Effectiveness of Myofascial Release in Improving Pain, Pain Pressure Threshold and Disability as Compared with Standard Care in Upper Trapezius Myofascial Trigger Points

Abstract Background Myofascial trigger point (MTrP) plays a major role in the genesis of mechanical neck pain, which may lead to chronic disorders. The purpose of the study is to investigate and compare the effect of ice massage plus integrated neuromuscular inhibition technique (INIT) versus INIT alone on active trigger points in the upper trapezius of persons having mechanical neck pain. Forty participants diagnosed as mechanical neck pain with upper trapezius active myofascial trigger points. They were randomized into two equal groups. Group A (experimental) received ice massage for 10 min plus INIT, while group B (control) received INIT alone. The treatment program continued for 2 weeks (3 sessions/week). The outcome measures are the pain intensity, pain pressure threshold, cervical lateral side bending and neck daily functions. Results The results showed that there were significant improvements in VAS at p = .899 and F = .78, PPT at p = .288 and F = .553, cervical side bending at p = .094 and F < 0.00001, and NDI at p = .164 and F = 0.00001 in both groups, while there were no statistically significant differences between both groups as p > 0.05. Conclusion Ice massage and INIT are effective methods in managing active trigger points in the upper trapezius of persons having mechanical neck pain without statistically significant difference.

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Trigger Point Dry Needling versus Strain–counterstrain Technique for Upper Trapezius Myofascial Trigger Points: A Randomised Controlled Trial

Acupuncture in Medicine ◽

10.1136/acupmed-2015-010868 ◽

2016 ◽

Vol 34 (3) ◽

pp. 171-177 ◽

Cited By ~ 14

Author(s):

E Segura-Ortí ◽

S Prades-Vergara ◽

L Manzaneda-Piña ◽

R Valero-Martínez ◽

JA Polo-Traverso

Keyword(s):

Randomised Controlled Trial ◽

Trigger Point ◽

Controlled Trial ◽

Trigger Points ◽

Dry Needling ◽

Significant Group ◽

Myofascial Trigger Points ◽

Upper Trapezius ◽

Pain Pressure Threshold ◽

Randomised Controlled

Background Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. Objectives To compare the effects of upper trapezius trigger point dry needling (DN) and strain–counterstrain (SCS) techniques versus sham SCS. Study Design Randomised controlled trial. Method 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects’ own ratings of perceived disability were measured. Results The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI −4.9 to 2.1) or sham SCS (1.8, 95% CI −6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. Conclusions There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. Trial Registration Number NCT01290653.

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A Comparative Study on the Effects of Trigger Point Release vs Myofascial Release for Myofascial Trigger Points of Upper Trapezius in Smartphone Users

International Journal Of Scientific Advances ◽

10.51542/ijscia.spi1.03 ◽

2021 ◽

Vol SP (1) ◽

Author(s):

Anjali Suresh ◽

Rama Chandra L. A. ◽

Prasanna Mohan

Keyword(s):

Pain Intensity ◽

Trigger Point ◽

Trapezius Muscle ◽

Trigger Points ◽

The Body ◽

Myofascial Trigger Points ◽

Myofascial Release ◽

Upper Trapezius ◽

Upper Trapezius Muscle ◽

Neck Disability

Background/aim: The increasing use of smartphone in daily life has brought about numerous musculoskeletal problems. Impairments in the neck is the most common when compared to other parts of the body. The aim of this study was to compare the effects of two different manual treatment techniques in two separate groups, i.e., trigger point release and Myofascial release (MFR) on the trigger points (TrPs) in the upper trapezius muscle in smartphone users. Both group received Ultrasound therapy. The smartphone addiction scale -short version was administered to all participants to determine the level of addiction and those who scores were high were included in the study. The set criteria in the study included the pain intensity on the visual analogue scale (VAS) neck disability using the Neck Disability Index and Cervical Range of motion side flexion using cervical goniometer. Subjects and methods: This clinical trial study assessed the outcome measures within and between groups before, after the intervention and a follow up was done after 15 days. The target population were smartphone users between the age group of 18 to 35 years. 106 subjects (48 males, 53 females) participants who had been selected from among the eligible participants of 176 and who had TrPs in their upper trapezius muscle. Results: The effect of Trigger point release and Myofascial release on patients of each groups with TrPs in the upper trapezius muscle resulted in increased cervical lateral flexion (P < 0.001), decreased pain intensity on VAS (P < 0.001) and decreased decrease in Neck disability (P < 0.001) within the groups and between the group there was no significance. Conclusion: Both manual techniques Trigger point release and Myofascial release reduced the symptoms of TrPs in the upper trapezius in both the groups equally, neither technique being superior to the other.

