Effect of extracorporeal shockwave therapy on myofascial pain syndrome of upper trapezius: A systematic review

Background/Aims Myofascial pain syndrome is a frequent problem in the musculoskeletal system. As a method of treatment for myofascial pain syndrome, dry needling therapy is an effective and convenient treatment for patients because they do not need to be treated every day. However, as patients often have post-needle soreness or some patients are afraid of needles, there are limitations to this treatment. The purpose of this study is to compare the effectiveness of radial shockwave therapy with dry needling therapy to treat myofascial pain. Methods A total of 42 patients attending the rehabilitation department with at least one myofascial pain trigger point in their upper back muscles, were randomly assigned to receive radial shockwave therapy or dry needling therapy. Treatment was performed once a week for 3 weeks in both groups. Participants' pain pressure threshold, measured using an algometer, and pain levels, measured using a numeric pain scale, were assessed before the designated treatment was applied each week. Each patient also performed upper trapezius, rhomboid and infraspinatus muscle stretches twice a day throughout the study period. Results There was no difference in pain pressure threshold at the three trigger points before treatment with the different modalities commenced. At the end of the study, the radial shockwave therapy group had a significant improvement in trapezius pain pressure threshold, increasing from 11.7 at baseline to 14.8 at the end of study. There was no significant between-group difference in pain level (P=3.4 vs P=2.6) at the end of the study. Both treatments significantly reduced pain levels: from 7.2 to 3.4 in the radial shockwave group (P<0.001) and from 6.8 to 2.6 in the dry needling therapy group (P<0.001). Conclusions Dry needling and radial shock wave therapies are effective in reducing myofascial pain syndrome originating in the upper back muscles. Participants' pain pressure threshold increased after 3 weeks of treatment with both therapies. Radial shock therapy can be used as an alternative to dry needling in the treatment of myofascial pain syndrome in patients who have trouble attending daily physical therapy or in whom dry needling therapy is contraindicated.

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The Effect of Kinesio Taping in Reducing Myofascial Pain Syndrome on the Upper Trapezius Muscle: A Systematic Review and Meta-Analysis

European Scientific Journal ESJ ◽

10.19044/esj.2018.v14n6p336 ◽

2018 ◽

Vol 14 (6) ◽

pp. 336

Author(s):

Mansour Alotaibi ◽

Abdulraouf Ayoub ◽

Theodore King ◽

Shadab Uddin

Keyword(s):

Systematic Review ◽

Myofascial Pain ◽

Meta Analysis ◽

Trapezius Muscle ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

P Value ◽

Myofascial Trigger Points ◽

Kinesio Taping ◽

Upper Trapezius

Background: Myofascial Pain Syndrome is a condition causing pain at myofascial trigger points. Kinesio Taping has been widely used to decrease pain and improve range of motion. Objective: The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of therapeutic programs that include kinesio taping on reducing myofascial pain syndrome symptoms. Methods: Independent research was performed for legit studies using the following electronic databases: PubMed, CINAHL, MEDLINE, SPORT Discus, EM base, and Cochrane Central Register of Controlled Trials, from February 2017 to March 2017. The keywords were “keniso tape myofascial” AND “taping myofascial” AND “myofascial pain Syndrome” AND “myofascial trigger points.” The research resulted in 5,793 articles that eventually included 6 articles that had met the inclusion and exclusion criteria, and the data extracted data from the articles was about the pain severity, and was measured by Visual Analog Scale (VAS). Results: The collected data was pooled from the results of 256 subjects (199 females and 57 males). Using KT showed improvement but not significant statistically in three of the analyzed studies, and the remaining three studies showed a statistical significant reduction in VAS score. The overall P value that computed by the European Scientific Journal February 2018 edition Vol.14, No.6 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 337 Comprehensive Meta-Analysis 2.0 software was statistically significant (P value= 0.001) between the KT group and the control group. Conclusion: This systematic review and meta-analysis was performed on six studies in regarding to the efficacy of KT on the myofascial pain in the upper trapezius muscle. The meta-analysis suggests KT with other therapeutic protocols to treat myofascial pain syndrome and increase cervical range of motion as well as the functional activities.

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Faculty Opinions recommendation of Therapeutic effects of lidocaine patch on myofascial pain syndrome of the upper trapezius: a randomized, double-blind, placebo-controlled study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718173019.793487050 ◽

2013 ◽

Author(s):

Rajesh Gupta

Keyword(s):

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Controlled Study ◽

Therapeutic Effects ◽

Double Blind ◽

Double Blind Placebo ◽

Upper Trapezius ◽

Lidocaine Patch

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Focused Extracorporeal Shockwave Therapy in Physical Medicine and Rehabilitation

Current Physical Medicine and Rehabilitation Reports ◽

10.1007/s40141-020-00306-z ◽

2020 ◽

Author(s):

Richard Crevenna ◽

Michael Mickel ◽

Othmar Schuhfried ◽

Christina Gesslbauer ◽

Andrej Zdravkovic ◽

...

Keyword(s):

Pain Syndrome ◽

Surrounding Tissue ◽

Patellar Tendinopathy ◽

Physical Medicine ◽

Physical Treatment ◽

Extracorporeal Shockwave Therapy ◽

Non Union ◽

Extracorporeal Shockwave ◽

Shockwave Therapy ◽

Physical Medicine And Rehabilitation

Abstract Purpose of Review Focused extracorporeal shockwave therapy (fESWT) is a physical treatment modality developed over the last 25 years for musculoskeletal indications. It has many indications in the field of physical medicine and rehabilitation (PM&R) and is effective, time-efficient, and cost-efficient. This review focuses on basics and on clinical indications as well as on significant trends in fESWT. Recent Findings In PM&R, stimulation of healing processes in tendons, surrounding tissue, and bones via mechanotransduction seems to be a relevant biological effect. The International Society for Medical Shockwave Treatment (ISMST) describes different types of indications (such as approved standard indications—in accordance with most scientific evidence—like calcifying tendinopathy of the shoulder, plantar fasciitis lateral epicondylopathy of the elbow, greater trochanter pain syndrome, patellar tendinopathy, Achilles tendinopathy and bone non-union, common empirically tested clinical uses, exceptional or expert indications, and experimental indications). Summary fESWT is a relevant treatment option in PM&R and regenerative medicine. In recent years, historical paradigms (for example, application in cancer patients) have changed and new indications (such as nerve regeneration, myofascial trapezius syndrome, low back pain, dermatosclerosis, and lymphedema) are supported. Future translational research should focus on establishing actual exceptional indications and experimental indications for clinical routine.

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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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