülebilir.Anahtar Kelimeler: Miyofasiyal Ağrı Sendromu; Tetik Nokta Enjeksiyonu; Kinezyo BantlamaABSTRACTObjective: The complex pathology of myofascial pain syndrome (MPS) with its underlying central and perip-heral neural mechanisms may contribute to the difficulty in treating MPS, particularly in the chronic setting.Even if a certain level of pain relief is achieved after the trigger point injection (TPI), which is the most widelyused treatment method, in MPS, this effect persists for a short time and a few treatment sessions are gene-rally required. Hence, a multidisciplinary approach to treatment seems to be most useful. Moreover, a fewstudies are supporting the efficacy of kinesio taping (KT) for MPS in the trapezius muscle. The aim of thisstudy was to investigate the effectiveness of only TPI and the combination of TPI with KT on the trapeziusmuscle in the treatment of MPS.Material and Methods: Fourty patients with MPS were randomly divided into two groups (20 patients pergroup): Group 1: only TPI (1 ml of 20 mg betamethasone dipropionate combined with 3 ml of 2% lidocaineand 1 ml of saline solution); Group 2: TPI plus KT. Visual analog scale (VAS) and neck disability index (NDI)were recorded at baseline and 1, 3 months post-treatment.Results: The mean age of patients was 45.9±12.49 and 47.0±14.34 years in Group 1 and Group 2, respec-tively. VAS and NDI scores in 1 and 3 months significantly decreased in both groups compared to baseline(p<0.05). However, the VAS and NDI scores at 3 months were significantly lower in Group 2 versus Group 1(p<0.05).Conclusion: Recently, the most extensively admitted strategy for the management of MPS is to treat theunderlying etiology. Trigger points might reactivate and MPS might sustain if the main cause is not treated. Amultidisciplinary approach to treatment appears to be most beneficial. TPI plus KT may be considered as analternative treatment approach for the prevention of recurrences and chronicity in the treatment of MPS.Keywords: Myofascial Pain Syndrome; Trigger Point Injection; Kinesio Taping

Anahtar Kelimeler:

MİYOFASİYAL AĞRI SENDROMUNDA TETİK NOKTA, ENJEKSİYONU İLE TETİK NOKTA ENJEKSİYONU, BERABERİNDE KİNEZYO BANTLAMANIN ETKİNLİĞİNİN KARŞILAŞTIRILMASI

PDF

___

1. Simons D, Travell J, Simons L, editors. Travell and Simons’ myofascial pain and dysfunction: the trigger point manual. 2nd ed. Baltimore: Williams & Wilkins, 1999, p. 94-173.
2. Han SC, Harrison P. Myofascial pain syndrome and trigger-point management. Reg Anesth. 1997; 22(1): 89-101.
3. Alotaibi M, Ayoub A, King T, Uddin S. The Effect of Kinesio Taping in reducing Myofascial Pain Syndrome on the Upper Trapezius Muscle: A Systematic Review and Meta-Analysis. Eur Sci J. 2018; 14(6): 336-50.
4. Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management. Am Fam Physician. 2002; 65(4): 653-60.
5. Nouged E, Dajani J, Ku B, Al-Eryani K, Padilla M, Enciso R. Local Anesthetic Injections for the Short-Term Treatment of Head and Neck Myofascial Pain Syndrome: A Systematic Review with MetaAnalysis. J Oral Facial Pain Headache. 2019; 33(2): 183-98.
6. Ay S, Evcik D, Tur BS. Comparison of injection methods in myofascial pain syndrome: a randomized controlled trial. Clin Rheumatol. 2010; 29(1): 19-23.
7. Lugo LH, García HI, Rogers HL, Plata JA. Treatment of myofascial pain syndrome with lidocaine injection and physical therapy, alone or in combination: a single blind, randomized, controlled clinical trial. BMC Musculoskelet Disord. 2016; 17: 101.
8. Parthasarathy S, John Charles S A. Analgesic efficacy of ultrasound identified trigger point injection in myofascial pain syndrome: A pilot study in Indian patients. Indian J Pain 2016; 30: 162-5.
9. Raeissadat SA, Rayegani SM, Sadeghi F, Rahimi-Dehgolan S. Comparison of ozone and lidocaine injection efficacy vs dry needling in myofascial pain syndrome patients. J Pain Res. 2018; 11: 1273-9.
10. Parthasarathy S, Sundar S, Mishra G. Assessment of predisposing factors in myofascial pain syndrome and the analgesic effect of trigger point injections- A primary therapeutic interventional clinical trial. Indian J Anaesth. 2019; 63(4): 300-3.