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Dry needling in the deactivation of myofascial trigger points

10.25242/8868113820212405 ◽

2021 ◽

Author(s):

Elaine Cruz ◽

Davi Rodrigues Martins ◽

Richarlison Amaral ◽

Rodrigo Manhães ◽

Mairkon Almeida Soares

Keyword(s):

Clinical Trials ◽

Range Of Motion ◽

Randomized Clinical Trials ◽

Trigger Point ◽

Pressure Pain Threshold ◽

Trigger Points ◽

Dry Needling ◽

Myofascial Trigger Points ◽

Pressure Threshold ◽

Pain Pressure Threshold

Dry Needling (DN) is a technique indicated to treat injuries of muscle origin and widely used in the deactivation of myofascial trigger points (PGMs). Its application almost always produces immediate effect, decreasing pain and increasing range of motion. The main objective of the present study was to verify the effectiveness of Dry Needling in the deactivation of myofascial trigger points. A search was carried out through three distinct databases and 10 articles dating from the last ten years were selected, with a score greater than or equal to six, in the classification of the PEDro platform (Physiotherapy Evidence Database). All selected articles were classified as randomized controlled trials, where eight are blind randomized clinical trials and two double blind randomized clinical trials. Outcomes ranged from decreased trigger points, increased range of motion, pain intensity and pain pressure threshold. The studies included in this review suggest that Dry Needling has a fundamental role in the treatment of PGMs, mainly increasing the pressure pain threshold, thus suggesting trigger point deactivation.

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Pain pressure thresholds for evaluating myofascial pain in the equine brachiocephalicus muscle

Revista Fisioterapia Invasiva ◽

10.1055/s-0039-3401885 ◽

2019 ◽

Vol 02 (02) ◽

pp. 114-114

Author(s):

Calatayud-Bonilla M. ◽

Resano-Zuazu M. ◽

Segura-Ortí E.

Keyword(s):

Myofascial Pain ◽

Intraclass Correlation ◽

Trigger Points ◽

Myofascial Trigger Points ◽

Minimum Detectable Change ◽

Pressure Threshold ◽

Pain Pressure Threshold ◽

Pressure Algometer ◽

Manual Palpation ◽

Distal Aspect

Abstract Introduction Myofascial pain is one of the most common musculoskeletal pathologies in humans, with the presence of myofascial trigger points (MTrPs). A MTrP is defined as a hyperirritable nodule in a taut band of musculoskeletal fibers. The pain pressure threshold is a tool for the assessment of pain used in humans with proven reliability, however there is no evidence of the same in the study of MTrPs in horses. Aims The aim of this study was to evaluate the reliability of the measurement of pressure pain sensitivity in horses with MTrPs in the brachiocephalicus muscle. A second aim was to calculate the minimum detectable change (MDC) for this result. Material and Methods Twenty horses were evaluated, aged between five and fifteen years old. All without pathology or previous pharmacological treatment. The cranial angle of the scapula was taken as the anatomic reference. A first evaluator, whose reliability was already confirmed, performed a manual palpation of the distal aspect of the brachiocepalicus muscle. A MTrP was located in all animals included in the study. The anatomic reference and the MTrP were marked. The pain pressure threshold of the MTrP was measured using a pressure algometer (Wagner Instruments, EE.UU., kg/cm2). The same evaluator applied the tip of the algometer parallel to the neck and transversal to the muscle fibers, gradually increasing pressure until the ‘jump sign’ or facial expressions of pain were detected by a second operator who also recorded the measurements. The measurements were repeated consecutively twice in this manner. The first operator was blind to the measurements. The intraclass correlation index (ICC) was calculated to evaluate reliability. Results The mean thresholds of pain pressure sensitivity registered for the first and second measurement were 3.29 (1.0) kg/cm2 and 3.31 (0.9) kg/cm2. The ICC was 0.86 (95% CI: 0.68 to 0.95). The MDC was 0.9 kg/cm2 (95% CI: 0.6 to 1.4). Conclusions Acceptable reliability was found for the measurement of the pain pressure threshold in horses with MTrPs in the brachiocephalicus muscle.

