Treatment of Chronic Resistant Myofascial Pain Using a Multidisciplinary Protocol [The Myofascial Pain Program]

Abstract

Objectives: To determine the effect of a multidisciplinary treatment program on patients with chronic musculoskeletal pain resistant to standard invasive and non-invasive treatments and to assess the validity of the Global Self Assessment Scale of Improvement [GSASI] when compared to other patient self-rating scales of pain and dysfunction.

Methods: We treated 52 patients with chronic myofascial pain who failed physical, chiropractic, medical, or surgical therapies with myofascial technique physical therapy, biofeedback and clinical psychophysiology, medication and trigger point injections. To quantify outcomes, we used the McGill Pain Rating Index [PRI] and the Present Pain Index [PPI] measuring the patient's emotional assessment of his or her pain, a visual analog scale [VAS] measuring the patient's severity of pain, and a GSASI measuring pain relief, mobility, mood, and ability to function in daily life.

Results: Using the GSASI, 77 percent of patients had good [51–75 percent] or excellent [>75 percent] improvement in terms of pain relief, mobility, sleep, and mood. The PRI improved 13.9 points from an average of 27.04 [P < 0.0005], the PPI improved 1.2 points from an average of 3.3208 [P < 0.0001], and the VAS improved 3.4 points from 6.8558 [P < 0.0001]. The mean combined improvement of the two McGill Scores and the VAS was 66.35 percent.

Conclusions: The multidisciplinary treatment protocol was an effective means of reducing pain and improving mobility, sleep, and mood. The GSASI correlated well with the three other scales.

KEYWORDS:

• Myofascial pain
• clinical neurophysiology
• visual analog scale
• McGill Pain Scale
• Global Self Assessment Scale of Improvement