Comparison of Myofascial Release Technique and Instrument Assisted Soft Tissue Mobilization in Lumbar Region
Condition: Trigger Point Pain, Myofascial
MeSH terms: Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      Trigger point are hyper-irritable points, appear as nodules on palpation, discrete and focal
      spots in the taut band of skeletal muscles. Myofascial release technique and instrument
      assisted soft tissue mobilization both techniques are used to break the adhesions and
      mobilize the soft tissue, releasing the trigger points. The study will contribute in
      comparing the level of pain threshold perceived by males and females in our society.
      .Moreover, finding a noninvasive effective treatment that is non-exhaustive for the therapist
      and non-painful for the patient.
    

Detailed description: 
      Trigger points are hyper-irritable points, appear as nodules on palpation, discrete and focal
      spots in the taut band of skeletal muscles. Usually these points are sensitive to pressure,
      if direct compression is applied over them, that can evoke jump sign, tenderness and pain is
      produced locally but it is referred to surrounding areas. There are many types of trigger
      points on the basis of location, chronicity and tenderness. They are classified as central,
      satellite, diffuse, inactive,and active. The trigger points can be developed by repetitive
      overuse injuries or sustained loading like lifting heavy weight, carrying babies, bags,
      briefcase etc. It can also be manifested by poor posture or prolonged period of inactivity
      such as bed rest or sitting causing pain, reduced range of motion, muscle tightness. When
      there are number of trigger points in muscles causing micro-cramps resulting in myofascial
      pain syndrome. Trigger points are the areas of contracted muscles causing restriction of in
      blood flow within the tissues. She claimed that by applying sustained pressure over trigger
      points with thumbs, knuckles and elbow followed by stretching of the muscle produced much
      better results compared to trigger point injections. Myofascial trigger points in lumbar
      region play an important role in genesis of mechanical low back pain. The hyper-irritable
      spots usually present within the taut band of skeletal muscles which on compression can give
      rise to characteristics like; referred pain, autonomic phenomena like (sweating,
      vasoconstriction and pilomotor activity) and motor dysfunction. It is essential to inquire
      the gender differences in pain perception level because many diseases like migraine,
      rheumatoid arthritis, and low back pain are more common among females than males. Females not
      only report more pain but they also experience more intense pain in their body parts as
      compared to males. Factors like psychological and physiological contribute in difference in
      pain perception among females and male. A study suggests that females show greater perception
      towards pain threshold as compared to males.

      Myofascial release technique is usually considered as alternative of medicine therapy highly
      recommended to treat immobility of skeletal muscles and pain by improving blood circulation
      and oxygen in these muscles and is non-invasive method. Moreover, it produces stretch reflex
      in muscles. By applying sustained pressure for 30 seconds over the trigger points until the
      patient's pain intensity is decreased considerably. As this pressure applied would help to
      break the adhesive fibres connection within the muscle helping to push out the blood
      containing waste products and toxins because after 30 seconds fresh blood containing
      nutrients will flow and trigger points are released.

      Instrument assisted soft tissue mobilization (IASTM) is also a professional practice to treat
      soft tissues. Moreover, IASTM mainly decreases pain sensitivity and pain threshold of
      myofascial trigger points. It is applied by using the instrument made up of stainless steel
      with edges and contours according to different body locations allowing deeper penetration
      treating soft tissue disorders. Instrument assisted soft tissue mobilization is master
      intervention using specialized tool to manipulate the skin , muscles, myofascial, tendons by
      various direct compressive strokes. IASTM technique is very effective as it effectively break
      the restrictions in fascia and scar tissue. Adhesions may developed within the soft tissue
      after surgery, immobilization, strain, are broken down by using this instrument allowing full
      restoration of function.

      The tool I am using in my study for instrument assisted soft tissue mobilization technique is
      M2T Blade technique is a multifunctional instrument invented by Adam Broger consisting of
      many planes and is very effective in treating pain and spasm. M2T Blade is a new invention
      and it is beneficial in reducing myofascial pain. Its efficacy is proven over soft tissues
      that it releases fascial tightness. Moreover it also improves range of motion of a joint.
      Highly loaded blades are designed to provide a specific distribution is given. The
      three-dimensional analysis methodology is used here.
    

Intervention name(s): Myofascial Release Technique; Instrument Assisted Soft tissue Mobilization
Intervention type(s): Other; Other
Intervention description(s): Myofascial Release Technique will be applied with forearm/ ulnar border of palm. Deep pressure will be applied and glided medially towards the thoraco-lumbar region.; instrument assisted soft tissue mobilization is done via M2T Blade. it is a multifunctional instrument consisting of many planes and is very effective in treating pain and spasm. Its efficacy is proven over soft tissues that it releases fascial tightness.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: trigger point,; myofascial release; instrument assisted soft tissue mobilization; range of motion; pain