Myofascial Pain Syndrome Clinical Trial
Official title:
Comparative Efficacy of Platelet Rich Plasma Injection and Dry Needling in Management of Trigger Points in Masseter Muscle in Myofascial Pain Syndrome Patients
Title: Comparative Efficacy of Platelet Rich Plasma injection and Dry Needling in management
of trigger points in masseter muscle in Myofascial Pain Syndrome patients.
Rationale: Pain and trismus caused by Myofascial pain syndrome in masticatory muscles are one
of the prime concerns for the patients. In the recent times, Platelet Rich Plasma therapy has
been studied extensively and has produced promising results. It is used to promote sarcomere
repair by concentrating growth factors and decrease inflammation by inhibiting
pro-inflammatory and apoptotic cells.
Thus, the present study is designed to evaluate the efficacy of Platelet Rich Plasma
injection in trigger points in masseter muscle in myofascial pain syndrome patients.
Research Question P: Population (Patients with trigger points in masseter muscle) I:
Intervention (PRP injection) C: Control (Dry needling) O: Outcome (Improvement in symptom of
pain ) T: Time Frame (1 year) S: Study Design (Randomized clinical trial) Setting in Haryana
, India Is Platelet Rich Plasma more effective as compared to dry needling alone in treatment
of trigger points in masseter muscle in Myofascial Pain Syndrome patients ?
Myofascial pain syndrome (MPS) is a commonly encountered condition frequently associated with
the muscles of mastication. It is defined as a regional muscular pain condition characterized
by myofascial trigger points found in one or more muscles and/ or connective tissues. A
trigger point is an exquisitely tender spot in discrete taut band of hardened muscle that
produce local and referred pain, among other symptoms. Associated symptoms may include muscle
weakness, muscle spasm, stiffness, decreased range of motion and autonomic dysfunction.
Trigger point can be active i.e. always tender or latent i.e. tender only when palpated.
Any kind of muscle overuse or direct trauma to the muscle can lead to the development of
trigger points. Although muscle damage is not required for the development of trigger point,
it may be caused by the disruption of the cell membrane, damage to the sarcoplasmic reticulum
with a subsequent release of high amounts of calcium ions, and disruption of cytoskeletal
proteins, such as desmin, titin and dystrophin. Muscle overuse leads to ATP depletion which
causes oxidative stress resulting in local ischemia and lowered pH with subsequent
accumulation of inflammatory mediators at these trigger points.
Various therapeutic modalities have been used to treat myofascial trigger points and
myofascial pain syndrome including therapeutic ultrasound, muscle stretching, manipulation,
acupuncture, occlusal appliances, botulinum injection, pharmacotherapy and dry needling.
Platelet rich plasma (PRP) is a newer therapeutic modality for treatment of trigger points.
PRP contains many growth factors important for muscle regeneration and myogenesis. The goal
of PRP therapy is to concentrate the main growth factors from native blood and to reintroduce
them in the injured tissue. Besides healing, it can also decrease pro-inflammatory and
apoptotic cells, reducing inflammation. However, still there is paucity of literature and
lack of RCT related to use of PRP in trigger points.
So, the present study has been designed to evaluate the efficacy of Platelet Rich Plasma
injection in trigger points in masseter muscle in myofascial pain syndrome patients.
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