Successful Pain Relief by Treatment of Myofascial Components In Patients with Hip Pathology Scheduled for Total Hip Replacement

SUMMARY

Objective: To establish the efficacy of the treatment of myofascial component in patients scheduled for total hip replacement.

Materials and Methods: Thirty two patients with hip pain from different diseases have been evaluated and treated for myofascial pain syndrome of the muscles in the hip area. Only 21 patients, 7 male and 14 female, participated in the follow-ups and were included in the study. Their average age was 57 years [ranging from 22 to 84]. Osteoarthritis was the most prevalent disorder, followed by previous total hip replacement and aseptic necrosis. Assessment of pain was done by visual analog scale [VAS] and pressure algometry [PA]. In-activation of myofascial trigger points [MTrPs] was performed according to the technique described by Fischer and was followed by physical therapy procedures and home stretching exercises.

Results: Significant improvement was achieved in both VAS [form 6.1 ± 2.5 to 3.3 ± 3.6 cm] and in algometry [from 2.5 ± 1.4 to 4.2 ± 1.9 kg/cm²] from initial evaluation until discharge. The mean duration of treatment was 5.3 weeks, and the mean number of treated muscles per patients was three. Nine patients have been reevaluated on long-term follow-up. This group maintained their improvements on a significant level relatively to the initial values after average of 13 months [ranging from 7 to 24].

Conclusions: Needling and infiltration of MTrPs and tender spots [TSs] has proved a useful technique for long-term relief of pain in patients scheduled for total hip replacement. Increase in PA corresponded to reduction of pain measured by VAS, and confirmed so that the immediate cause of pain were the treated myofascial TSs and TrPs.

KEYWORDS:

• Pain
• chronic pain
• hip pain
• myofascial pain syndrome
• hip replacement