Abstract
ObjectivesTo investigate the effects of topical agents for the treatment of Myofascial Pain Syndrome (MPS) and Myofascial Trigger Point (MTRP).MethodsSubjects with an identifiable trigger point in the trapezius muscle, age 18-80 were recruited for a single-session randomized, placebo-blinded clinical study. Baseline measurements of trapezius muscle pressure pain threshold (PPT: by pressure algometer) along with right and left cervical lateral flexion (rangiometer) were obtained by a blinded examiner. An assessor blinded to the outcomes assessments applied one of 6 topical formulations which had been placed in identical plastic containers. Five of these topicals were proposed active formulations; the control group was given a non-active formulation (PLA). Five minutes after the application of the formula the outcome measures were re-tested. Data were analyzed with a 5-way ANOVA and Holms-adjusted t-tests with an alpha level of 0.05.Results120 subjects were entered into the study (63 females; ages 16-82); 20 subjects randomly allocated into each group. The pre- and post-treatment results for pressure threshold did show significant intra-group increases for the Ben-Gay Ultra Strength Muscle Pain Ointment (BG), the Professional Therapy MuscleCare Roll-on (PTMC roll-on) and Motion Medicine Cream (MM) with an increased threshold of 0.5 kg/cm2 (+/-0.15), 0.72 kg/cm2 (+/-0.17) and 0.47 Kg/cm2 (+/-0.19) respectively. With respect to the inter-group comparisons, PTMC roll-on showed significant increases in pressure threshold compared with Placebo (PLA) (p = 0.002) and Icy Hot Extra Strength Cream (IH) (p = 0.006). In addition, BG demonstrated significant increases in pressure threshold compared with PLA (p = 0.0003).ConclusionsWith regards to pressure threshold, PTMC roll-on, BG and MM showed significant increases in pain threshold tolerance after a short-term application on a trigger points located in the trapezius muscle. PTMC roll-on and BG were both shown to be superior vs placebo while PTMC was also shown to be superior to IH in patients with trigger points located in the trapezius muscle on a single application.CMCC Research Ethics Board Approval # 1012X01, 2011
Highlights
Myofascial Pain Syndrome (MPS) is exceedingly common in Western society [1,2,3]
Significant intra-group increases for BG, PTMC roll-on and Medicine Cream (MM) cream were obtained with an increased threshold of 0.5 kg/cm2 (+/-0.15), 0.72 kg/cm2 (+/-0.17) and 0.47 Kg/cm2 (+/-0.19) respectively
This study investigated the immediate effect of six different topical analgesic creams on pressure pain threshold at a single trapezius Myofascial Trigger Point (MTrP) and on bilateral cervical lateral flexions
Summary
Myofascial Pain Syndrome (MPS) is exceedingly common in Western society [1,2,3]. Vernon and Schneider note that MPS is thought to be the leading diagnosis among pain management specialists [4,5] and the leading diagnosis in pain patients reporting to general latent (not clinically active, but tender on manual palpation) [7,8,9]. Several systematic reviews have recently been published on a variety of treatments [4,10,11,12,13,14], including pharmacologic agents, physical agents, complementary and alternative therapies. One commonly used therapy is the application of topical agents to relieve pain [15,16,17]. These agents can be classified as pharmacologic or non-pharmacologic. Non-pharmacologic agents generally fall into the complementary and alternative medicine (CAM) category for MPS and MTrP treatments. They may contain putative analgesic agents or counterirritant agents and they may exert cold, hot or neutral effects
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