Myofasziale Schmerzsyndrome

Zusammenfassung

Myofasziale Schmerzsyndrome haben eine hohe Bedeutung in der Differenzialdiagnose von Muskelschmerzen. Obwohl sie eine der häufigsten Ursachen akuter und chronischer muskuloskelettaler Schmerzen darstellen, werden sie zu selten differenzialdiagnostisch bedacht, teils auch aufgrund mangelnden Wissens über strukturierte therapeutische Strategien. Diagnostisch steht der klinische Befund im Vordergrund. Therapeutisch führend sind physikalisch-manuelle Techniken, ergänzt durch invasive Techniken wie die trockene Nadelung und Triggerpunktinjektionen. Die Identifizierung und Ausschaltung aktivierender und aufrechterhaltender Faktoren haben hohe Bedeutung für den Therapieerfolg. Der temporäre Einsatz oraler Medikation mit Muskelrelaxanzien, ggf. auch Analgetika und nichtsteroidalen Antirheumatika, runden das therapeutischen Konzept ab. Für chronische therapierefraktäre Syndrome stehen im Einzelfall und unter individueller Abwägung Injektionen mit Botulinumtoxin A und ggf. auch der Einsatz von Stoßwellen als therapeutische Option zur Verfügung.

Abstract

Myofascial pain syndromes are important in the differential diagnosis of myalgias. Despite their high prevalance in both acute and chronic musculoskeletal pain, they often remain unconsidered partly due to a lack of knowledge about systematic therapeutic strategies. Clinically, the manual examination is essential. Regarding therapy, main elements are manual physical therapies complemented by invasive techniques like dry needling and trigger point injections. Identification and elimination of activating or perpetuating factors are highly important for therapeutic success. The temporary use of oral drugs like muscle relaxants, analgetics, and NSAID completes the therapeutic concept. In individual cases, chronic therapy-resistant syndromes can be treated with additional injections of botulinum toxin A and by shock wave therapy, respectively, as a therapeutic off-label option.

Schlüsselwörter

myofaszialer Schmerz - Triggerpunkte - Muskelschmerz

Key words

myofascial pain - trigger points - muscle pain

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