scholarly journals Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pavlos Bobos ◽  
Evdokia Billis ◽  
Dimitra-Tania Papanikolaou ◽  
Constantinos Koutsojannis ◽  
Joy C. MacDermid
Keyword(s):  
Neck Pain ◽  
Pain Threshold ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Neck Muscle ◽  
Myofascial Trigger Points ◽  
Neck Disability ◽  
Over Time

Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM) was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67) completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05). However, no differences were found within and between the therapeutic groups (p<0.05) in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

scholarly journals Application of Combined Laser and Compression Therapy on the Pain and Level of Disability on Trigger Points in Upper Trapezius Muscle

2021 ◽  
Author(s):  
Saeed Rezaei ◽  
Azadeh Shadmehr ◽  
Siamak Bashardoust Tajali ◽  
Behrooz Attarbashi Moghadam ◽  
Shohreh Jalaei
Keyword(s):  
Pain Threshold ◽  
Neck Disability Index ◽  
Pressure Pain Threshold ◽  
Trapezius Muscle ◽  
Compression Therapy ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Upper Trapezius ◽  
Upper Trapezius Muscle ◽  
Neck Disability

Introduction: Musculoskeletal disorders are among the main causes of disability in modern life. Myofascial trigger points are very common among musculoskeletal disorders and may occur through ordinary common activities. This study aimed to determine the combined effects of laser therapy and Ischemic Compression (IC) on the treatment of Myofascial Trigger Points (MTrPs) at the upper trapezius muscle. Materials and Methods: Twenty men with at least one active trigger point at their upper trapezius muscle voluntarily participated in this study. Trigger  points  were under treatment of laser irradiation (6 Joules per point) and also ischemic compression. Treatment approaches were applied over the pain point every other day for 5 sessions in 10 days. Neck disability index, pain intensity by visual analog scale, pressure pain threshold by algometry, and cervical lateral flexion by goniometer were assessed and recorded before the intervention, and immediately after the last session. Results: At the end of treatment, statistically significant improvements were seen in the neck disability index, VAS value, pressure pain threshold, and cervical lateral flexion. VAS values of the treatment and control groups were compared with the baseline (P<0.001). Conclusion: Application of combined laser and compression therapy was effective on the pain and level of disability of patients with trigger points in the upper trapezius muscle.

scholarly journals Ultrasound-Guided Miniscalpel-Needle Release versus Dry Needling for Chronic Neck Pain: A Randomized Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Yongjun Zheng ◽  
Dongping Shi ◽  
Xiaotong Wu ◽  
Minghong Gu ◽  
Zisheng Ai ◽  
...  
Keyword(s):  
Neck Pain ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Chronic Neck Pain ◽  
Physical Component Score ◽  
Dry Needling ◽  
Ultrasound Guided ◽  
Component Score ◽  
Neck Function ◽  
Neck Disability

Objective. To compare ultrasound-guided miniscalpel-needle (UG-MSN) release versus ultrasound-guided dry needling (UG-DN) for chronic neck pain.Methods. A total of 169 patients with chronic neck pain were randomized to receive either UG-MSN release or UG-DN. Before treatment and at 3 and 6 months posttreatment, pain was measured using a 10-point visual analogue scale (VAS). Neck function was examined using the neck disability index. Health-related quality of life was examined using the physical component score (PCS) and mental component score (MCS) of the SF-36 health status scale.Results. Patients in the UG-MSN release had greater improvement on the VAS (by 2 points at 3 months and 0.9 points at 6 months) versus in the UG-DN arm; (bothP<0.0001). Patients receiving UG-MSN release also showed significantly lower scores on the adjusted neck disability index, as well as significantly lower PCS. No severe complications were observed.Conclusion. UG-MSN release was superior to UG-DN in reducing pain intensity and neck disability in patients with chronic neck pain and was not associated with severe complications. The procedural aspects in the two arms were identical; however, we did not verify the blinding success. As such, the results need to be interpreted with caution.

scholarly journals The effect of giving verbal feedback during neck stabilisation exercise as an addition to physical therapy in patients with chronic neck pain: A randomised controlled trial

2021 ◽  
pp. 026921552110441
Author(s):  
Yi-Jia Lin ◽  
Wei-Chun Hsu ◽  
Lin-Fen Hsieh ◽  
Kae-Chwen Chang ◽  
Ying-Chen Kuo ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Chronic Neck Pain ◽  
Group A ◽  
Group B ◽  
Randomised Controlled ◽  
Neck Disability

