11/13. Scapulocostal syndrome.The scapulocostal syndrome, myofascitis of the shoulder muscles, is caused by altered posture, prolonged immobilization of the shoulder region or fixed scapular/spinal deformities. The author studied 440 patients ranging from 18 to 60 years of age whose altered posture caused deep pain in the shoulder region originating from the medial aspect of the scapular spine. Treatment consisted of infiltrating a trigger point in the subscapularis region of the medial aspect of the scapular spine (root of the scapular spine) with a mixture of 2cc plain 1% lidocaine hydrochloride (Xylocaine [Astra]) plus 1cc beta-methasone sodium phosphate and acetate suspension (Celestone Soluspan [Schering]) followed by physical therapy exercises. 190 patients (43.19%) received one block, 175 (39.77%) received two blocks, and 75 (17.04%) received three blocks. Upon completion of treatment, 97.7% of the patients were relieved of their discomfort and returned to their original occupation.- - - - - - - - - - ranking = 1keywords = discomfort (Clic here for more details about this article) |
12/13. Pseudo-spinal headache.BACKGROUND AND OBJECTIVES: Myofascial trigger points are often not considered in the differential diagnosis of headaches. methods: A patient who presented with severe bifrontal headaches was treated by injections of the sternocleidomastoid muscle trigger points with local anesthetics. RESULTS: The patient experienced complete resolution of all symptoms, which had not reappeared after 14 months. CONCLUSIONS: Myofascial pain may mimic other disorders, and myofascial headaches can be easily treated once properly diagnosed.- - - - - - - - - - ranking = 6.2941390763193keywords = headache (Clic here for more details about this article) |
13/13. Trigger point injections for myofascial pain during epidural analgesia for labor.BACKGROUND AND OBJECTIVES: Myofascial pain is the leading cause of chronic low back pain and in most cases can be successfully resolved with trigger point injections of local anesthetics. This type of pain can exist during pregnancy and exceed the analgesia provided by an epidural for labor. methods: A 31-year-old primiparous woman received an epidural infusion for labor analgesia. Despite complete resolution of labor pain and a solid, bilateral T10 block, the patient reported discomfort at two discrete locations in her right lumbar paraspinous muscle. RESULTS: The administration of local anesthetic via trigger point injections resulted in successful palliation of the myofascial pain. CONCLUSIONS: Myofascial pain can be an etiology of back pain in the parturient. Trigger point injections, even when used concomitantly with a functioning epidural infusion, can be a valuable aid for the provision of complete analgesia.- - - - - - - - - - ranking = 3.9612864747459keywords = back pain, discomfort, back (Clic here for more details about this article) |
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