Comparison of high-power pain threshold ultrasound therapy with local injection in the treatment of active myofascial trigger points of the upper trapezius muscle.
ABSTRACT To compare the effects of high-power pain threshold ultrasound (HPPTUS) therapy and local anesthetic injection on pain and active cervical lateral bending in patients with active myofascial trigger points (MTrPs) of the upper trapezius muscle.
Randomized single-blinded controlled trial.
Physical medicine and rehabilitation department of university hospital.
Subjects (N=49) who had active MTrPs of the upper trapezius muscle.
HPPTUS or trigger point injection (TrP).
Visual analog scale, range of motion (ROM) of the cervical spine, and total length of treatments.
All patients in both groups improved significantly in terms of pain and ROM, but there was no statistically significant difference between groups. Mean numbers of therapy sessions were 1 and 1.5 in the local injection and HPPTUS groups, respectively.
We failed to show differences between the HPPTUS technique and TrP injection in the treatment of active MTrPs of the upper trapezius muscle. The HPPTUS technique can be used as an effective alternative to TrP injection in the treatment of myofascial pain syndrome.
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ABSTRACT: OBJECTIVE: The purpose of this study was to investigate effects of different manual techniques on cervical ranges of motion and pressure pain sensitivity in subjects with latent trigger point of the upper trapezius muscle. METHODS: One hundred seventeen volunteers, with a unilateral latent trigger point on upper trapezius due to computer work, were randomly divided into 5 groups: ischemic compression (IC) group (n = 24); passive stretching group (n = 23); muscle energy technique group (n = 23); and 2 control groups, wait-and-see group (n = 25) and placebo group (n = 22). Cervical spine range of movement was measured using a cervical range of motion instrument as well as pressure pain sensitivity by means of an algometer and a visual analog scale. Outcomes were assessed pretreatment, immediately, and 24 hours after the intervention and 1 week later by a blind researcher. A 4 × 5 mixed repeated-measures analysis of variance was used to examine the effects of the intervention and Cohen d coefficient was used. RESULTS: A group-by-time interaction was detected in all variables (P < .01), except contralateral rotation. The immediate effect sizes of the contralateral flexion, ipsilateral rotation, and pressure pain threshold were large for 3 experimental groups. Nevertheless, after 24 hours and 1 week, only IC group maintained the effect size. CONCLUSIONS: Manual techniques on upper trapezius with latent trigger point seemed to improve the cervical range of motion and the pressure pain sensitivity. These effects persist after 1 week in the IC group.Journal of manipulative and physiological therapeutics 06/2013; · 1.06 Impact Factor
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ABSTRACT: Myofascial trigger points (MTrPs) are considered the principal clinical feature of myofascial pain syndrome (MPS). An MTrP consists of spot tenderness within a taut band of muscle fibers and its stimulation can produce both local and referred pain. The clinical diagnosis of MPS depends on correct history taking and a physical examination aimed at identifying the presence of MTrP. The purpose of this study was to investigate the intra-rater reliability of a palpation protocol used for locating an MTrP in the upper trapezius muscle. Twenty-four subjects with MTrP in the upper trapezius muscle were examined by an experienced physiotherapist. During each of eight experimental sessions, subjects were examined twice in randomized order using a palpation protocol. An anatomical landmark system was defined and the MTrP location established using X and Y values. The intraclass correlation coefficient ICC(1,1) values were 0.62 (95% CI: 0.30-0.81) for X and 0.81 (95% CI: 0.61-0.91) for Y. The Bland-Altman plots for X and Y showed a mean of difference of 0.04 and -0.2 mm, respectively. Limits of agreement for X ranged from -26.3 to 26.2 mm and for Y from -27 to 26.4 mm. The ICC(1,1) for the observed values revealed a moderate to high correlation and the Bland-Altman analysis showed means of difference very close to zero with narrow limits of agreement. An experienced physiotherapist can reliably identify MTrP locations in upper trapezius muscle using a palpation protocol.The Journal of manual & manipulative therapy 11/2012; 20(4):171-7.