Klinik Araştırma
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Fibromyalji Sendromunun Tedavisinde Lokal Anestetik Enjeksiyonu ve Fotobiyomodülasyon Tekniklerinin Etkinliklerinin Karşılaştırılması

Yıl 2019, Cilt: 2 Sayı: 3, 112 - 118, 20.12.2019
https://doi.org/10.33713/egetbd.587588

Öz

Amaç: Bu çalışmada fibromiyalji tanılı hastaların tedavisinde
lokal anestetik enjeksiyon yöntemi ile fotobiyomodülasyon yönteminin
etkinliklerinin karşılaştırılması amaçlanmıştır.



Hastalar ve Yöntem: Amerikan Romatoloji Cemiyeti tanısal kriterlerine göre
fibromiyalji sendromu tanısı konmuş olan 20 ila 60 yaş arasındaki 40 kadın
hasta çalışmaya dahil edilmiştir. Hastalar randomize olarak iki çalışma koluna
ayrılmış, bir gruba omuz kuşağındaki hassas noktalara prilokain enjeksiyonu
yapılırken, diğer gruba ise fotobiyomodülasyon tekniği ile düşük doz lazer
uygulaması yapılmıştır. Ayrıca, her iki çalışma kolundaki hastalara uygun
postüral ve germe egzersizlerinin yer aldığı bir eğitim programı uygulanmıştır.
Hassas nokta sayısı, sabah sertliği, uyku kalitesi, kas spazmları ve kısıtlılık
parametreleri likert ölçeği ile, ağrı seviyeleri görsel analog skala ile,
hastaların genel durumları Fibromiyalji Etki Anketi ile ve hastaların
psikososyal durumları ise Beck Depresyon Ölçeği ile değerlendirilmiştir.



Bulgular: Her iki çalışma kolunda uygulanan tedavi yöntemlerinin
hastalarda istatistiksel olarak anlamlı iyileşme sağladığı tespit edilmiş,
ancak iki tedavi modalitesinin arasında istatistiksel olarak anlamlı fark
bulunmadığı tespit edilmiştir. Lokal anestetik enjeksiyonu ile hassas nokta
sayısındaki azalmanın, kas spazmlarındaki düzelmenin ve kısıtlılık
seviyesindeki düşüşün daha fazla olduğu, fotobiyomodülasyon kolunda ise sabah
sertliğinin, uyku kalitesinin ve Beck depresyon skalası skorlarının daha fazla
düzelme gösterdiği belirlenmiştir.



Sonuç: Bulgularımıza göre her iki yöntemin de fibromiyalji
sendromunun tedavisinde etkin şekilde kullanılabileceği görülmüştür. Ancak,
hastaların klinik özellikleri göz önünde tutularak en uygun tedavi yönteminin
seçilmesi hastaların tedavi başarısını artıracaktır. 

