title: Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study.
abstract: Chronic pain has been often associated with myofascial pain syndrome (MPS), which is determined by myofascial trigger points (MTrP). New features have been tested for MTrP diagnosis. The aim of this study was to evaluate two-dimensional ultrasonography (2D US) and ultrasound elastography (UE) images and elastograms of upper trapezius MTrP during electroacupuncture (EA) and acupuncture (AC) treatment. 24 women participated, aged between 20 and 40 years (M ± SD = 27.33 ± 5.05) with a body mass index ranging from 18.03 to 27.59 kg/m2 (22.59 ± 3.11), a regular menstrual cycle, at least one active MTrP at both right (RTPz) and left trapezius (LTPz) and local or referred pain for up to six months. Subjects were randomized into EA and AC treatment groups and the control sham AC (SHAM) group. Intensity of pain was assessed by visual analogue scale; MTrP mean area and strain ratio (SR) by 2D US and UE. A significant decrease of intensity in general, RTPz, and LTPz pain was observed in the EA group (p = 0.027; p < 0.001; p = 0.005, respectively) and in general pain in the AC group (p < 0.001). Decreased MTrP area in RTPz and LTPz were observed in AC (p < 0.001) and EA groups (RTPz, p = 0.003; LTPz, p = 0.005). Post-treatment SR in RTPz and LTPz was lower than pre-treatment in both treatment groups. 2D US and UE effectively characterized MTrP and surrounding tissue, pointing to the possibility of objective confirmation of subjective EA and AC treatment effects.
authors.affiliation: Department of Morphology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
authors.forename: Cristina Emöke Erika
authors.initials: CE
authors.lastname: Müller
authors.affiliation: Department of Morphology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
authors.forename: Maria Fernanda Montans
authors.initials: MF
authors.lastname: Aranha
authors.affiliation: Department of Pediatric Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil mbgaviao@fop.unicamp.br.
authors.forename: Maria Beatriz Duarte
authors.initials: MB
authors.lastname: Gavião
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D004311:Double-Blind Method; D054459:Elasticity Imaging Techniques / Q000379:methods*; D015671:Electroacupuncture / Q000379:methods; D005260:Female; D006801:Humans; D009209:Myofascial Pain Syndromes / Q000000981:diagnostic imaging* / Q000628:therapy*; D010865:Pilot Projects; D016896:Treatment Outcome; D061028:Trigger Points / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: acupuncture; chronic pain; elasticity imaging techniques; myofascial pain syndromes; ultrasonography