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Treatment of myofascial trigger points of the infraspinatus is effective in relieving shoulder pain and improving shoulder functions: A randomized clinical trial

10.21203/rs.2.21424/v1 ◽

2020 ◽

Author(s):

Sungeon Park ◽

Joochul Cho ◽

Seungwon Lee

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Trigger Points ◽

Shoulder Abduction ◽

Dash Score ◽

Myofascial Trigger Points ◽

Pressure Threshold ◽

Shoulder Flexion ◽

Infraspinatus Muscle ◽

Pain Pressure Threshold

Abstract Background This study aimed to investigate the effects of ischemic compression treatment (ICT) and low-level laser therapy (LLLT) applied on the trigger points of the infraspinatus muscle on shoulder pain and function in patients with shoulder pain. Methods Thirty patients with shoulder pain were randomly categorized into the ICT group (n = 15) and LLLT groups (n = 15). ICT was performed on three myofascial trigger points (MTrPs) of the infraspinatus muscle twice a week for 4 weeks (eight sessions), with 5 minutes of treatment per trigger point. LLLT was performed similarly. Shoulder pain was assessed using the visual analogue scale (VAS) and pain pressure threshold (PPT), and shoulder function was assessed using the Korean Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, rotator cuff strength, and range of motion (ROM) of shoulder flexion and abduction. Results Significant changes in VAS score and PPT were found after the intervention in both groups (p < 0.05). Significant changes were observed in the Korean DASH score, rotator cuff strength, and ROM of shoulder flexion (p < 0.05) but not in the ROM of shoulder abduction (p < 0.05). There were no significant differences between the two groups. Conclusion This study showed that both ICT and LLLT applied on the MTrPs of the infraspinatus muscle were effective for relieving shoulder pain and improving shoulder functions in patients with shoulder pain.

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The Effect of Therapeutic Low-Frequency Ultrasound applied to Myofascial Trigger Points: A Pilot Pre-Post Design Study

SciMedicine Journal ◽

10.28991/scimedj-2021-0303-5 ◽

2021 ◽

Vol 3 (3) ◽

pp. 242-249

Author(s):

Michal Elboim Gabyzon ◽

Amit Drat ◽

Leonid Kalichman

Keyword(s):

Trigger Point ◽

Low Frequency ◽

Trigger Points ◽

Preliminary Evidence ◽

Calf Muscle ◽

Myofascial Trigger Points ◽

Pressure Threshold ◽

Pain Pressure Threshold ◽

Low Frequency Ultrasound ◽

Hop Test

Ultrasound at a frequency of 1 or 3 MHz is frequently used to treat various musculoskeletal conditions, but research on ultrasound operating at 38-50 kHz frequencies (US-KHz) is lacking. Study aimed to evaluate the short-term effect of US-KHz on pain pressure threshold (PPT), ankle dorsiflexion range of motion (ROM), and motor performance (the Side Hop Test) in subjects with a myofascial trigger point (TrP) in the calf muscle. US-KHz was applied to the area of the palpable TrP in the calf muscle for 10 minutes (continuous pulse, transducer head size 19.6 cm2, power 0.75-1.25 w/cm2) in twenty volunteers (18-45 years old). Significant improvements (p<0.001) were noted in the Side Hop Test 24 hours after the intervention. ROM improved significantly after 5 minutes with changes maintained 24 hours later. No change was found in the PPT. This pilot study presents preliminary evidence of the efficacy of US-KHz in treating TrPs. Doi: 10.28991/SciMedJ-2021-0303-5 Full Text: PDF

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Effects of Dry Needling of the Upper Trapezius Active Trigger Points on Pain and Pain Pressure Threshold in Women With Chronic Non-Specific Neck Pain

Function and Disability Journal ◽

10.32598/fdj.4.29 ◽

2021 ◽

Vol 4 (1) ◽

pp. 29-29

Author(s):

Fereshteh Navaee ◽

◽

Marzieh Yassin ◽

Javad Sarrafzade ◽

Reza Salehi ◽

...

Keyword(s):

Neck Pain ◽

Trigger Point ◽

Local Treatment ◽

Trigger Points ◽

Dry Needling ◽

Upper Trapezius ◽

Pressure Threshold ◽

Pain Pressure Threshold ◽

Significant Difference ◽

Passive Stretch

Background and Objectives: The purpose of the present study was to examine the effectiveness of dry needling as local treatment of upper trapezius trigger points related to chronic neck pain on pain and pain pressure threshold in women with chronic nonspecific neck pain. Methods: Thirty females with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the intervention for three weeks. The outcomes were pain intensity and pain pressure threshold. Every outcome was recorded at baseline and 2 days after the ﬁfth session. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. The results of the independent t-test showed a significant difference in measurements between the dry needling and passive stretch groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in women with nonspecific neck pain.

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