MPDD Doctor review

2/21/13

via email

Dear EPGL Staff,

As you know I have had the opportunity to purchase and implement the Muscle

Pain Detection Device into my pain management practice. I just wanted to give

you some feedback as to my experience with the device, which up to this point

has been quite encouraging. The scope of my practice has allowed me to

frequently use the device. I see a wide variety of painful conditions, many of

which are challenging to treat. Needless to say, a proper diagnosis is essential

for good care. My practice is referral based and include painful conditions

involving the neck, shoulders, chest, thoracic and lumbar back, gluteal and hip

region, knee and leg pain. I often see patients that have tried and failed many

other modalities.

Up to this point I have to say that my experience with the Muscle Pain Detection

Device has been very positive. It is easy to use and tolerated very well by the

patients. I have had zero patient complaints and in fact they are quite enthused

to try a diagnostic tool that offers some insight as to the source of their pain

problem. It is encouraging to them when we are able to specifically identify the

muscle region causing their pain. They are then very responsive to treatment of

the painful muscle via injections and a structured exercise regimen.

It's interesting that I will often get a referral to treat a patient for a particular

problem (for example a cervical or lumbar epidural injection) and then after

using the MPDD find that the patient either has a muscle problem causing the

pain or has muscle pain in addition to the original problem. Seeing this over

and over again has basically prompted me to used the MPDD on almost every

patient that is scheduled for an injection. I'm hoping to incorporate the device

more often even on my medically managed patients also. My goal is to

properly diagnose and treat these patients with the least amount of

intervention and medication.

Without being too long winded, I just have to tell you about a few of my

experiences with the device. It's no surprise that the device can confirm a

palpated trigger point quite easily. However, I find it interesting that the device

identifies painful muscle regions that are not palpated by traditional exam. For

example, I had an elderly gentleman who has had chronic neck pain for

years. He has had surgery, facet joint injections, medications and physical

therapy but just has not had any relief of the pain. He pointed to the cervical 2

paraspinous region as the source of the discomfort. However, when I used the

MPDD I was able to identify painful muscles 3cm lateral to where he was

pointing. I injected this region and started him on appropriate home

exercises. He is now starting to notice relief!!

I had another patient with low back pain who was scheduled to see me for

injections into the joints of the back. She had had good relief with these

injectionsin the past. However she was frustrated that she had developed right

inguinal (groin) pain and had been dealing with it for months. I was unable to

palpate any trigger points. I then used the MPDD on her back and gluteal

region and identified a tender muscle over a gluteal multifidi muscle. As I was

stimulating the muscle the patient responded with "That's it!" I injected the

muscle and within five minutes her inguinal pain was gone. Needless to say she

was very happy (and so was I).

I had another patient that was referred to me for hip joint injections secondary

to arthritis of the right hip joint. I injected the joint twice with no relief. I then

used the MPDD and identified tender muscles over the gluteus minimus,

gluteus medius, and piriformis region. I injected these muscles and it was like

flipping a switch, her pain improved 90%. This is something she can easily

repeat with little to no risk. She was otherwise facing surgery.

Another gentleman I was treating with gluteal pain actually had no pain when I

palpated manually and tested over the gluteal musculature with the

MPDD. However, when I tested the muscles up higher in the lumbar back with

the MPDD (Iliocostalis muscle), this reproduced hi pain! I injected the muscle

and he had relief of the gluteal pain. This shows how relevant referred muscle

pain is. With referred pain it is often difficult to identify the actual source as it is

away from the painful site and in and of itself may produce minimal or no pain

during day to day life. As you can see this certainly adds to the quality of care

and is satisfying to both patient and physician.

I can go on and on with cases where the MPDD has helped me identify muscle

pain sources but I won't bore you. Let's just say that I'm using it on a daily basis

on well over 50% of my patients.

So in my experience I am consistently finding that the painful areas that a

patient points to as being the source of the pain are often different then where

the MPDD detects the discomfort. This is important, as it is frustrating to

patient and physician when traditional treatments offers no relief. The MPDD

allows us to change that in many cases, at least in my experience. I usually do 3

not inject muscles that the MPDD doesn't detect as painful even if the patients

states it hurts in a certain area. This prohibits needless, ineffective injections.

It would be interesting to hear from the other physicians using the device. I

think shared experiences can help identify consistent pain patterns which can

the be better treated. It would be good to develop clinical "Pearls" that would

assist physicians as they start to use the device. There is a learning curve and I

recommend using a good anatomy text (I use the Netter Series and the Visible

Body computer application) to really brush up on the anatomy as it is important

obviously. It is also a help to have knowledge of the traditional trigger point

patterns (as developed by Dr Travell). I have purchased the wall charts and they

have helped me in learning the wide variety of trigger point

patterns. Knowledge is power!

As far as downfalls of the MPDD are concerned there are few. When I started

using the device it took some practice to identify where to start and adjusting

the power but that quickly became a non issue with experience. It does take

some time to use the device but I'm finding that again with experience I have

cut that down dramatically and it is essentially also now a non issue. I find that I

need to change the battery a few times a week but this is obviously not a big

deal. Also, I have purchased a large lot of grounding pads and conduction gel

so I don't run out. I have found a couple of good distributors that are cost

effective and can relay that information if it would help you. Considering that I

use the device daily on multiple patients even the up front cost of the device

has been a moot point as it has probably paid for itself within the first month or

two of consistent use.

If you like I can periodically update you on my experience with the

device. Again, I would also like to hear how other physicians and health care

providers are doing with it as I am always eager to learn new things that can

improve patient care.

Sincerely,

Kenneth J Wenz, MD

Coastal Interventional Pain Associates

Myrtle Beach, SC