Kaynakça

  • Clauw, D.J., Fibromyalgia. Jama, 2014. 311(15).
  • Abeles, A.M., et al., Narrative review: the pathophysiology of fibromyalgia. Ann Intern Med, 2007. 146(10): p. 726-34.
  • Yunus, M.B., Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum, 2007. 36(6): p. 339-56.
  • Köseoğlu,M., Yılmaz,N., A Fibromyalgia Syndrome and Neuropathic Pain. Aegean J Med Sci 2018;1:26-31.
  • Vincent, A., et al., Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken), 2013. 65(5): p. 786-92.
  • Bennett, R.M., Clinical manifestations and diagnosis of fibromyalgia. Rheum Dis Clin North Am, 2009. 35(2): p. 215-32.
  • Spaeth, M., Epidemiology, costs, and the economic burden of fibromyalgia. Arthritis Res Ther, 2009. 11(3): p. 117.
  • Orlandi, A.C., et al., Improvement in pain, fatigue, and subjective sleep quality through sleep hygiene tips in patients with fibromyalgia. Rev Bras Reumatol, 2012. 52(5): p. 666-78.
  • Busch, A., et al., Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev, 2002(3): p. CD003786.
  • Cummings, T.M. and A.R. White, Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil, 2001. 82(7): p. 986-92.
  • Ruaro, J.A., et al., Low-level laser therapy to treat fibromyalgia. Lasers Med Sci, 2014. 29(6): p. 1815-9.
  • Walker, J., Relief from chronic pain by low power laser irradiation. Neurosci Lett, 1983. 43(2-3): p. 339-44
  • Walker, J.B. and L.K. Akhanjee, Laser-induced somatosensory evoked potentials: evidence of photosensitivity in peripheral nerves. Brain Res, 1985. 344(2): p. 281-5.
  • Anders, J.J., R.J. Lanzafame, and P.R. Arany, Low-Level Light/Laser Therapy Versus Photobiomodulation Therapy. Photomedicine and Laser Surgery, 2015. 33(4): p. 183-184.
  • Ediz, L., et al., The validity and reliability of the Turkish version of the Revised Fibromyalgia Impact Questionnaire. Clin Rheumatol, 2011. 30(3): p. 339-46.
  • Hisli N, Beck Depresyon Envanterinin Geçerliliği Üzerine Bir Çalışma. Türk Psikoloji Dergisi, 1989. 22: p. 118-126.
  • Cassisi, G., et al., Complementary and alternative medicine in fibromyalgia: a practical clinical debate of agreements and contrasts. Clin Exp Rheumatol, 2013. 31(6 Suppl 79): p. S134-52.
  • Kingsley, J.D., T. Demchak, and R. Mathis, Low-level laser therapy as a treatment for chronic pain. Front Physiol, 2014. 5: p. 306.
  • Perrot, S. and I.J. Russell, More ubiquitous effects from non-pharmacologic than from pharmacologic treatments for fibromyalgia syndrome: a meta-analysis examining six core symptoms. Eur J Pain, 2014. 18(8): p. 1067-80.
  • Tuncay, R., et al., Fibromiyalji Sendromunda, Lokal Anestezik Enjeksiyonu ve Düşük Güçlü Lazer Tedavisinin Etkinliğinin Karşılaştırılması. Romatizma, 2006. 21(1): p. 1-4.
  • de Souza, R.C., et al., Low-level laser therapy and anesthetic infiltration for orofacial pain in patients with fibromyalgia: a randomized clinical trial. Med Oral Patol Oral Cir Bucal, 2018. 23(1): p. e65-e71.
  • Hong, C.Z. and T.C. Hsueh, Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. Arch Phys Med Rehabil, 1996. 77(11): p. 1161-6.
  • Altındağ, Ö. and A. Gür, Miyofasiyal Ağrı Sendromunda Kuru İğneleme ve Lokal Anestezik Enjeksiyonun Etkinligi. Harran Üniversitesi Tıp Fakültesi Dergisi, 2006. 3(3): p. 84-88.Genc, H., R. Erdem, and B. Karaoğlan, Myofasial ağrı sendromunda lokal anestezik enjeksiyonu ve kuru iğnelemenin etkileri. Romatol Tıb Rehab, 1997. 8: p. 29-33.
  • Güzel, R., et al., Efficacy of Local Anesthetic Injection Versus Dry Needling in Myofascial Pain Syndrome Treatment. Turk J Phys Med Rehab, 2006. 52(1): p. 22-27.
  • Vayvay, E.S., et al., The effect of Laser and taping on pain, functional status and quality of life in patients with fibromyalgia syndrome: A placebo- randomized controlled clinical trial. J Back Musculoskelet Rehabil, 2016. 29(1): p. 77-83.
  • Simunovic, Z., Low level laser therapy with trigger points technique: a clinical study on 243 patients. J Clin Laser Med Surg, 1996. 14(4): p. 163-7.
  • Hakguder, A., et al., Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med, 2003. 33(5): p. 339-43.
  • de Carvalho Pde, T., et al., Effect of low-level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double-blinded randomized controlled trial. Trials, 2012. 13: p. 221.
  • Gur, A., et al., Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial. Lasers Surg Med, 2004. 35(3): p. 229-35.
  • Panton, L., et al., Effects of Class IV laser therapy on fibromyalgia impact and function in women with fibromyalgia. J Altern Complement Med, 2013. 19(5): p. 445-52.
  • Thorsen, H., et al., [Low energy laser treatment--effect in localized fibromyalgia in the neck and shoulder regions]. Ugeskr Laeger, 1991. 153(25): p. 1801-4.
  • Waylonis, G.W., et al., Chronic myofascial pain: management by low-output helium-neon laser therapy. Arch Phys Med Rehabil, 1988. 69(12): p. 1017-20.
  • Bjordal, J.M., Low level laser therapy (LLLT) and World Association for Laser Therapy (WALT) dosage recommendations. Photomed Laser Surg, 2012. 30(2): p. 61-2.
  • Yeh, S.W., et al., Low-Level Laser Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis. Pain Physician, 2019. 22(3): p. 241-254.

