Clinical Study Of Ultrasound-guided Small Needle Knife In The Treatment Of Myofascial Pain Syndrome Of Neck And Shoulder

Objective:To investigate the efficacy and safety of visualized ultrasound-guided small needle knife in the treatment of myofascial pain syndrome of neck and shoulder.Method:In this study,76 patients with neck and shoulder pain diagnosed as myofascial pain syndrome were selected from the shoulder pain clinic of the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People’s Hospital)from December 2019 to January 2021.The study subjects were divided into two groups with 38 patients in each group by random number table method according to the order of patients visiting.Patients receiving ultrasound-guided small needle knife therapy were taken as the experimental group,and patients receiving traditional small needle knife therapy were taken as the control group.First record two groups of myofascial trigger point pain gray-scale ultrasonography manifestations,myofascial trigger point pain and adjacent area of young’s modulus value.Then,Record the two groups before treatment,treatment,treatment after mid Visual Analogue Scale,the Neck Disability Index,Beck Depression Inventory Scale,Neck Range of Motion,young’s modulus value before and after treatment and whether there is treatment in the two groups of the whole treatment process,pneumothorax,bleeding,nerve damage and other adverse events occurred.Finally,the data were processed and analyzed statistically.Result:In the course of the study,a total of 3 cases were shed,including 1case in the experimental group and 2 cases in the control group.The remaining 73 cases were included in the statistics,37 cases in the experimental group and 36 cases in the control group.1.In this study,there were no significant differences in gender,age,course of disease,body mass index between the experimental group and the control group(P>0.05),indicating comparability.2.In this study,the trigger point of myofascial pain in the gray scale sonogram was manifested as the low echo area,and the Young’s modulus value of which was higher than that of the adjacent area(P<0.05).3.Comparison within groups: Visual analog score,cervical disability index and Baker Self-Rating Depression Scale were lower in the middle and post-treatment of the two groups than before treatment,range of motion of cervical joint was higher than before treatment,and Young’s modulus after treatment was lower in the two groups than before treatment(P<0.05).4.Comparison between groups: There were no significant differences in VAS,NDI,BDI,ROM and Young’s modulus between 2 groups before treatment(P>0.05),indicating comparability.VAS,NDI and BDI of the experimental group were significantly lower than those of the control group(P<0.05),and Young’s modulus was significantly lower than those of the control group after treatment(P<0.05).In the evaluation of range of motion of cervical vertebra in the middle period of treatment in the two groups,the anterior flexion,right flexion and left rotation in the experimental group were more obvious than those in the control group(P<0.05),while there were no significant differences between the two groups in posterior extension,left flexion and right rotation(P>0.05).In the evaluation of range of motion of cervical vertebra after treatment in the two groups,the anterior flexion,posterior extension,left flexion,right flexion and left rotation of the experimental group were significantly improved compared with the control group(P<0.05),while there was no significant difference between the right rotation and the control group(P>0.05).5.Young’s modulus of myofascial trigger point was positively correlated with Visual Analogue Score(correlation coefficient r=0.8,P<0.01).6.During the whole study,3 patients in the control group experienced adverse events,which were all presented as local hematoma formation at the treatment site,while no significant bleeding occurred in the experimental group.No adverse events,such as needle sickness,pneumothorax or nerve damage,occurred in patients in both groups.Conclusion:1.Small needle knife therapy guided by ultrasound and traditional small needle knife therapy are both effective in the treatment of myofascial pain syndrome of neck and shoulder,but the efficacy and safety of small needle knife therapy guided by ultrasound are better than traditional small needle knife therapy,which is worthy of clinical application and promotion.2.Young’s modulus of trigger point of myofascial pain in neck and shoulder was positively correlated with visual analog score.