Objectives To study the addition of feedback-guided neck strength home exercise to physical therapy as an enhanced rehabilitation programme in the treatment of patients with chronic neck pain. Design A prospective randomised controlled trial. Setting Rehabilitation department of an academic hospital. Subjects Patients with chronic neck pain. Interventions The patients in both groups received supervised physical therapy sessions 3 times a week for 12 weeks. Patients in Group A ( N = 38) used the neck strengthening exerciser device for 20 min daily at home for 6 weeks and patients in Group B ( N = 20) performed 20 min of daily regular neck exercise at home for 6 weeks. Outcome measures Neck disability index, pain visual analogue scale, active range of motion of the neck, Patient Global Assessment and patient evaluation of treatment effect. All subjects were assessed at baseline as well as at 6- and 12-week follow-ups. Results At the 6-week follow-up, Group A exhibited significantly greater improvements ( P < 0.05) in pain Visual Analogue Scale (Group A: 2.97 ± 1.57; Group B: 4.20 ± 1.82), neck disability index (Group A: 13.95 ± 8.07; Group B: 20.07 ± 9.14) and active cervical extension (Group A: 65.26 ± 12.76; Group B: 51.45 ± 11.78). At 12-week follow-up, Group A also exhibited significantly greater active cervical extension (Group A: 67.74 ± 11.94; Group B: 53.85 ± 14.09; P < 0.05). Conclusion Adding neck strengthening exerciser home training to physical therapy was demonstrated to be more effective than physical therapy alone for patients with chronic neck pain.

Chronic neck pain patients with traumatic or non-traumatic onset: Differences in characteristics. A cross-sectional study

2017 ◽  
Vol 14 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Inge Ris ◽  
Birgit Juul-Kristensen ◽  
Eleanor Boyle ◽  
Alice Kongsted ◽  
Claus Manniche ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neck Pain ◽  
Pain Threshold ◽  
Neck Disability Index ◽  
Pressure Pain Threshold ◽  
Chronic Neck Pain ◽  
Traumatic Group ◽  
Neck Disability ◽  
Pain Patients

AbstractBackground and aimsPatients with chronic neck pain can present with disability, low quality of life, psychological factors and clinical symptoms. It is unclear whether patients with a traumatic onset differ from those with a non-traumatic onset, by having more complex and severe symptoms. The purpose of this study was to investigate the clinical presentation of chronic neck pain patients with and without traumatic onset by examining cervical mobility, sensorimotor function, cervical muscle performance and pressure pain threshold in addition to the following self-reported characteristics: quality of life, neck pain and function, kinesiophobia, depression, and pain bothersomeness.MethodsThis cross-sectional study included 200 participants with chronic neck pain:120 with traumatic onset and 80 with non-traumatic onset. Participants were recruited from physiotherapy clinics in primary and secondary health care. For participants to be included, they were required to be at least 18 years of age, have had neck pain for at least 6 months, and experienced neck-related activity limitation as determined by a score of at least 10 on the Neck Disability Index. We conducted the following clinical tests of cervical range of motion, gaze stability, eye movement, cranio-cervical flexion, cervical extensors, and pressure painthreshold.The participants completed the following questionnaires: physical and mental component summary of the Short Form Health Survey, EuroQol-5D, Neck Disability Index, Patient-Specific Functional Scale, Pain Bothersomeness, Beck Depression Inventory-II, and TAMPA scale of kinesiophobia. The level of significance for all analyses was defined as p < 0.01. Differences between groups for the continuous data were determined using either a Student’s, t-test or Mann Whitney U-test.ResultsIn both groups, the majority of the participants were female (approximately 75%). Age, educational level, working situation and sleeping patterns were similar in both groups. The traumatic group had symptoms for a shorter duration (88 vs.138 months p = 0.001).Participants in the traumatic group showed worse results on all measures compared with those in the non-traumatic group, significantly on neck muscle function (cervical extension mobility p = 0.005, craniocervical flexion test p = 0.007, cervical extensor test p = 0.006) and cervical pressure pain threshold bilateral (p = 0.002/0.004), as well on self-reported function (Neck Disability Index p = 0.001 and Patient-Specific Functional Scale p = 0.007), mental quality of life (mental component summary of the Short Form Health Survey p = 0.004 and EuroQol-5D p = 0.001) and depression (Beck Depression Inventory-II p = 0.001).ConclusionsThis study showed significant differences between chronic neck pain patients when differentiated into groups based on their onset of pain. However, no specific clinical test or self-reported characteristic could differentiate between the groups at an individual patient level.ImplicationsPressure pain threshold tests, cervical muscle performance tests and patient-reported characteristics about self-perceived function and psychological factors may assist in profilingchronic neck pain patients. The need for more intensive management of those with a traumatic onset compared with those with a non-traumatic onset should be examined further.

scholarly journals Does Upper Cervical Manual Therapy Provide Additional Benefit in Disability and Mobility over a Physiotherapy Primary Care Program for Chronic Cervicalgia? A Randomized Controlled Trial

2020 ◽  
Vol 17 (22) ◽  
pp. 8334
Author(s):  
Vanessa González-Rueda ◽  
César Hidalgo-García ◽  
Jacobo Rodríguez-Sanz ◽  
Elena Bueno-Gracia ◽  
Albert Pérez-Bellmunt ◽  
...  
Keyword(s):  
Neck Pain ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Chronic Neck Pain ◽  
Control Group ◽  
Upper Cervical Spine ◽  
Rotation Test ◽  
Upper Cervical ◽  
Neck Disability ◽  
Therapy Protocol