Comparing Efficiencies of Local Anesthetic Injection and Photobiomodulation in the Treatment of Fibromyalgia Syndrome

Yıl 2019, Cilt: 2 Sayı: 3, 112 - 118, 20.12.2019
https://doi.org/10.33713/egetbd.587588

Öz

Aim. This study aimed to
evaluate the efficiencies of local anesthetic injection and photobiomodulation
methods in the treatment of fibromyalgia syndrome.

Patients and Method. A total of 40 patients
between 20 to 60 years-of-age and diagnosed with fibromyalgia syndrome
according to the diagnostic criteria of the American College of Rheumatology
were included in the study. Patient were randomized into two study arms, of
which the first group received prilocaine injection to the tender points on the
shoulder girdle, and the second group of patients received photobiomodulation
by low-dose laser application. Also, both study groups received an education
program that included postural and stretching exercises. The number of tender
points, morning stiffness, sleep quality, muscle spasms, and disability parameters
were compared using likert scale, pain levels were compared using visual analog
scale (VAS), general status was compared using Fibromyalgia Impact Questionnaire
(FIQ), and psychological status were compared using Beck Depression Inventory (BDI).

Results: Both methods showed
statistically significant improvements. Additionally, regarding the improvement
levels, local anesthetic injection decreased the number of trigger points, and
improved muscle spasm and disability levels more. On the other hand, low-dose
laser therapy improved the morning stiffness, sleep quality, and Beck
depression scale scores more.







Conclusion: According to our
results, both methods were efficient for the treatment of fibromyalgia syndrome.
Individual patient assessment, and selecting the method that most fits the
patient needs is crucial for successful outcomes. 

