Ann Rehabil Med.  2016 Oct;40(5):885-892. 10.5535/arm.2016.40.5.885.

Comparison of the Effects of Ultrasound-Guided Interfascial Pulsed Radiofrequency and Ultrasound-Guided Interfascial Injection on Myofascial Pain Syndrome of the Gastrocnemius

• Park SM
• Cho YW
• Ahn SH
• Lee DG
• Cho HK
• Kim SY

• KMID: 2382921
• DOI: http://doi.org/10.5535/arm.2016.40.5.885

Abstract

OBJECTIVE
To investigate the comparative treatment effects of ultrasound-guided pulsed radiofrequency treatment (UG-PRF) in the gastrocnemius interfascial space and ultrasound-guided interfascial injection (UG-INJ) on myofascial pain syndrome.
METHODS
Forty consecutive patients with myofascial pain syndrome of the gastrocnemius were enrolled and were allocated to one of the two groups. Twenty patients were treated by UG-PRF delivered to the gastrocnemius interfascial space (UG-PRF group) and the other 20 patients were treated by interfascial injection (UG-INJ group). The primary outcome measure was the numeric rating score (NRS) for pain on pressing the tender point in the gastrocnemius, and the secondary outcome measure was health-related quality of life as determined by the Short Form-36 questionnaire (SF-36). NRSs were obtained at the first visit, immediately after treatment, and at 2 and 4 weeks post-treatment, and physical component summary scores (PCS) and mental component summary scores (MCS) of the SF-36 questionnaire were measured at the first visit and at 4 weeks post-treatment.
RESULTS
Immediately after treatments, mean NRS in the UG-PRF group was significantly higher than that in the UG-INJ group (p<0.0001). However, at 2 and 4 weeks post-treatment, the mean NRS was significantly lower in the UG-PRF group (both p<0.0001). Similarly, at 4 weeks post-treatment, mean PCS and MCS were significantly higher in the UG-PRF group (p<0.0001 and p=0.002, respectively).
CONCLUSION
Based on these results, the authors conclude that ultrasound-guided gastrocnemius interfascial PRF provides an attractive treatment for myofascial pain syndrome of the gastrocnemius.

Keyword

Pulsed radiofrequency treatment; Gastrocnemius muscle; Myofascial pain syndromes; Trigger point pain; Injections

MeSH Terms

Humans
Muscle, Skeletal
Myofascial Pain Syndromes*
Outcome Assessment (Health Care)
Pulsed Radiofrequency Treatment
Quality of Life

Figure

• 

  Fig. 1 Ultrasound images showing the needle point in the interfascial space of UG-PRF group and UG-INJ group. (A) UG-PRF group: the probe identified the gastrocnemius (x) and its fascia (arrow head). A 22-gauge 10 cm needle with a 5-mm tip was inserted into the gastrocnemius interfascial space (arrow). Before starting PRF, 5 mL normal saline was infused through the needle and it separated the gastrocnemius interfascial space to better identify that space and better position the needle into that space (hollow arrow head). (B) The UG-INJ group: the probe identified the gastrocnemius (x) and its fascia (arrow head). A 22-gauge 10 cm needle with a 5-mm tip was inserted into the gastrocnemius interfascial space (arrow). Under ultrasound guidance, 10 mL of 0.2% lidocaine was injected into the gastrocnemius interfascial space (hollow arrow head). UG-PRF, ultrasound-guided pulsed radiofrequency treatment; UG-INJ, ultrasound-guided interfascial injection.

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  Fig. 2 Change in mean numeric rating scales between the UG-PRF and UG-INJ groups over time. NRS, numeric rating score; UG-PRF, ultrasound-guided pulsed radiofrequency treatment; UG-INJ, ultrasound-guided interfascial injection.

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