Early results of supervised versus unsupervised rehabilitation of patients with cervical pain

Purpose: Comparison of early effects of supervised (led by physiotherapist) and unsupervised rehabilitation protocols in patients with myofascial pain syndrome, disk-root conflict and degenerative spine disease at cervical level. Methods: Three groups of patients (n = 60 each) with clinically and neurophysiologically confirmed myofascial pain syndrome, disk-root conflict and degenerative spine disease were randomly subdivided to supervised and unsupervised treatment subgroups (n = 30 each). Thirty healthy subjects with similar demographic and anthropometric properties as patients were enrolled to control group. Patients were examined before and after rehabilitation with visual analog scale of pain, Spurling’s test, painful passive elongation and active trigger points detection in trapezius muscle, sensory perception studies and surface electromyography (at rest, during maximal contraction) and electroneurography. Results: Supervised treatment resulted in decrease of pain intensity (P = .001) and Spurling’s symptoms incidence (P = .008) in patients from disk-root conflict group. Painful elongation and incidence of trigger points in trapezius muscle were the least observed at P = .009 after supervised therapy of myofascial pain syndrome. Supervised therapy resulted in decrease of resting electromyography amplitude and increase of maximal contraction electromyography amplitude from trapezius muscle (P = .02) in myofascial pain syndrome patients and from biceps and abductor pollicis brevis muscles of patients from other groups (P from .05 to .001). Median nerve electroneurography and sensory perception results improved at P = .05 after supervised treatment in disk-root conflict group. Conclusions: Twenty-day supervised rehabilitation provides better therapeutic effects than unsupervised one in treatment of muscle dysfunctions in patients with myofascial pain syndrome, degenerative changes and disk-root conflict at cervical spine.

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Evolution of Muscles Dysfunction From Myofascial Pain Syndrome Through Cervical Disc-Root Conflict to Degenerative Spine Disease

Spine ◽

10.1097/brs.0000000000001691 ◽

2017 ◽

Vol 42 (3) ◽

pp. 151-159 ◽

Cited By ~ 2

Author(s):

Przemysław Lisiński ◽

Juliusz Huber

Keyword(s):

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Cervical Disc ◽

Degenerative Spine ◽

Degenerative Spine Disease ◽

Spine Disease

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THE INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE IS MORE EFFECTIVE THAN CONTRACT RELAX STRETCHING TO ULTRASOUND MODALITY IN INCREASING NECK RANGE OF MOTION OF MYOFASCIAL SYNDROME IN UPPER TRAPEZIUS MUSCLE

Majalah Ilmiah Fisioterapi Indonesia ◽

10.24843/mifi.2018.v06.i02.p06 ◽

2018 ◽

Vol 6 (2) ◽

pp. 26

Author(s):

Putu Ayu Sita Saraswati ◽

Ni Komang Juni Antari ◽

Anak Agung Gede Angga Puspa Negara

Keyword(s):

Myofascial Pain ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Upper Trapezius ◽

Significant Difference ◽

Upper Trapezius Muscle ◽

Neck Disability ◽

Inhibition Technique

ABSTRACT``Myofascial pain syndrome in upper trapezius muscle is a muscle pain that implicated by one or somemyofascial trigger points in upper trapezius muscle. Working with static position in long time stimulating the presence ofmyofascial trigger points that causing pain and movement limitation of the neck that stimulate neck disability. Physicaltherapy’s intervention for reducing pain in this case could be integrated neuromuscular inhibition technique or contractrelax stretching combined with ultrasound modality. Purpose: to compare the both interventions in reducing neckdisability of myofascial pain syndrome in upper trapezius muscle. Method: this was an experimental study withRandomized Pre and Post Test Group Design. Samples were divided into 2 treatment group that consist 12 samplesfor each group. The first group treated with integrated neuromuscular inhibition technique with ultrasound while thesecond group treated with contract relaxes stretching with ultrasound. The data was collected by measuring neck rangeof motion using goniometer at the time before and after treatment. Result: the 1st group showed that the Neck ROMincrease 5.083±1.0840 (p<0.001) and the 2nd group showed that the Neck ROM increase 3.333±0.7780(p<0.001). Itmeans there were significant effect of each treatment in both groups. The results of independent t-test showed p<0.001,so that there was significant difference of increased Neck ROM between these groups. The result of independent t-testshowed p value 0.001, so there was significant difference between two groups at increasing neck ROM. Conclusion:combination integrated neuromuscular inhibition technique is more effective than contract relax stretching to ultrasoundmodality in increasing neck range of motion of myofascial syndrome in upper trapezius muscle.Keywords: myofascial, neck disability, trapezius, INIT, ultrasound, stretching

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MYOFACIAL PAIN SYNDROME OF THE UPPER TRAPEZIUS MUSCLE INCIDENTS BASED ON AGE AND LENGTH OF WORK FOR BATIK TULIS WORKERS IN WIRADESA DISTRICT

