Effect of Strumming Manipulation in Pain Parameters in Myofascial Pain Syndrome of the Para-scapular Region in Males of the Age Group of 20-30 Years
Authors: Suresh A M R , Muniyan Mohan Kumar , . Kalpana 
Published: September 2021

Background: Treatment of myofascial trigger points can be considered a promising approach for the treatment of patients with myofascial pain syndrome. It would be worthwhile to identify predictors/means of successful myofascial trigger point treatment and to investigate whether the treatment is more successful when used alone or combined such as electrotherapy, thermotherapy and manual therapy. Previous studies have examined the effect of single ischemic compression and a combination of ischemic compression and stretching and concluded that both interventions had positive effects on patients' recovery. However the effects of single component of deep tissue massage such as a brief strummimg manipulation in pain parameters is not understood completely in clinical decision making.
Objective: To study the effects of brief strumming manipulation in pain parameters in myofascial pain of the para-scapular region in males of the age group of 20-30 years.
Materials and Methods: Experimental study design with 25 male participants were recruited on the basis of inclusion and exclusion criteria for the study, active trigger point either over the rhomboid or levator scapulae was identified and marked as per diagnostic criteria described by Simon DG (1999 and 2002). Baseline readings for VAS and PPT were recorded on day one before the intervention and final readings were taken 10 minutes after the sixth session (3 days a week on alternate day basis for two weeks). Each treatment session of strumming manipulation was for 2 - 3 minutes followed by a rest period of 2 - 3 minutes and repeated 3 times (total duration of the session was for 12 - 15 minutes) followed by 10 - 15 minutes of Ice compression over the manipulated area. Subjects were instructed to continue ice compression at home 2 - 3 times a day for 10 - 15 minutes each session during the non-interventional days and not to carry out any unaccustomed work like lifting heavy things, straining activities of upper limb during study period. Data collected as pre and post intervention values are analysed statistically.
Result: The Pre-VAS mean of 6.88±0.78 and the Post-VAS mean of 2.44±1.29 and the paired t-test mean difference of 4.44±1.15 with t (24) =19.17 with pre and post statistical significance of p=0.000. The Pre-PPT mean of 2.79±1.13 and the Post-PPT mean of 4.98±1.22 and the paired t-test mean difference of -2.18±1.30 with t (24) = -8.39 with pre and post statistical significance of p=0.000.
Conclusion: Strumming manipulation followed by ice compression is efficacious in reducing pain and muscle tenderness in male patients with para-scapular region with active MTrPs. Its immediate and short-term effects established in this combination may serve as a prime treatment plan in the clinical setting to counteract pain and muscle tenderness due to active MTrPs.

Key words: myofascial pain syndrome; trigger points; manipulation; massage; visual analog pain scale; pain threshold.