[Manual trigger point therapy of shoulder pain : Randomized controlled study of effectiveness].
BACKGROUND
Although chronic shoulder pain is highly prevalent and myofascial trigger points (mTrP) are thought to be found in the majority of patients with shoulder complaints, the influence on the pain mechanism remains unclear. There are only very few controlled clinical studies on the effects of manual trigger point compression therapy.


OBJECTIVE
This randomized controlled trial (RCT) compared the short-term effects of manual trigger point compression therapy (n = 6) with manual sham therapy (n = 6) in patients with unilateral shoulder pain due to myofascial syndrome (MFS).


METHODS
The measurement data were collected before and after two sessions of therapy. Pressure pain thresholds (PPT) of mTrP and symmetrically located points on the asymptomatic side were measured together with neutral points in order to detect a potential unilateral or generalized hyperalgesia. Additionally, the pain was assessed on a visual analog scale (VAS) at rest and during movement and the neck disability index (NDI) and disabilities of the arm, shoulder and hand (DASH) questionnaires were also completed and evaluated.


RESULTS
Both treatment modalities led to a significant improvement; however, the manual trigger point compression therapy was significantly more effective in comparison to sham therapy, as measured by different parameters.


CONCLUSIONS
The significant improvement of PPT values in the interventional group even at sites that were not directly treated, indicates central mechanisms in pain threshold modulation induced by manual compression therapy. The weaker but still measurable effects of sham therapy might be explained by the sham modality being a hands on technique or by sufficient stimulation of the trigger point region during the diagnostics and PPT measurements.
Fakultät Wirtschafts- und Sozialwissenschaften (Abt. Physiotherapie und Rehabilitationswissenschaften), Hochschule Osnabrück, Caprivistr. 30, 49076, Osnabrück, Deutschland.
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Sohns
Fakultät Wirtschafts- und Sozialwissenschaften (Abt. Physiotherapie und Rehabilitationswissenschaften), Hochschule Osnabrück, Caprivistr. 30, 49076, Osnabrück, Deutschland.
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Schnieder
FORBs Facharztzentrum für Orthopädie und Rehabilitation des Bewegungssystems, Osnabrück, Deutschland.
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Licht
Fakultät Wirtschafts- und Sozialwissenschaften (Abt. Physiotherapie und Rehabilitationswissenschaften), Hochschule Osnabrück, Caprivistr. 30, 49076, Osnabrück, Deutschland. H.von-Piekartz@hs-osnabrueck.de.
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von Piekartz
D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold; D015990:Placebo Effect; D020069:Shoulder Pain / Q000175:diagnosis / Q000628:therapy*; D064746:Therapy, Soft Tissue / Q000379:methods*; D016896:Treatment Outcome
Chronic pain; Compression, ischemic; Myofascial pain syndromes; Pain threshold; Trigger points, myofascial