NEURAL THERAPY IN MYOFASCIAL PAIN SYNDROME

Neural therapy (NT), therapeutic local anesthesia (TLA) or therapeutic neural blockade (TNB) is a treatment method used in the treatment of functional disorders, chronic inflammation and pain by regulating the autonomic nervous system by applying local anesthetics such as 0.5-1% procaine and lidocaine to the skin, tissues, ganglia, nerves, scars, trigger points, acupuncture points, epidural space and ganglia. NT can be used in painful and degenerative diseases of the musculoskeletal system (such as headaches, neck-back and waist pain, joint pain), temporomandibular joint dysfunction, fibromy-algia syndrome, chronic fatigue syndrome, rheumatic diseases, lower extremity circulation disorders, restless leg syndrome, facial paralysis, trigeminal neuralgia, neurological diseases, tinnitus, orthopedic rehabilitation, depression and anxiety disorder, gastrointestinal system diseases, allergic diseases, obe-sity and addiction treatments. Injection types of NT; 1) Local injections: Intradermal injections, applied superficially, are the first preferred injection type in NT, 2) Segmental injections: Segmental treatment applied in neural therapy is based on the fact that a stimulus given through the skin or originating from internal organs affects all or part of a segment (cutaneous-visceral/viscero-cutaneous reflex), 3) Interference field injections: The areas where biological healing cannot fully occur after physical and emotional traumas to which the body is exposed are called interference fields or focuses, 4) Ganglion Injections: When there is no response to treatment, including the autonomic ganglia in the relevant region in the treatment and ensuring detoxification can increase the success of the treatment. Sir Henry Head (1861-1940) observed that in visceral diseases or dysfunctions, there was hypersensitivity in the skin area innervated by the same segment. Head zones appear as hypersensitivity in the dermatome area located in the same segment as the internal organ where dysfunction or disease is detected. Re-ferred pain, particularly from myofascial trigger points (MTPs), may overlap with Head zones, causing patients to describe the pain as visceral in origin. For that reason, a treatment that focuses only on MTP may not be sufficient. Underlying biomechanical disorders, postural abnormalities, and neurophysio-logical contributions must also be evaluated. Based on current studies and our personal experiences, we believe that NT can be effective in the treatment of chronic pain and myofascial pain, that visceral effects can be created through the cutaneo-visceral arch while treating the MTP, or that myofascial pain syndrome can be treated by treating visceral dysfunction. However, there is still a need for ran-domized controlled studies on this subject that include more patients and examine short- and long-term outcomes.