PROFIL KARAKTERISTIK KLINIS SINDROM NYERI MIOFASIAL PADA PASIEN DENGAN NYERI KRONIS: SINGLE CENTER OBSERVATIONAL STUDY
Main Article Content
Abstract
Nyeri adalah respon fisiologis tubuh terhadap stimulus noksius tidak menyenangkan akibat cedera eksternal atau suatu kondisi penyakit internal yang terjadi di dalam tubuh. Nyeri muskuloskletal merupakan kondisi yang sering terjadi, namun jarang mendapatkan perhatian dan terabaikan, sehingga terapi yang diberikan tidak adekuat. Sindrom nyeri miofasial (SNM) merupakan salah satu kondisi nyeri muskuloskletal dengan karakterisitik kekakuan otot secara lokal. Komponen utama pada SNM adalah adanya titik picu miofasial dan didapatkan taut band.
Penelitian ini bertujuan untuk mengetahui karakteristik klinis sindrom nyeri miofasial pada pasien dengan nyeri kronis. Penelitian ini merupakan studi observasional deskriptif secara potong lintang dengan menggunakan data primer, dilaksanakan pada bulan Mei-Agustus 2024. Subyek melakukan pengisian kuisioner untuk profil karakteristik klinis SNM. Terdapat 263 responden yang memenuhi kriteria inklusi, dengan rata-rata usia 50.01±13.9 tahun; durasi nyeri < 1 minggu (50.6%); dua otot yang terlibat (40%); lokasi pada punggung bawah (54.4%); dengan keterlibatan otot tersering pada M. Trapezius, M. Levator scapulae, M. Longisimus, M. Sternocledomastoideus, M. Rhomboids
(46.4%); perbaikan NPRS dari 3.9 ± 1.107 (pre dry needling) menjadi 1.5 ± 0.973 (post dry needling); penatalaksanaan kombinasi dry needling dan terapi oral (44.5%) dan pilihan terapi oral terbanyak adalah parasetamol (85,7%). Terdapat temuan variasi dalam presentasi profil klinis nyeri SNM pada nyeri kronis. Pengetahuan tentang karakteristik khas nyeri SNM pada pasien nyeri kronis dapat digunakan untuk mengembangkan pendekatan terapeutik yang lebih efektif untuk kondisi nyeri yang sulit ditangani.
Kata Kunci: dry needling, nyeri kronis, sindrom nyeri miofasial
Article Details
References
[2]. Phan VT, Stratton P, Tandon HK, Sinaii N, Aredo JV, Karp BI, et al. Widespread myofascial dysfunction and sensitisation in women with endometriosis‐associated chronic pelvic pain: A cross‐sectional study. European Journal of Pain. 2021 Apr;25(4):831–40.
[3]. Wyns A, Hendrix J, Lahousse A, De Bruyne E, Nijs J, Godderis L, et al. The Biology of Stress Intolerance in Patients with Chronic Pain-State of the Art and Future Directions. J Clin Med. 2023 Mar 14;12(6):2245.
[4]. Kocur P, Wilski M, Lewandowski J, Łochyński D. Female Office Workers With Moderate Neck Pain Have Increased Anterior Positioning of the Cervical Spine and Stiffness of Upper Trapezius Myofascial Tissue in Sitting Posture. PM&R. 2019 May;11(5):476–82.
[5]. Martín‐Pintado‐Zugasti A, Fernández‐Carnero J, León‐Hernández JV, Calvo‐Lobo C, Beltran‐Alacreu H, Alguacil‐Diego I, et al. Postneedling Soreness and Tenderness After Different Dosages of Dry Needling of an Active Myofascial Trigger Point in Patients With Neck Pain: A Randomized Controlled Trial. PM&R. 2018 Dec;10(12):1311–20.
[6]. Uraiwan Chatchawan. Pre- and post-treatment study of the application of a traditional Thai massage protocol for treating office syndrome. Asia-Pacific Journal of Science and Technology. 2023;28:9.
[7]. Ishiki H, Kinkawa J, Watanabe A, Watanabe C, Chiba T, Yasui H, et al. Prevalence of myofascial pain syndrome in patients with incurable cancer. Journal of Bodywork and Movement Therapies. 2018 Apr;22(2):328–32.
[8]. Bordoni B, Sugumar K, Varacallo M. Myofascial Pain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Oct 12]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK535344/
[9]. Wheeler AH. Myofascial Pain Disorders: Theory to Therapy. Drugs. 2004;64(1):45–62.
[10]. Fares MY, Fares J, Salhab HA, Khachfe HH, Bdeir A, Fares Y. Low Back Pain Among Weightlifting Adolescents and Young Adults. Cureus [Internet]. 2020 Jul 11 [cited 2024 Oct 12]; Available from: https://www.cureus.com/articles/36256-low-back-pain-among-weightlifting-adolescents-and-young-adults
[11]. Du SH, Zhang YH, Yang QH, Wang YC, Fang Y, Wang XQ. Spinal posture assessment and low back pain. EFORT Open Reviews. 2023 Sep 1;8(9):708–18.
[12]. Richardson CA, Jull GA. Muscle control–pain control. What exercises would you prescribe? Manual Therapy. 1995 Nov;1(1):2–10.
[13]. Hanten WP, Olson SL, Butts NL, Nowicki AL. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Phys Ther. 2000 Oct;80(10):997–1003.
[14]. Touma J, May T, Isaacson AC. Cervical Myofascial Pain. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Oct 12]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK507825/
[15]. Ballyns JJ, Shah JP, Hammond J, Gebreab T, Gerber LH, Sikdar S. Objective Sonographic Measures for Characterizing Myofascial Trigger Points Associated With Cervical Pain. Journal of Ultrasound in Medicine. 2011 Oct;30(10):1331–40.
[16]. Shah JP, Thaker N, Heimur J, Aredo JV, Sikdar S, Gerber L. Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM R. 2015 Jul;7(7):746–61.
[17]. Ge HY, Monterde S, Graven-Nielsen T, Arendt-Nielsen L. Latent Myofascial Trigger Points Are Associated With an Increased Intramuscular Electromyographic Activity During Synergistic Muscle Activation. The Journal of Pain. 2014 Feb;15(2):181–7.
[18]. Han S, Harrison P. Myofascial pain syndrome and trigger-point management. Regional Anesthesia and Pain Medicine. 1997 Jan;22(1):89–101.
[19]. Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol. 2011 Apr;25(2):185–98.
[20]. Celik D, Mutlu EK. Clinical implication of latent myofascial trigger point. Curr Pain Headache Rep. 2013 Aug;17(8):353.
[21]. Irnich D, Gautschi R, Behrens N. Terminology. In: Myofascial Trigger Points [Internet]. Elsevier; 2013 [cited 2024 Oct 16]. p. 5–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780702043123000027
[22]. Hinther A, Nakoneshny SC, Chandarana SP, Matthews TW, Hart R, Schrag C, et al. Efficacy of Multimodal Analgesia for Postoperative Pain Management in Head and Neck Cancer Patients. Cancers (Basel). 2021 Mar 12;13(6):1266.
[23]. Gerwin RD. The Management of Myofascial Pain Syndromes. Journal of Musculoskeletal Pain. 1993 Jan;1(3–4):83–94.
[24]. Liu L, Huang QM, Liu QG, Thitham N, Li LH, Ma YT, et al. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation. 2018 Jan;99(1):144-152.e2.