Which Type of Transcutaneous Electrical Nerve Stimulation is More Effective in Myofascial Pain Syndrome?

Study Overview
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Brief Summary
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The aim of this project is to compare the effects of conventional, burst and modulated TENS primarily on pain level, number of trigger points, pressure pain threshold, neck joint range of motion and disability in MAS treatment.

Detailed Description
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Myofascial pain syndrome (MAS) is a regional pain syndrome characterized by trigger points detected by one or several muscle groups and reflected pain manifestation caused by palpation of these points. Transcutaneous electrical nerve stimulation (TENS) is a physical therapy modality that provides an analgesic effect by delivering a controlled low voltage electrical current to the nervous system through electrodes placed on the skin. Knowledge on how modulation parameters such as frequency, wave width and form alter TENS activity are limited.

Official Title
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Which Type of Transcutaneous Electrical Nerve Stimulation is More Effective in Myofascial Pain Syndrome? A Randomized Controlled Trial

Conditions
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Myofascial Pain Syndromes

Intervention / Treatment
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* Device: Transcutaneous electrical nerve stimulation
* Device: Hot pack


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having a diagnosis of myofascial pain syndrome according to the criteria defined by Travell and Simons Exclusion Criteria: The onset of symptoms is less than 3 months Severe cervical disc hernia, radiculopathy or myelopathy Stage 3-4 cervical degeneration Tumoral, infectious, psychiatric, neurological, uncontrolled systemic disease Cardiac pacemaker Diagnosed with fibromyalgia syndrome Kyphoscoliosis Acute trauma history Having had previous brain or shoulder surgery Injections for MAS and / or physiotherapy programs in the last 3 months Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Conventional TENS<br>Frequency:80 Hz, duration:100 μs | Device: Transcutaneous electrical nerve stimulation<br>* All groups were administered hotpack for 20 minutes, different types of TENS therapy for 20 minutes, 5 days a week, total of 15 sessions.<br>* Other names: TENS;Device: Hot pack<br>* All groups were administered hotpack for 20 minutes, different types of TENS therapy for 20 minutes, 5 days a week, total of 15 sessions.<br>|
| Active Comparator: Burst TENS<br>Frequency:100 Hz, fr mod: 0, 200 µs, 2 Bps Hz | Device: Transcutaneous electrical nerve stimulation<br>* All groups were administered hotpack for 20 minutes, different types of TENS therapy for 20 minutes, 5 days a week, total of 15 sessions.<br>* Other names: TENS;Device: Hot pack<br>* All groups were administered hotpack for 20 minutes, different types of TENS therapy for 20 minutes, 5 days a week, total of 15 sessions.<br>|
| Active Comparator: Modulated TENS<br>Frequency:80 Hz, fr mod: 50%, Amplitude mode: 40%, duration: 200 µs | Device: Transcutaneous electrical nerve stimulation<br>* All groups were administered hotpack for 20 minutes, different types of TENS therapy for 20 minutes, 5 days a week, total of 15 sessions.<br>* Other names: TENS;Device: Hot pack<br>* All groups were administered hotpack for 20 minutes, different types of TENS therapy for 20 minutes, 5 days a week, total of 15 sessions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | using Visual Analog Scale score; (0-10); 0 indicates no pain and 10 indicates worst imaginable pain | Measurements will be made before treatment, at the 1st week after treatment and at the 1st month after treatment. | 
| Number of trigger points in the upper back region | using number | Measurements will be made before treatment, at the 1st week after treatment and at the 1st month after treatment. | 
| Pressure pain | using algometer (kg/cm2) | Measurements will be made before treatment, at the 1st week after treatment and at the 1st month after treatment. | 
| Neck joint range of motion | using double inclinometer | Measurements will be made before treatment, at the 1st week after treatment and at the 1st month after treatment. | 
| Disability | using Modified Neck Disability Index | Measurements will be made before treatment, at the 1st week after treatment and at the 1st month after treatment. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Myofascial Pain Syndromes, Transcutaneous Electrical Nerve Stimulation