Multi-modal Imaging for Myofascial Pain Syndrome

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Washington University School of Medicine

Disqualifiers: Pregnancy, Cancer, Neuropathy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

40 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Multi-modal Imaging for Myofascial Pain Syndrome?

Research shows that ultrasound imaging can help identify myofascial trigger points, which are key in diagnosing myofascial pain syndrome. This suggests that imaging techniques, like those used in the treatment, could be effective in managing this condition by providing a more accurate diagnosis. ^{1 2 3 4 5}

How does the multi-modal imaging treatment for myofascial pain syndrome differ from other treatments?

This treatment is unique because it uses advanced imaging techniques like MRI to better understand and visualize the muscle structures involved in myofascial pain syndrome. Unlike traditional methods, this approach aims to provide detailed insights into the muscle's microstructure, potentially leading to more accurate diagnosis and targeted treatment. ^{6 7 8 9 10}

What is the purpose of this trial?

The goal of this study is to develop new imaging biomarkers for quantitative assessments of myofascial pain.

Eligibility Criteria

This trial is for healthy volunteers who currently have mild or no chronic pain in their neck and shoulder, can perform daily activities without limitation due to pain, and understand the study's purpose. They must be able to give informed consent.

Inclusion Criteria

Healthy Volunteer

I have never had chronic pain in my neck or shoulder that stopped me from daily activities or work.

I understand the study's purpose and agree to participate.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Imaging

Participants undergo multi-modal imaging including MRI, sEMG, and fiber-optic imaging

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after imaging

2-4 weeks

Treatment Details

Interventions

• Multi-modal, multi-parametric, multiscale imaging

Trial Overview The study aims to develop new ways of imaging muscles and fascia (the connective tissue around muscles) to better understand myofascial pain. It involves advanced imaging techniques that look at the muscle-fascia unit in different ways.

Participant Groups

Group I: Multi-modal imaging of myofascial pain Experimental Treatment 1 Intervention

Participants with and without myofascial-related pain disease will receive multi-modal, multi-parametric, multi-scale imaging, including magnetic resonance imaging, surface electromyography, and fiber-optic imaging and sensing.

Who Is Running the Clinical Trial?

Washington University School of Medicine

Lead Sponsor

Trials

2,027

Recruited

2,353,000+

National Center for Complementary and Integrative Health (NCCIH)

Collaborator

Trials

886

Recruited

677,000+

Findings from Research

A study involving 201 participants and 1344 ultrasound images demonstrated that convolutional neural networks (CNN) can effectively identify muscles with myofascial trigger points (MTrPs) compared to traditional texture analysis methods, achieving a higher F1-score of 0.7299.

The research highlights the challenges in accurately diagnosing myofascial pain syndrome and suggests that while deep learning techniques show promise, there are still limitations to their effectiveness in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Myofascial Trigger Point Identification in B-Mode Ultrasound: Texture Analysis Versus a Convolutional Neural Network Approach. Koh, RGL., Dilek, B., Ye, G., et al.[2023]

Kinesio taping significantly reduces pain intensity and improves range of motion in patients with myofascial pain syndrome, based on a meta-analysis of 20 randomized controlled trials involving 959 patients.

While kinesio taping shows effectiveness in pain relief and mobility, it does not appear to have a significant impact on overall disability or functional improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence for kinesio taping in management of myofascial pain syndrome: a systematic review and meta-analysis. Zhang, XF., Liu, L., Wang, BB., et al.[2022]

Imaging studies have shown that myofascial trigger points exhibit distinct biomechanical properties and blood flow patterns compared to healthy tissue, indicating a potential objective way to assess myofascial pain syndrome.

Ultrasound-based imaging methods are currently favored for evaluating myofascial pain syndrome due to their efficacy, cost-effectiveness, and ease of use, although more research is needed to improve diagnostic accuracy and reproducibility.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of Myofascial Trigger Points via Imaging: A Systematic Review. Mazza, DF., Boutin, RD., Chaudhari, AJ.[2023]

A scoping review of 493 intervention studies revealed significant inconsistencies in the diagnostic criteria for fibromyalgia (FM) and myofascial pain syndrome (MPS), with FM criteria being more standardized than those for MPS.

The variability in terminology and diagnostic criteria used across studies highlights the need for a consistent lexicon to improve the accuracy of diagnosing chronic musculoskeletal pain conditions like FM and MPS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fibromyalgia and myofascial pain syndrome: Two sides of the same coin? A scoping review to determine the lexicon of the current diagnostic criteria. Bourgaize, S., Janjua, I., Murnaghan, K., et al.[2019]

Myofascial pain syndrome, characterized by myofascial trigger points (MTrPs), is often diagnosed through palpation, but this method has poor reliability among different examiners.