Kaynakça

  • Clauw, D.J., Fibromyalgia. Jama, 2014. 311(15).
  • Abeles, A.M., et al., Narrative review: the pathophysiology of fibromyalgia. Ann Intern Med, 2007. 146(10): p. 726-34.
  • Yunus, M.B., Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum, 2007. 36(6): p. 339-56.
  • Köseoğlu,M., Yılmaz,N., A Fibromyalgia Syndrome and Neuropathic Pain. Aegean J Med Sci 2018;1:26-31.
  • Vincent, A., et al., Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken), 2013. 65(5): p. 786-92.
  • Bennett, R.M., Clinical manifestations and diagnosis of fibromyalgia. Rheum Dis Clin North Am, 2009. 35(2): p. 215-32.
  • Spaeth, M., Epidemiology, costs, and the economic burden of fibromyalgia. Arthritis Res Ther, 2009. 11(3): p. 117.
  • Orlandi, A.C., et al., Improvement in pain, fatigue, and subjective sleep quality through sleep hygiene tips in patients with fibromyalgia. Rev Bras Reumatol, 2012. 52(5): p. 666-78.
  • Busch, A., et al., Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev, 2002(3): p. CD003786.
  • Cummings, T.M. and A.R. White, Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil, 2001. 82(7): p. 986-92.
  • Ruaro, J.A., et al., Low-level laser therapy to treat fibromyalgia. Lasers Med Sci, 2014. 29(6): p. 1815-9.
  • Walker, J., Relief from chronic pain by low power laser irradiation. Neurosci Lett, 1983. 43(2-3): p. 339-44
  • Walker, J.B. and L.K. Akhanjee, Laser-induced somatosensory evoked potentials: evidence of photosensitivity in peripheral nerves. Brain Res, 1985. 344(2): p. 281-5.
  • Anders, J.J., R.J. Lanzafame, and P.R. Arany, Low-Level Light/Laser Therapy Versus Photobiomodulation Therapy. Photomedicine and Laser Surgery, 2015. 33(4): p. 183-184.
  • Ediz, L., et al., The validity and reliability of the Turkish version of the Revised Fibromyalgia Impact Questionnaire. Clin Rheumatol, 2011. 30(3): p. 339-46.
  • Hisli N, Beck Depresyon Envanterinin Geçerliliği Üzerine Bir Çalışma. Türk Psikoloji Dergisi, 1989. 22: p. 118-126.
  • Cassisi, G., et al., Complementary and alternative medicine in fibromyalgia: a practical clinical debate of agreements and contrasts. Clin Exp Rheumatol, 2013. 31(6 Suppl 79): p. S134-52.
  • Kingsley, J.D., T. Demchak, and R. Mathis, Low-level laser therapy as a treatment for chronic pain. Front Physiol, 2014. 5: p. 306.
  • Perrot, S. and I.J. Russell, More ubiquitous effects from non-pharmacologic than from pharmacologic treatments for fibromyalgia syndrome: a meta-analysis examining six core symptoms. Eur J Pain, 2014. 18(8): p. 1067-80.
  • Tuncay, R., et al., Fibromiyalji Sendromunda, Lokal Anestezik Enjeksiyonu ve Düşük Güçlü Lazer Tedavisinin Etkinliğinin Karşılaştırılması. Romatizma, 2006. 21(1): p. 1-4.
  • de Souza, R.C., et al., Low-level laser therapy and anesthetic infiltration for orofacial pain in patients with fibromyalgia: a randomized clinical trial. Med Oral Patol Oral Cir Bucal, 2018. 23(1): p. e65-e71.
  • Hong, C.Z. and T.C. Hsueh, Difference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia. Arch Phys Med Rehabil, 1996. 77(11): p. 1161-6.
  • Altındağ, Ö. and A. Gür, Miyofasiyal Ağrı Sendromunda Kuru İğneleme ve Lokal Anestezik Enjeksiyonun Etkinligi. Harran Üniversitesi Tıp Fakültesi Dergisi, 2006. 3(3): p. 84-88.Genc, H., R. Erdem, and B. Karaoğlan, Myofasial ağrı sendromunda lokal anestezik enjeksiyonu ve kuru iğnelemenin etkileri. Romatol Tıb Rehab, 1997. 8: p. 29-33.
  • Güzel, R., et al., Efficacy of Local Anesthetic Injection Versus Dry Needling in Myofascial Pain Syndrome Treatment. Turk J Phys Med Rehab, 2006. 52(1): p. 22-27.
  • Vayvay, E.S., et al., The effect of Laser and taping on pain, functional status and quality of life in patients with fibromyalgia syndrome: A placebo- randomized controlled clinical trial. J Back Musculoskelet Rehabil, 2016. 29(1): p. 77-83.
  • Simunovic, Z., Low level laser therapy with trigger points technique: a clinical study on 243 patients. J Clin Laser Med Surg, 1996. 14(4): p. 163-7.
  • Hakguder, A., et al., Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med, 2003. 33(5): p. 339-43.
  • de Carvalho Pde, T., et al., Effect of low-level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double-blinded randomized controlled trial. Trials, 2012. 13: p. 221.
  • Gur, A., et al., Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial. Lasers Surg Med, 2004. 35(3): p. 229-35.
  • Panton, L., et al., Effects of Class IV laser therapy on fibromyalgia impact and function in women with fibromyalgia. J Altern Complement Med, 2013. 19(5): p. 445-52.
  • Thorsen, H., et al., [Low energy laser treatment--effect in localized fibromyalgia in the neck and shoulder regions]. Ugeskr Laeger, 1991. 153(25): p. 1801-4.
  • Waylonis, G.W., et al., Chronic myofascial pain: management by low-output helium-neon laser therapy. Arch Phys Med Rehabil, 1988. 69(12): p. 1017-20.
  • Bjordal, J.M., Low level laser therapy (LLLT) and World Association for Laser Therapy (WALT) dosage recommendations. Photomed Laser Surg, 2012. 30(2): p. 61-2.
  • Yeh, S.W., et al., Low-Level Laser Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis. Pain Physician, 2019. 22(3): p. 241-254.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Araştırma
Yazarlar

Zeynep Ateş 0000-0003-0033-8143

Şirzat Çoğalgil Bu kişi benim 0000-0003-3303-9975

Yayımlanma Tarihi 20 Aralık 2019
Kabul Tarihi 12 Kasım 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 2 Sayı: 3

Kaynak Göster

EndNote Ateş Z, Çoğalgil Ş (01 Aralık 2019) Comparing Efficiencies of Local Anesthetic Injection and Photobiomodulation in the Treatment of Fibromyalgia Syndrome. Ege Tıp Bilimleri Dergisi 2 3 112–118.

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