F-1-02-07
THE EFFICACY OF TRIGGER POINT INJECTION FOR TREATMENT OF NOCTURNAL CALF CRAMPS ASSOCIATED WITH MYOFASCIAL PAIN
P. Prateepavanich, V. Kuptniratsaikul, T. Charoensuk. (Mahidol University, Bangkok, Thailand)
Abstract:
Purpose: To assess quantitatively the efficacy of trigger point injection compared with oral quinine in the treatment of nocturnal calf cramps associated with myofascial pain.
Method: Twenty four subjects of nocturnal calf cramps associated with gastrocnemius trigger points were divided into two groups of twelve for randomized single-blinded comparative clinical study. Patients in group 1. were treated with xylocaine injection at the trigger points meanwhile 300 mg. of quinine sulfate per oral was prescribed in the patients of group 2. for four weeks. All the subjects were taught to do calf stretching daily.
Result: Two subjects in group 2. withdrew from the study because of the cinchonism side effect. The outcomes of treatments in each group were statistically significant reduction in frequency, duration and intensity of cramps (95% confidence interval). When comparing between the two groups we found no difference except the intensity of the cramp was reduced significantly in the group treated by trigger point injection.
Conclusion: The result of this study shows both strategies are useful for nocturnal calf cramps associated with myofascial pain. This suggests trigger point injection technique may be considered as a treatment of choice for this group of patients especially in cases when quinine is not recommended.
F-1-02-08
IMPACT OF AEROBIC EXERCISE ON SYMPTOMS AND DISABILITY IN FIBROMYALGIA SYNDROME
Gursel Y, Ataman S, Gok H, Ersoz G, Gundtiz N, Yalcin P (Ankara University, Ankara, Turkey)
Different therapeutic modalities have been tried in fibromyalgia, a chronic pain syndrome (FMS) whose aetiology has not yet been clearly understood. The beneficial effects of nonsteroidal antiinflammatory drugs, tricyclic antidepressants, serotonin agonists, psychotropic agents and physical therapy as well as various educational and exercise programs have been indicated in some studies. In this study, we aimed to evaluate the impact of aerobic exercise on pain, sleep, tender point score and disability in patients with FMS. 9 female patients with FMS (mean age=32.22±8.16) and 9 sedentary healthy females (mean age=28.33±8.27) were included in the study. Two groups were compared in terms of aerobic fitness level by direct measurement of VO2max in ergospirometric maximal exercise test conducted on treadmill. Patients then attended an aerobic exercise program of 6 weeks duration that included whole body. Sleep pattern, tender point score, painful area score, pain (with VAS and Likert type scale), pain disability index and activities of daily living (HAQ) were evaluated before and after exercise program. Pulmonary function tests and ergospirometric maximal exercise test were repeated on each patient after the exercise program. We didn't find statistically significant difference between patients with FMS and healthy sedentary group with respect to aerobic condition and pulmonary function tests (p>0.05). After exercise program, a significant change was determined in pulmonary capacity and maximum oxygen consumption of patients (p<0.05). Similarly, we found statistically significant decrease in tender point score and improvement in sleep quality (p<0.05) while meaningful improvement has not been observed in pain and disability (p>0.05). These results illustrate that aerobic exercise programs can be used in treatment of FMS by itself as a single therapy or as an adjunctive to other therapies.