Introduction: Neck pain is a condition with a high incidence in primary care. Patients with chronic neck pain often experience reduction in neck mobility. However, no study to date has investigated the effects of manual mobilization of the upper cervical spine in patients with chronic mechanical neck pain and restricted upper cervical rotation. Objective: To evaluate the effect of adding an upper cervical translatoric mobilization or an inhibitory suboccipital technique to a conventional physical therapy protocol in patients with chronic neck pain test on disability and cervical range of motion. Design: Randomized controlled trial. Methods: Seventy-eight patients with chronic neck pain and restricted upper cervical rotation were randomized in three groups: Upper cervical translatoric mobilization group, inhibitory suboccipital technique group, or control group. The neck disability index, active cervical mobility, and the flexion–rotation test were assessed at baseline (T0), after the treatment (T1), and at three-month follow-up (T2). Results: There were no statistically significant differences between groups in neck disability index. The upper cervical translatoric mobilization group showed a significant increase in the flexion–rotation test to the more restricted side at T1 (F = 5.992; p < 0.004) and T2 (F = 5.212; p < 0.007) compared to the control group. The inhibitory suboccipital technique group showed a significant increase in the flexion–rotation test to the less restricted side at T1 (F = 3.590; p < 0.027). All groups presented high percentages of negative flexion–rotation tests. (T1: 69.2% upper neck translator mobilization group; 38.5% suboccipital inhibition technique group, 19.2% control group; at T2: 80.8%; 46.2% and 26.9% respectively). No significant differences in the active cervical mobility were found between groups. Conclusion: Adding manual therapy to a conventional physical therapy protocol for the upper cervical spine increased the flexion–rotation test in the short- and mid-term in patients with chronic neck pain. No changes were found in the neck disability index and the global active cervical range of motion.

scholarly journals Reliability of pressure pain threshold on myofascial trigger points in the trapezius muscle of women with chronic neck pain

2021 ◽  
Vol 67 (5) ◽  
pp. 708-712
Author(s):  
Alessandra Kelly de Oliveira ◽  
Almir Vieira Dibai-Filho ◽  
Gabriela Soleira ◽  
Ana Carolina Fracarolli Machado ◽  
Rinaldo Roberto de Jesus Guirro
Keyword(s):  
Neck Pain ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Trapezius Muscle ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Pressure Pain

A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

2019 ◽  
Vol 9 (3Jun) ◽  
Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh
Keyword(s):  
Virtual Reality ◽  
Visual Analogue Scale ◽  
Neck Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Repeated Measure ◽  
Balance Test ◽  
Proprioceptive Training ◽  
Neck Disability

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

Granisetron vs. lidocaine injection to trigger points in the management of myofascial pain syndrome: a double-blind randomized clinical trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zahra Rezasoltani ◽  
Hanna Ehyaie ◽  
Reza Kazempour Mofrad ◽  
Fatemeh Vashaei ◽  
Reza Mohtasham ◽  
...  
Keyword(s):  
Neck Pain ◽  
Myofascial Pain ◽  
Neck Disability Index ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Double Blind ◽  
Upper Trapezius ◽  
Disability Scale ◽  
Neck Disability

Abstract Objectives Granisetron and lidocaine injections have been used for the management of myofascial pain syndrome. This study was aimed to compare the efficacy of granisetron and lidocaine injections to trigger points of upper trapezius in the management of myofascial pain syndrome. Methods We performed a double-blind randomized clinical trial in an outpatient clinic of physical medicine and rehabilitation at a teaching hospital. A total of 40 patients aged ≥18 with neck pain due to myofascial pain syndrome were included. They had pain for at least one month with the intensity of at least 30 mm on a 100 mm visual analog scale. Each participant received a single dose of 1 mL lidocaine 2% or 1 mg (in 1 mL) granisetron. The solutions were injected into a maximum of three trigger points of the upper trapezius. We instructed all patients to remain active while avoiding strenuous activity for three or four days, and to perform stretch exercise and massage of their upper trapezius muscles. We assessed the patients before the interventions, and one month and three months post-injection. The primary outcome was the Neck Disability Index and the secondary outcome was the Neck Pain and Disability Scale. Results Both interventions were successful in reducing neck pain and disability (all p-values <0.001). However, the neck pain and disability responded more favorably to lidocaine than granisetron (p=0.001 for Neck Disability Index, and p=0.006 for Neck Pain and Disability Scale). No significant side-effect was recognized for both groups. Conclusions Both lidocaine and granisetron injections to trigger points are effective and safe for the management of the syndrome and the benefits remain at least for three months. However, lidocaine is more effective in reducing pain and disability. The injections are well-tolerated, although a transient pain at the site of injections is a common complaint. One mL of lidocaine 2% is more effective than 1 mg (in 1 mL) granisetron for injecting into the trigger points of the upper trapezius in myofascial pain syndrome.

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