Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity.
OBJECTIVE
To investigate the immediate effect of physical therapeutic modalities on myofascial pain in the upper trapezius muscle.


METHODS
Randomized controlled trial.


METHODS
Institutional practice.


METHODS
One hundred nineteen subjects with palpably active myofascial trigger points (MTrPs).


METHODS
Stage 1 evaluated the immediate effect of ischemic compression, including 2 treatment pressures (P1, pain threshold; P2, averaged pain threshold and tolerance) and 3 durations (T1, 30s; T2, 60s; T3, 90s). Stage 2 evaluated 6 therapeutics combinations, including groups B1 (hot pack plus active range of motion [ROM]), B2 (B1 plus ischemic compression), B3 (B2 plus transcutaneous electric nerve stimulation [TENS]), B4 (B1 plus stretch with spray), B5 (B4 plus TENS), and B6 (B1 plus interferential current and myofascial release).


METHODS
The indexes of changes in pain threshold (IThC), pain tolerance (IToC), visual analog scale (IVC), and ROM (IRC) were evaluated for treatment effect.


RESULTS
In stage 1, the IThC, IToC, IVC, and IRC were significantly improved in the groups P1T3, P2T2, and P2T3 compared with the P1T1 and P1T2 treatments (P<.05). In stage 2, groups B3, B5, and B6 showed significant improvement in IThC, ItoC, and IVC compared with the B1 group; groups B4, B5, and B6 showed significant improvement in IRC compared with group B1 (P<.05).


CONCLUSIONS
Ischemic compression therapy provides alternative treatments using either low pressure (pain threshold) and a long duration (90s) or high pressure (the average of pain threshold and pain tolerance) and short duration (30s) for immediate pain relief and MTrP sensitivity suppression. Results suggest that therapeutic combinations such as hot pack plus active ROM and stretch with spray, hot pack plus active ROM and stretch with spray as well as TENS, and hot pack plus active ROM and interferential current as well as myofascial release technique, are most effective for easing MTrP pain and increasing cervical ROM.
Hou
Chuen-Ru
CR
Institute of Biomedical Engineering, National Cheng Kung University, Taina, Taiwan. hcr@speech114.csie.ncku.edu.tw
Tsai
Li-Chen
LC
Cheng
Kuang-Feng
KF
Chung
Kao-Chi
KC
Hong
Chang-Zern
CZ
D000328:Adult; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000534:rehabilitation*; D009333:Neck; D017288:Pain Threshold; D026741:Physical Therapy Modalities; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome