摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_01

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

Objectives: To compare the effectiveness of alprazolam versus placebo and also versus ibuprofen and an alprazolam-ibuprofen combination in the treatment of patients with fibromyalgia. Methods: Subjects who met Yunus et al.'s modified criteria for fibromyalgia and gave their informed consent participated in a 5-week double-blind clinical trial. No subject had a currently active major depression. Weekly evaluations included psychological assessments [Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Beck Depression Inventory], subjective measurements of pain, pain relief and physical activity level [visual analog scales], musculoskeletal examination for tender points, and an observer- and self-rated measurement of global improvement [Clinical Global Impressions scale]. Results: Analyses were conducted on 61 subjects who completed at least 1 week of treatment and on the subgroup of 45 study completers. Alprazolam- and ibuprofen-treated subjects tended to improve more in some pain-related symptoms, but not all differences were statistically significant nor was there a constant pattern of improvement. Alprazolam-treated subjects experienced sedation, drowsiness, fatigue and weakness more commonly than subjects not receiving this treatment. Gastrointestinal [GI]symptoms, headaches, irritability and insomnia were experienced by placebo-treated subjects at rates similar to those treated with active medication. GI symptoms were more serious in ibuprofen-treated subjects. Conclusions: Although these subjects with fibromyalgia syndrome obtained some benefit from alprazolam and ibuprofen, neither was consistently significantly superior to the other or to a placebo treatment. Little benefit was obtained from a combination of the two drugs. Variability in the course of the disorder limits generalizations that can be derived from this short-term clinical trial. Long-term studies are needed because of the chronic nature of this illness.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_02

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

Objectives: The purpose of this article is to review the previously published data on myofascial trigger point injection and to present a proposed technique of myofascial trigger point [TrP] injection modified from tha described by Drs. Travell and Simons. Findings: Trigger point injection is an effective and valuable procedure to inactivate an active TrP, and subsequently relieve the pain and tightness of the muscle involved in myofascial pain syndrome. It is essential to elicit a local twitch response [LTR]during TrP injection to obtain the best results of immediate relief of pain. LTR is a brisk twitching of the muscle fibers of the taut band during mechanical stimulation [including needling] on the most sensitive site, the TrP region. Sometimes, other remote TrPs can also be inactivated if the "key TrP" is appropriately selected for injection based on skillfull clinical judgement. The trigger point injections are indicated for quick relief of acute, subacute, or chronic myofascial pain, for substitution of narcotic medicine, for restoration of functional impairment due to myofascial trigger points, or for supplementary therapy of chronic myofascial pain to facilitate its recovery. It is generally recommended to use 0.5% of procaine or lidocaine at a dose of 0.5-1.0 cc per TrP region for TrP injection. The proposed technique of TrP injection includes identification of the taut band containing the active TrP, skin preparation with sterile technique, rapid needle insertion into the multiple sites of a TrP region, injection of local anesthetic only if LTR is elicited, hemostatis, stretching and spray, and appropriate post-injection cares including cold or hot pack application, therapeutic exercise, therapeutic massage, and home program. The frequency and total number of injections should be determined based on clinical judgement. Some complications, such as muscle fiber damage, excessive bleeding, infection, syncope, or internal organ injury, may occur, but are usually preventable with careful and skillful injection technique. Conclusions: A technique of trigger point injection is proposed. Other than the traditional injection method, local twitch responses should be elicited as many times as possible during injection. The insertion of the needle should be quick to minimize muscle fiber damage. This technique is usually very effective to obtain immediate and complete pain relief.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_03

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_04

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_05

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_06

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_07

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_08

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_09

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor

摘要:

No abstract available for this article.

ISSN:1058-2452    

DOI:10.1300/J094v02n01_10

出版商:Taylor&Francis    

年代:1994

数据来源: Taylor