Jurnal Fisioterapi dan Rehabilitasi ◽

10.33660/jfrwhs.v4i2.108 ◽

2020 ◽

Vol 4 (2) ◽

pp. 26-33

Author(s):

Nurul Aktifah

Keyword(s):

Sampling Method ◽

Myofascial Pain ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Descriptive Study ◽

Upper Trapezius ◽

Upper Trapezius Muscle ◽

Myofacial Pain

Background: Myofascial pain syndrome of the upper trapezius muscle is pain in the muscles that is characterized by trigger points. Work with a statistical position for 8 hours every day can cause the syndrome. Objective: To determine the incidence of Myofascial pain syndrome of the upper trapezius muscle based on age and length of work of batik workers. Research Methods: Descriptive study. Respondents in this study were 25 batik workers using accidental sampling method. The research instrument uses the Visual Analogue Scale (VAS). Results: myofascial pain syndrome in upper trapezius muscle category of uncontrolled severe pain experienced by respondents aged 46-60 amounted to 10 respondents (40%) and the length of work less than 10 years were 11 respondents (44%). Conclusion: The results of this study illustrate that age and length of work can be risk factors for myofascial pain syndrome of upper trapezius muscle in batik tulis workers in Wiradesa District.

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Therapeutic Effect of Superficial Acupuncture in Treating Myofascial Pain of the Upper Trapezius Muscle: A Randomized Controlled Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/9125746 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Chao Ching Wang ◽

Tse Hung Huang ◽

Kuo Ching Chiou ◽

Zi Yu Chang

Keyword(s):

Pain Threshold ◽

Myofascial Pain ◽

Controlled Trial ◽

Pressure Pain Threshold ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Upper Trapezius ◽

Upper Trapezius Muscle

The aim of this study was to compare the treatment efficacies of superficial acupuncture and traditional acupuncture on trigger points of the upper trapezius muscle. Forty people were recruited and randomly allocated to the traditional and superficial acupuncture groups. Each subject received two treatments per week in a four-week period. Outcomes were measured by visual analogue scale (VAS), the Northwick Park neck pain questionnaire scores (NPQ), and pressure pain threshold (PPT) assessments of trigger points. Data collected before the interventions were considered as baseline. Assessments were performed after the first treatment and at the end of the second and fourth weeks of treatment. Patients reported significant (p<0.05) and immediate improvements in VAS and PPT for both superficial acupuncture and traditional acupuncture after the first treatment and after two and four weeks. Significant improvements (p<0.05) in NPQ were attained after two weeks of treatments in both groups. Because superficial acupuncture is associated with less pain while producing immediate pain relief, we recommend it for treating myofascial pain syndrome in the upper trapezius muscle.

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Dry needling versus ultrasonic in treating cervical myofascial pain syndrome

QJM ◽

10.1093/qjmed/hcaa064.005 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

H A Ali ◽

A K Elzohiery ◽

M M Arafa ◽

N A Elkadery

Keyword(s):

Skeletal Muscles ◽

Myofascial Pain ◽

Trigger Point ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Trigger Points ◽

Ultrasonic Waves ◽

Dry Needling ◽

Myofascial Trigger Points

Abstract Background Myofascial pain syndrome (MPS) is a complex pain syndrome characterized by myofascial trigger points (MTrPs) in skeletal muscles. Ultrasound (US) therapy is one of the main devices used in physical therapy, for the treatment of MTrPs in MPS. Dry needling is skilled technique also used in the treatment of MTrPs in MPS. Purpose This study aimed to compare the effect of dry needling with the effect of ultrasonic waves in the treatment of cervical myofascial pain. Subjects a sample of 30 patients with myofascial trigger points in trapezius muscle was randomly chosen and divided into 2 groups each contains 15 patients. Methods the first group was treated by ultrasonic waves in a pulsed mode (1MHz, 1W/cm², 1:1 ratio) 5 min to each trigger point and the second group was treated with deep dry needling (peppering technique) to each trigger point with a rate of 3 times per week for 3 weeks. Results All patients shows significant improvement (P > 0.001) immediately after treatment period with disappearance of trigger points, increasing in cervical ROM and decreasing in VAS ; but 3 weeks later trigger points reappeared, ROM decreased and VAS increased again. Conclusion both modalities of treatment were considered effective in treating myofascial pain syndrome.

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Ultrasound‐Guided Erector Spinae Plane Block and Trapezius Muscle Injection for Myofascial Pain Syndrome

Journal of Ultrasound in Medicine ◽

10.1002/jum.15694 ◽

2021 ◽

Author(s):

Damla Yürük ◽

Ömer Taylan Akkaya ◽

Özgür Emre Polat ◽

Hüseyin Alp Alptekin

Keyword(s):

Myofascial Pain ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Erector Spinae ◽

Ultrasound Guided ◽

Erector Spinae Plane Block

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

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0154 ◽

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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