Cases reported "Myofascial Pain Syndromes"

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1/7. Upper crossed syndrome and its relationship to cervicogenic headache.

    OBJECTIVE: To discuss the management of upper crossed syndrome and cervicogenic headache with chiropractic care, myofascial release, and exercise. CLINICAL FEATURES: A 56-year-old male writer had been having constant 1-sided headaches radiating into the right eye twice weekly for the past 5 years. Tenderness to palpation was elicited from the occiput to T4 bilaterally. trigger points were palpated in the pectoralis major, levator scapulae, upper trapezius, and supraspinatus muscles bilaterally. Range of motion in the cervical region was decreased in all ranges and was painful. Visual examination demonstrated severe forward translation of the head, rounded shoulders, and right cervical translation. INTERVENTION AND OUTCOME: The patient was adjusted using high-velocity, short-lever arm manipulation procedures (diversified technique) and was given interferential myofascial release and cryotherapy 3 times weekly for 2 weeks. He progressed to stretching and isometric exercise, McKenzie retraction exercises, and physioball for proprioception, among other therapies. The patient's initial headache lasted 4 days. He had a second headache for 1.5 days during his exercise training. During the next 7 months while returning to the clinic twice monthly for an elective chiropractic maintenance program, his headaches did not recur. He also had improvement on radiograph. CONCLUSION: The principles of upper crossed syndrome and the use of exercise, chiropractic care, and myofascial release in the treatment of cervicogenic headache are discussed. A review of the literature indicates that analyzing muscle imbalance as well as vertebral subluxation may increase the effectiveness of chiropractic treatment for cervicogenic headache.
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ranking = 1
keywords = headache
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2/7. Postherpetic pain: more than sensory neuralgia?

    OBJECTIVE: To describe a series of older adult patients with postherpetic myofascial pain, a heretofore rarely described complication of herpes zoster. DESIGN: Case series. SETTING: Outpatient older adult pain clinic. patients: Five older adults are presented with myofascial pain that developed as a complication of herpes zoster. RESULTS: Pain duration at the time of presentation ranged from 4 months to 7 years. All patients reported functional impairment from pain despite oral analgesics. Myofascial pathology was diagnosed by the presence of taut bands and trigger points in the affected myotome. Upon successful treatment of the myofascial pain with nonpharmacologic modalities (e.g., physical therapy, trigger point injections, dry needling, and/or percutaneous electrical nerve stimulation), all patients reported symptomatic improvement, and four out of five were able to significantly reduce or discontinue their opioids. CONCLUSION: Postherpetic pain is traditionally conceptualized as a purely sensory phenomenon. Identification of the intrusion of a myofascial component may be worthwhile, both from the standpoint of enhanced pain relief and reduction in the need for oral analgesics. Formal exploration of this phenomenon is needed.
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ranking = 2.8033562982306
keywords = neuralgia
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3/7. Myofascial pain may present clinically as occipital neuralgia.

    Three case presentations illustrate that the clinical signs and symptoms of occipital neuralgia may be produced by myofascial pain. Assessment of myofascial trigger points is needed before making a diagnosis of occipital neuralgia. Myofascial trigger points can be effectively treated with minimally invasive procedures, thereby avoiding irreversible surgical interventions.
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ranking = 4.2050344473459
keywords = neuralgia
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4/7. Postpartum cervical myofascial pain syndrome: review of four patients.

    Four postpartum patients with complaints of headache and neck pain were examined. All had received epidural analgesia and had a long second stage associated with prolonged pushing. Many similarities to postdural puncture headache were noted. The headache started the day after delivery and involved the occipital region primarily, along with the neck and shoulder girdle areas. However, the pain did not change with positional changes and was associated with marked tenderness of muscles at specific anatomic points. A diagnosis of cervical myofascial pain was made. All patients responded quickly to physical therapy. The authors suggest that many patients initially considered to have postdural puncture headache may actually have postpartum cervical myofascial pain.
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ranking = 0.36363636363636
keywords = headache
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5/7. Severe chronic headache treated by simple dental procedures. case reports.

    Seven cases of severe unremitting headache caused by temporomandibular joint dysfunction and the myofascial pain dysfunction syndrome are reported. Most patients had been examined and treated by one or other representative of the medical disciplines.
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ranking = 0.45454545454545
keywords = headache
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6/7. 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.
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ranking = 0.63636363636364
keywords = headache
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7/7. Myofascial trigger points in intercostal muscles secondary to herpes zoster infection of the intercostal nerve.

    chronic pain in the chest wall is a major complication after herpes zoster infection of intercostal nerves. It is usually difficult to control pain of such origin. Two cases are reported of postherpetic neuralgia after herpes zoster infection involving the intercostal nerves. Both patients had shooting, burning, aching, and localized pain in the muscle supplied by the involved intercostal nerves 1 to 3 months after onset. Compression palpation of a tender spot in one of these muscles induced a referred pain that followed the corresponding interspace, usually in the distal anterior direction. Local twitch responses could be elicited during injection of 0.5% or 1% lidocaine into one of these tender spots; the pain in the interspace was consistently eliminated immediately after injection. One patient had complete pain relief after three series of injections. The effect of pain relief for the other patient lasted for 1 to 2 weeks after the initial injection and lasted progressively longer (up to 2 months) after repeated injections. It appears that many of the tender spots formed in intercostal muscles after herpes zoster are myofascial trigger points that respond to injection with referred pain, local twitch responses, and immediate pain relief.
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ranking = 0.70083907455766
keywords = neuralgia
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