Efficacy of Combination Therapies on Neck Pain & Muscle Tenderness in Patients With Upper Trapezius MTrPs
Condition: Myofascial Trigger Point Pain
MeSH terms: Myofascial Pain Syndromes; Myalgia; Neck Pain
Study type: Interventional

Summary: 
      Myofascial pain syndrome thought to be the main cause of neck pain and shoulder muscle
      tenderness in the working population is characterized by myofascial trigger points (MTrPs).
      This study aimed to examine the immediate and short-term effect of the combination of two
      therapeutic techniques for improving neck pain and muscle tenderness in patients with upper
      trapezius Myofascial Trigger points.
    

Detailed description: 
      Purpose: Myofascial pain syndrome, thought to be the main cause of neck pain and shoulder
      muscle tenderness in the working population, is characterized by myofascial trigger points
      (MTrPs). This study aimed to examine the immediate and short-term effect of the combination
      of two therapeutic techniques for improving neck pain and muscle tenderness in male patients
      with upper trapezius active MTrPs.

      Methods: This was a pretest-posttest single-blinded randomized controlled trial. Sixty male
      subjects with mechanical neck pain due to upper trapezius active MTrPs were recruited and
      randomly allocated into group A, which received muscle energy technique (MET) and ischemic
      compression technique (ICT)along with conventional intervention; group B, which received all
      the interventions of group A except ICT; and group C, which received conventional treatment
      only. Baseline (Pr), immediate post-intervention (Po), and 2-week follow-up (Fo) measurements
      were made for all variables. Pain intensity and pressure pain threshold (PPT)were assessed by
      a visual analog scale (VAS) and pressure threshold meter, respectively. All three groups
      received their defined intervention plans only. Repeated-measures analysis of variance was
      used to perform intra- inter-group analyses. Cohen's d test was used to assess the effect
      size of the applied interventions within the groups.
    

Intervention name(s): MET; ICT; Conventional Intervention
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The patient was in a supine position with the cervical spine in the opposite lateral flexion to the treating part so that the upper trapezius muscle fibers were in a lengthened position.19 The moderate isometric contraction (approximately 75% of maximal) of the upper trapezius muscles was elicited for a period of 5 seconds followed by 3 seconds of relaxation while reaching the new barrier. The technique was repeated four times in each session.; The patient lying in the supine position with the cervical spine in opposite lateral flexion to the treating part so that the upper trapezius muscle fibers were kept in a lengthened position.18,22 The physiotherapist applied gradually increasing pressure to the MTrPs until the subject perceived the first noticeable pain. At that moment, the pressure was maintained until the discomfort and/or pain eased by around 50% as perceived by the patient, at which time the pressure was increased until the discomfort appeared again. This process was maintained for 90 seconds.; Hot packs (75°C) for 20 minutes and active stretching exercises for the upper trapezius muscle (slow, 5 repetitions per session, 10-second hold and 10-second relaxation between two repetitions). Active stretching exercises were done by all the participants under the supervision of the physical therapist. This approach was standardized for all participants.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Neck pain; Upper trapezius muscle; Myofascial trigger points; Muscle tenderness; Pain pressure threshold