The effect of manual pressure release on myofascial trigger points in the upper trapezius muscle

Abstract

Introduction Sustained manual pressure has been advocated as an effective treatment for myofascial trigger points (MTrPs). 1 Hou C.R. Tsai L.C. Cheng K.F. Chung K.C. Hong C.Z. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of Physical and Medical Rehabilitation. 2002; 82: 1406-1414 Abstract Full Text Full Text PDF Scopus (221) Google Scholar , 2 Simons D.G. Understanding effective treatments of myofascial trigger points. Journal of Bodywork and Movement Therapies. 2002; 6: 81-88 Abstract Full Text PDF Scopus (131) Google Scholar , 3 Simons D.G. Travell J.G. Simons L.S. 2nd ed. Myofascial pain and dysfunction, the trigger point manual, the upper extremities. vol. 1. Williams and Wilkins, Baltimore, USA1999 Google Scholar This study aimed to investigate the effect of manual pressure release (MPR) on the pressure sensitivity of latent MTrPs in the upper trapezius muscle, using a novel pressure algometer. Design Randomised blinded clinical trial. Methods Participants: Thirty-seven subjects (mean age 23.1 years±3.2; M=12, F=23) were screened for the presence of latent MTrPs in the upper trapezius muscle (tender band that produced referred pain to the neck and/or head on manual pressure). Intervention: Subjects were randomly allocated into either treatment (MPR pressure sustained for 60 s) or control (sham myofascial release) group. Outcome Measures: The pressure pain threshold (PPT) was recorded pre- and post-intervention using a digital algometer, consisting of a capacitance sensor attached to the tip of the palpating thumb. Changes in pressure sensitivity were also measured during the application of MPR via a verbal analogue pain scale (0–10, 0=no pain, 10=severe pain). Results There was a significant increase in mean PPT following MPR (P<0.001), but not following the sham treatment. Pressure was monitored and maintained during the application of MPR, and a reduction in perceived pain and significant increase in tolerance to treatment pressure (P<0.001) appeared to be caused by a change in tissue sensitivity, rather than an unintentional reduction of pressure by the examiner. Conclusions The results suggest that MPR may be an effective therapy for MTrPs in the upper trapezius muscle. Sustained manual pressure has been advocated as an effective treatment for myofascial trigger points (MTrPs). 1 Hou C.R. Tsai L.C. Cheng K.F. Chung K.C. Hong C.Z. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of Physical and Medical Rehabilitation. 2002; 82: 1406-1414 Abstract Full Text Full Text PDF Scopus (221) Google Scholar , 2 Simons D.G. Understanding effective treatments of myofascial trigger points. Journal of Bodywork and Movement Therapies. 2002; 6: 81-88 Abstract Full Text PDF Scopus (131) Google Scholar , 3 Simons D.G. Travell J.G. Simons L.S. 2nd ed. Myofascial pain and dysfunction, the trigger point manual, the upper extremities. vol. 1. Williams and Wilkins, Baltimore, USA1999 Google Scholar This study aimed to investigate the effect of manual pressure release (MPR) on the pressure sensitivity of latent MTrPs in the upper trapezius muscle, using a novel pressure algometer. Randomised blinded clinical trial. Participants: Thirty-seven subjects (mean age 23.1 years±3.2; M=12, F=23) were screened for the presence of latent MTrPs in the upper trapezius muscle (tender band that produced referred pain to the neck and/or head on manual pressure). Intervention: Subjects were randomly allocated into either treatment (MPR pressure sustained for 60 s) or control (sham myofascial release) group. Outcome Measures: The pressure pain threshold (PPT) was recorded pre- and post-intervention using a digital algometer, consisting of a capacitance sensor attached to the tip of the palpating thumb. Changes in pressure sensitivity were also measured during the application of MPR via a verbal analogue pain scale (0–10, 0=no pain, 10=severe pain). There was a significant increase in mean PPT following MPR (P<0.001), but not following the sham treatment. Pressure was monitored and maintained during the application of MPR, and a reduction in perceived pain and significant increase in tolerance to treatment pressure (P<0.001) appeared to be caused by a change in tissue sensitivity, rather than an unintentional reduction of pressure by the examiner. The results suggest that MPR may be an effective therapy for MTrPs in the upper trapezius muscle.