Injection of Remote Myofascial Trigger Points for Pain Control: A Case Report

遠端肌激痛點注射對疼痛的控制：病例報告

曾瓊立(Chung-Li Tseng) ； 高木榮(Mu-Jung Kao) ； 周立偉(Li-Wei Chou) ； 洪章仁(Chang-Zern Hong)

《台灣復健醫學雜誌》 36卷1期 (2008/03) Pp. 47-52

https://doi.org/10.6315/2008.36(1)06

摘要

本病例報告之目的在於描述肌激痛點注射之遠端效應。有位雙肩上斜方肌長期疼痛之病患，在接受直接激痛點注射無效之後，於本門診先接受雙側橈側伸腕長肌、伸食指肌、及第一背骨間肌之激痛點注射後，再做上斜方肌之激痛點注射，其效果非常好，此病患之疼痛幾乎完全解除。此病患第一次在上斜方肌接受直接激痛點注射後，無法立即止痛之理由，可能是因爲此病患同時有肌纖膜疼痛症候群而導致疼痛閾值降低。於本門診所注射之肌激痛點則包括上斜方肌之衛星（次要）激痛點。激痛點注射之遠端效應可能與脊髓內之神經連結有關。

關鍵字

慢性疼痛 ； 肌激痛點 ； 肌激痛點注射 ； 遠端效應

並列摘要

The purpose of this case report is to demonstrate the remote effect of myofascial trigger point (MTrP) injection for pain control. It describes a patient suffering from chronic pain due to MTrPs in bilateral upper trapezius muscle with poor results to direct MTrP injection to upper trapezius. After injection to the MTrPs in bilateral extensor carpi radialis longus, extensor indicis, and first dorsal interosseous muscles, the effectiveness of MTrP injection to bilateral upper trapezius muscles remarkably enhanced. This patient finally became almost pain free. The reason for poor relief of pain immediately after the first MTrP injection (directly on the upper trapezius muscles) was probably due to low pain threshold as a consequence of superimposed fibromyalgia syndrome. The muscles selected for the subsequent injection were actually satellite MTrPs of the key MTrP in the upper trapezius muscle. The remote effectiveness of MTrP injection is probably related to the neural connection in the spinal cord.

並列關鍵字

chronic pain ； myofascial trigger point ； trigger point injection ； remote effect