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
