Seeking the Cause of Myofascial Pain Syndrome by Identifying which Manual Therapy is Effective against Muscle Tenderness and Stiffness

Abstract

[Purpose] The purpose of this study was to identify which manual therapy technique was effective against muscle tenderness and stiffness of myofascial pain syndrome and then, based on the result, to determine the cause of myofascial pain syndrome. [Subjects] The subjects were 23 men and 67 women who had an average age of 65.5 ± 19.0 years. All subjects had normal results in imaging and neurological examinations but complained of chronic pain along with muscle tenderness and stiffness. [Methods] Using a muscle hardness meter, the muscle hardness of the tender, stiff muscles was measured before, immediately after, and 1 week after manual therapy. The subjects were divided into two groups according to the therapy given myotherapy/massage, to provide direct stimulus to the muscle, or joint facilitation/joint mobilization, to improve functional joint disorders. Statistical analysis was conducted using repeated measures ANOVA, and multiple comparisons were performed. [Results] A significant difference in muscle hardness was seen between pre-treatment and post-treatment. A significant difference in muscle hardness was seen between before and 1 week after manual therapy, but not between post-treatment and 1 week after. A significant difference was seen between the direct stimulus to muscle technique and the functional joint disorder technique. Post-treatment muscle hardness decreased more with direct muscle stimulus than with the functional joint disorder technique, and muscle stiffness was decreased even 1 week after treatment. [Conclusion] Manual therapy for muscle tenderness and stiffness of myofascial pain syndrome was effective at reducing muscle stiffness. Moreover, techniques that provide direct stimulus to the muscle are better at reducing voluntary muscle stiffness than techniques that improve functional joint disorders.