Chronic pain with 30.3% global prevalence significantly impacts universal health. Low back pain (LBP) has 9.4% worldwide prevalence causing the most widespread disability. Neck pain (NP) ranks 4th highest regarding years lived with disability (YLD) with 4.9% worldwide prevalence. Principal cause of pain in 85% of patients visiting a tertiary pain clinic has myofascial origin. The mediate cause is multi-focal neuromuscular ischemia at myofascial trigger points (MTrPs) from muscle tightening and shortening following spondylotic radiculopathy induced partial denervation. Chronic refractory myofascial pain (CRMP) is a neuromusculosketal disease needing management innovations. Using targetted deep trigger point stimulation (DTPS) also known as Electrical Twitch Obtaining Intramuscular Stimulation) , we provide objective evidence of denervation supersensitivity (DS) in multiple myotomes as cause, aggravation and maintenance of CRMP. This study underscores our previous findings that DTPS is safe and efficacious for long-term use in CRMP. DTPS aids potential prevention (pre-rehabilitation), simultaneous diagnosis, treatment (rehabilitation) and prognosis in real-time for acute and CRMP management.
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