Shengping Zou, M.D.

A new muscle pain detection device to diagnose muscles as a source of back and/or neck pain
Hunter, Corey; Dubois, Michel; Zou, Shengping; Oswald, William; Coakley, Kathleen; Shehebar, Mourad; Conlon, Ann Marie
2010 Jan;11(1):35-43, Pain medicine
BACKGROUND: Trigger point (TrPs) identification has become the mainstay of diagnosis for the treatment of Myofascial Pain Syndrome; however, manual pressure (MP) to identify TrPs by determining low-pressure pain threshold has low interrater reliability and may lack validity since it is done on inactive muscles. To elicit contractions and mimic an active muscle or movement that 'causes' pain, a Muscle Pain Detection Device (MPDD) has been developed. A selected muscle is stimulated and painful muscles are precisely detected, allowing distinctions between primary and referred muscle pain as well as distinguishing other functional muscle pain thought to cause MPS. METHODS: An IRB approved randomized controlled study is presented of MP (20 patients) control vs MPDD (20 patients) to identify which muscle(s) was the source of pain in subjects presenting to the NYU Pain Management Center with a minimum 3 months history of back pain. Patients were unaware of their diagnostic method. Subjects were injected in 1-3 sites identified via MP or MPDD by a separate, blinded physician. Prior to, and following treatment at one week and one month, the patients were administered Oswestry and visual analog scale pain questionnaires by a blinded evaluator, and their range of motion was measured by a blinded physical therapist. RESULTS: The MPDD group reported significantly larger improvements in pain, mood and Oswestry scores compared with the control (P < 0.05). Moreover, the MPDD group reported 82.5% pain relief at 1 month, compared with 53.2% in the control (P < 0.001). The range of motion measurements failed to reveal any significant difference between the groups. CONCLUSIONS: Using the MPDD appears to be more valid and potentially more reliable than palpation to identify muscles causing regional pain that could benefit from injections
— id: 109669, year: 2010, vol: 11, page: 35, stat: Journal Article,

A randomized controlled evaluation of a new muscle pain detection device (MPDD) to diagnose muscle pain as the source of back and/or neck pain in patients
Hunter C.W.; Dubois M.; Zou S.; Oswald W.; Coakley K.; Shehebar M.; Conlon A.M.
2009 ;10(1):233-233, Pain medicine
Introduction: Manual pressure (MP) to identify Trigger Points (TrPs) by determining low pressure pain threshold has low inter-rater reliability and may lack validity since it is done on inactive muscles. Muscle pain is generally experienced with activity. To elicit a muscle contraction and mimic movement that causes pain, a Muscle Pain Detection Device (MPDD) has been developed. A selected muscle is stimulated and painful muscles are precisely detected, allowing distinctions between primary and referred muscle pain [in our nomenclature, Muscle Pain Amenable to Injection vs. TrPs] as well as distinguishing other functional muscle pain thought to cause myofascial pain syndrome. MPDD could provide a valid, reliable assessment of muscle pain which is frequently ignored/mistreated. Methods: An IRB approved doubleblind, randomized controlled study of the MPDD (20 patients) vs. MP (20 patients) control to identify which muscle(s) was the source of pain in 40 subjects presenting to the NYU Pain Management Center with a minimum 3 month history of back pain. Patients were unaware of their diagnostic group. Subjects were injected in 1-3 sites identified via MP or MPDD by a separate physician blinded from the method of detection. Prior to, and following treatment at one week and one month, the patients are given a physical exam and administered Oswestry and VAS pain questionnaires by a blinded evaluator. Results: The MPDD group reported statistically significant improvement in pain, mood and Oswestry scores at 1 week and one month (P < 0.004 - 0.001). The control reported no statistical improvements except for the Oswestry scores at 1 week. Moreover, the MPDD group reported 82.5% pain relief at 1 month, compared to 53.2% in the control (P < 0.001). Conclusion: Using the MPDD appears to be more valid and reliable than palpation to identify muscles causing regional pain that could benefit from muscle injections
— id: 111414, year: 2009, vol: 10, page: 233, stat: Journal Article,

Challenges to setting spinal cord stimulator parameters during intraoperative testing: factors affecting coverage of low back and leg pain
Gordon, Assaf T; Zou, Sheng Ping; Kim, Yong; Gharibo, Christopher
2007 Apr;10(2):133-141, Neuromodulation
Objective. Spinal cord stimulator (SCS) parameter settings have been well studied; however, the goal of this exploratory study was to examine the SCS parameters used during intra-operative stimulation (IOS) at trial lead placement. Methods. In this retrospective study, we report the IOS parameter settings for 22 patients who underwent thoracic SCS lead trial for treatment of refractory low back and/or leg pain. Results. Paresthesia coverage was shown to differ depending upon the pain syndrome and the region involved (back and/or leg, p = 0.03). Certain stimulation parameters were demonstrated to be linked, including pulse width with rate (p = 0.04) and bipolar activation distance with amplitude (p < 0.01). Important variations in field configuration practice patterns also emerged. Conclusions. Larger prospective studies are required to confirm and extend the current results. The ultimate goal for this report is to establish a foundation for future studies to create an evidence-based standardized algorithm for IOS to enhance the success rate of SCS trial screening
— id: 146259, year: 2007, vol: 10, page: 133, stat: Journal Article,

Successful treatment of phantom radiculopathy with fluoroscopic epidural steroid injections
Aydin, Steve M; Zou, Sheng Ping; Varlotta, Gerard; Gharibo, Christopher
2005 May-Jun;6(3):266-268, Pain medicine
Phantom limb pain has been well described in the literature. However, new-onset lumbar radicular pain superimposed on baseline lower extremity phantom pain is a clinical scenario that can be challenging to recognize. Furthermore, literature on recognition and treatment of phantom radiculopathy is all but lacking. We present a patient who experienced new-onset lumbar radiculopathy superimposed on her phantom pain that was successfully treated with fluoroscopic interlaminar and transforaminal epidural steroid injections
— id: 59240, year: 2005, vol: 6, page: 266, stat: Journal Article,