Multi-modal Imaging for Myofascial Pain Syndrome

Recruiting at 1 trial location

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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to discover new ways to use imaging to better understand and measure myofascial pain, a type of muscle pain often felt in the neck and shoulders. Researchers employ advanced imaging techniques, such as MRI and multi-modal, multi-parametric, multiscale imaging, to observe bodily changes associated with this pain. Suitable candidates for this trial include individuals who have experienced neck or shoulder pain for more than four weeks and report significant discomfort. As an unphased study, this trial provides a unique opportunity to contribute to pioneering research that could improve diagnosis and treatment options for myofascial pain.

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 prior data suggests that this imaging technique is safe for assessing myofascial pain?

Previous studies have shown that techniques like ultrasound imaging are safe and well-tolerated for diagnosing and treating myofascial pain. Research shows that imaging methods, such as MRI and surface electromyography (sEMG), are non-invasive, meaning they don't involve surgery or cutting into the body. These methods carry minimal risk and are commonly used in hospitals and clinics worldwide. Adverse events are rare, making them a safe choice for those considering participation in this type of imaging study. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about multi-modal imaging for myofascial pain syndrome because it offers a comprehensive approach to understanding and diagnosing this condition. Unlike traditional methods, which might focus on a single type of imaging, this approach combines magnetic resonance imaging, surface electromyography, and fiber-optic imaging. This multi-layered technique allows for detailed visualization of muscles and fascia, potentially leading to more precise diagnosis and personalized treatment plans. By capturing a wider array of data, this method aims to uncover hidden patterns and improve our understanding of myofascial pain mechanisms.

What evidence suggests that this imaging technique is effective for assessing myofascial pain?

Research has shown that different imaging techniques, like MRI and ultrasound, can aid in understanding myofascial pain syndrome. In this trial, participants will undergo multi-modal imaging, including magnetic resonance imaging, surface electromyography, and fiber-optic imaging and sensing. One study found that MRI, particularly Diffusion Tensor Imaging (DTI), clearly shows muscle structures, helping to identify areas affected by myofascial pain. Ultrasound also proves helpful, with a high accuracy rate of up to 88% for locating trigger points. These imaging methods assist doctors in better understanding and treating the condition. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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]

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]

Citations

1. withpower.com withpower.com/trial/phase-myofascial-pain-syndromes-8-2023-4660a

Multi-modal Imaging for Myofascial Pain Syndrome Kinesio taping significantly reduces pain intensity and improves range of motion in patients with myofascial pain syndrome, based on a meta-analysis of 20 ...

2. nature.com nature.com/articles/s41598-025-05869-2

Ultrasound features of myofascial trigger points This study systematically evaluates UT MTrPs using multimodal ultrasound (SWE, Grayscale, Doppler) combined with histological analysis in a ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8448923/

Assessment of Myofascial Trigger Points via Imaging Behr et al. reported similar results to achieve a sensitivity and specificity of 88% and 86%. Turo et al. achieved a sensitivity and specificity of 69% and 81%, ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8166277/

Potential Role of MRI Imaging for Myofascial Pain Our review suggests that DTI is the most effective imaging modality that has been used to define the microstructure of muscle and hence, could be optimal to ...

5. e-jyms.org e-jyms.org/journal/view.php?number=2845

Ultrasound imaging and guidance in the management ... Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11294799

Ultrasound imaging and guidance in the management of ... Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance.

7. sciencedirect.com sciencedirect.com/science/article/pii/S1521694224000159

Myofascial pain – A major player in musculoskeletal pain Myofascial pain is most effectively treated with a multimodal treatment plan including injection therapy (known as trigger point injections, physical therapy, ...

8. mdpi.com mdpi.com/1424-8220/24/3/718

Assessment of the Performance of Ultrasonography for ... Two- and three-dimensional ultrasound imaging to facilitate detection and targeting of taut bands in myofascial pain syndrome. Pain Med.

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5039775/

diagnostic ultrasound imaging and biomarkers - PMC Myofascial pain syndrome (MPS) is one of the most common conditions of chronic musculoskeletal pain, with a prevalence of 15% of patients in general medical ...