Immediate effect of ischaemic compression and trigger point pressure release on neck pain and upper trapezius trigger points: A randomised controlled trial

Abstract

Summary Objective The purpose of this study was to determine the immediate effect of ischaemic compression, trigger point pressure release and placebo ultrasound on pain, degree of cervical lateral flexion and pressure pain threshold of upper trapezius trigger points in subjects with non-specific neck pain. Design Randomised, single-blind, placebo-controlled trial. Setting Anglo-European College of Chiropractic (AECC) in Bournemouth, England. Subjects Forty-five subjects from the AECC student body between 18 and 55 years of age with non-specific neck pain of at least 30 mm on a visual analogue scale (VAS) for pain, an upper trapezius trigger point and decreased cervical lateral flexion to the opposite side of the active upper trapezius trigger point were entered into the study. Methods The subjects were randomly assigned to one of three treatment groups with 15 subjects in each group: trigger point pressure release, ischaemic compression or sham ultrasound (control group). Neck pain level was determined using a visual analogue scale, degree of lateral flexion was determined using a CROM goniometer and pain pressure thresholds were measured with a pain pressure algometer. All subjects attended one treatment session and outcome measures were repeated within five minutes after treatment. Results Clinical improvement was considered as a reduction of 20 mm or more on the visual analogue scale. Nine subjects in the ischaemic compression group improved after treatment compared to seven subjects in the trigger point pressure release group and four subjects in the control group. The number needed to treat for one patient to improve with ischaemic compression compared to trigger point pressure release was 7.5 (95% CI −4.53 to 2.05). The number needed to treat for one patient to improve with ischaemic compression compared to sham ultrasound was 2.5 (95% CI 1.39–12.51). The odds ratio for improvement with ischaemic compression compared to trigger point pressure release was 1.68 (95% CI 0.41–6.88). The odds ratio for improvement with ischaemic compression compared to sham ultrasound was 5.01 (95% CI 1.19–21.06). A one-way analysis of variance (ANOVA) indicated there was no statistically significant difference beyond chance in pain level, lateral flexion or pain threshold among the groups (P > 0.05). Conclusion Ischaemic compression is superior to sham ultrasound in immediately reducing pain in patients with non-specific neck pain and upper trapezius trigger points. Further research is needed to determine if there is a difference between ischaemic compression and trigger point pressure release.