This review highlights three promising ultrasound imaging techniques—conventional gray-scale imaging, Doppler imaging, and elastographic ultrasound imaging—that can objectively localize MTrPs, potentially improving diagnosis and treatment accuracy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of Myofascial Trigger Points Using Ultrasound. Kumbhare, DA., Elzibak, AH., Noseworthy, MD.[2016]

Chronic myofascial pain syndrome (MPS) is commonly associated with myofascial trigger points (MTrPs), and while imaging techniques like ultrasound and MRI are used, their effectiveness in diagnosing MPS and understanding MTrP physiology is still unclear.

Diffusion Tensor Imaging (DTI) is currently the most effective method for imaging muscle microstructure and could be optimal for visualizing MTrPs, while advanced techniques like HARDI and DKI hold potential for providing more detailed insights but are not yet widely used due to longer scan times.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Potential Role of MRI Imaging for Myofascial Pain: A Scoping Review for the Clinicians and Theoretical Considerations. Evans, V., Behr, M., Gangwar, A., et al.[2021]

The large-scale image microtome array (LIMA) system allows for effective integration of various imaging techniques, such as CT and histopathology, enabling precise alignment of multimodal datasets for better analysis of human tissues.

This innovative approach was demonstrated using human lung cancer nodules, showcasing its potential to enhance understanding of tissue characteristics and improve clinical research and education across various soft organ tissues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A process model for direct correlation between computed tomography and histopathology application in lung cancer. Sieren, JC., Weydert, J., Namati, E., et al.[2021]

Using integrated parallel imaging techniques (iPAT) with multiple receiver coil elements allowed for a 48% reduction in MRI acquisition time for patients with traumatic musculoskeletal disorders, without compromising image quality or diagnostic accuracy.

All pathologies, including fractures and cartilage damage, were detected equally well using both standard imaging and iPAT, suggesting that iPAT is a safe and effective alternative for faster imaging in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rapid musculoskeletal magnetic resonance imaging using integrated parallel acquisition techniques (IPAT)--initial experiences. Romaneehsen, B., Oberholzer, K., Müller, LP., et al.[2019]

Hybrid PET-MRI imaging combines high-resolution MRI with molecular information from PET, enhancing the early detection and understanding of musculoskeletal diseases like osteoarthritis and rheumatoid arthritis.

This advanced imaging technique allows for a comprehensive assessment of multiple tissues and functional processes, potentially leading to improved therapies and patient outcomes in non-oncologic musculoskeletal disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Potential of PET-MRI for imaging of non-oncologic musculoskeletal disease. Kogan, F., Fan, AP., Gold, GE.[2020]

Molecular imaging is a promising new field that aims to noninvasively detect specific molecular and physiological changes in chronic musculoskeletal diseases, potentially improving diagnosis and treatment.

This approach combines advances in various scientific disciplines and is being applied across multiple imaging techniques, which could enhance the development of novel therapies and allow for real-time tracking of treatment effects in living subjects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Molecular imaging of musculoskeletal diseases. Biswal, S.[2012]

References

1. England pubmed.ncbi.nlm.nih.gov

Myofascial Trigger Point Identification in B-Mode Ultrasound: Texture Analysis Versus a Convolutional Neural Network Approach. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Evidence for kinesio taping in management of myofascial pain syndrome: a systematic review and meta-analysis. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Assessment of Myofascial Trigger Points via Imaging: A Systematic Review. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Fibromyalgia and myofascial pain syndrome: Two sides of the same coin? A scoping review to determine the lexicon of the current diagnostic criteria. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Assessment of Myofascial Trigger Points Using Ultrasound. [2016]

6. New Zealand pubmed.ncbi.nlm.nih.gov

Potential Role of MRI Imaging for Myofascial Pain: A Scoping Review for the Clinicians and Theoretical Considerations. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

A process model for direct correlation between computed tomography and histopathology application in lung cancer. [2021]

8. Germany pubmed.ncbi.nlm.nih.gov

Rapid musculoskeletal magnetic resonance imaging using integrated parallel acquisition techniques (IPAT)--initial experiences. [2019]

9. China pubmed.ncbi.nlm.nih.gov

Potential of PET-MRI for imaging of non-oncologic musculoskeletal disease. [2020]

10. United States pubmed.ncbi.nlm.nih.gov

Molecular imaging of musculoskeletal diseases. [2012]