Blood Flow Within Active Myofascial Trigger Points Following Massage

Study Overview
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Brief Summary
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The physiological response at the myofascial trigger point (MTrP) to massage is not known, yet would provide important objective evidence for a treatment effect and clarify the resolution process of a MTrP.

Detailed Description
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The physiological response at the myofascial trigger point (MTrP) to massage is not known, yet would provide important objective evidence for a treatment effect and clarify the resolution process of a MTrP. The long-term goal is to understand how therapeutic intervention affects the physiology of the MTrP. The objective of the proposed research is to assess, in a placebo controlled trial, the effectiveness of trigger point release massage (also known as ischemic compression) on blood flow at an active MTrP. The central hypothesis is that the contraction nodule of an active MTrP is characterized by an ischemic state comprised of reduced blood flow and subsequent dysregulation in carbohydrate metabolism. The investigators hypothesize that trigger point release (TPR) can positively impact blood flow leading to a change in high energy carbohydrate tension. The present study has been formulated, in part, from a preliminary study conducted by the investigators, which supports reduced blood flow and physiological disruption at active MTrPs. The proposed research will provide a physiological basis for massage to corroborate subjective reports of reduced pain sensitivity, impart credibility to treatment techniques, and provide insight into a mechanism of action for healing the MTrP.

Official Title
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Blood Flow Within Active Myofascial Trigger Points Following Massage

Conditions
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Myofascial Pain, Tension-type Headache

Intervention / Treatment
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* Other: Trigger point release
* Other: Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Chronic or episodic tension-type headache active MTrP in upper trapezius age 21-49 BMI between 18.5-24.9 either gender any race or ethnicity Exclusion Criteria: No or latent MTrP in the upper trapezius migraine 4+/month cluster headache fibromyalgia neurological disease (e.g. Alzheimer's disease, Parkinson's disease, muscular dystrophy, multiple sclerosis) cardiovascular disease (e.g. prior heart attack or stroke) diabetes pregnancy a bleeding disorder (Self-report of hemophilia, known lack/deficiency of clotting factors, or presently °taking anti-coagulants (e.g. warfarin, Coumadin)) narcotic use currently receiving massage prior trigger point injection or needling therapies allergy to lidocaine-type anesthetics such as lidocaine and prilocaine

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 49 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Trigger point treatment<br>Trigger point release | Other: Trigger point release<br>* Trigger point therapy<br>|
| Sham Comparator: Ultrasound<br>Sham US at Trigger point | Other: Ultrasound<br>* sham ultrasound<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Blood Flow as measured by microdialysis |  | 1 hr pre intervention and 1 hr post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Glucose as measured by microdialysis |  | 1 hr pre intervention and 1 hr post intervention | 
| Change in Lactate as measured by microdialysis |  | 1 hr pre intervention and 1 hr post intervention | 
| Change in Pyruvate as measured by microdialysis |  | 1 hr pre intervention and 1 hr post intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Blood flow, Glucose, lactic acid