Active Myofascial Trigger Points Research Articles

Effects of Dry Needling on Active Myofascial Trigger Points and Pain Intensity in Tension-Type Headache: A Randomized Controlled Study.

Tension-type headache is the most prevalent type of headache and is commonly associated with myofascial pain syndrome and the presence of active myofascial trigger points. This randomized controlled trial aimed to assess the impact of dry needling on the total number of active trigger points, pain intensity, and perceived clinical change in tension-type headache subjects. Thirty-two subjects were randomly assigned to the control and dry needling groups. The presence of active trigger points in 15 head and neck muscles, the headache intensity, and the perceived clinical change were evaluated. A single dry needling technique was administered at each active trigger point across three sessions. Significant differences were observed in the post-treatment measures favouring the dry needling group, including reductions in the headache intensity scores (p = 0.034) and the total number of active trigger points (p = 0.039). Moreover, significant differences in the perception of clinical change were found between the control and treatment groups (p = 0.000). Dry needling demonstrated positive effects in reducing the number of active trigger points and improving the short-term headache intensity in tension-type headache patients. A single dry needling session applied in the cranio-cervical area resulted in a self-perceived improvement compared to the control subjects.

Efficacy of capacitive-resistive therapy on the treatment of myofascial pain – A randomized control trial

BackgroundMyofascial pain syndrome is a painful musculoskeletal condition with muscle spasm, referred pain, stiffness, restricted range of motion. Capacitive-resistive diathermy heats deep tissues by transferring energy through radiofrequency waves. Although this modality is used to treat various musculoskeletal disorders, there is no specific data on myofascial trigger points. Thus, we aimed to evaluate the effectiveness of capacitive-resistive diathermy on the myofascial trigger points. MethodsThirty-six volunteers with active myofascial trigger points were included. Patients were randomly and equally allocated into two groups. Group-1 is the capacitive-resistive diathermy treatment group; Group-2 is the placebo capacitive-resistive diathermy (PG). Visual analog scale (VAS), pain pressure threshold (PPT), neck disability index (NDI), neck range of motion (nROM), Short form-36 (SF-36) were used as outcomes before and after the intervention. ResultsIn both groups, VAS, PPT, NDI score significantly improved within the groups (p < 0.05). The CRG showed a statistically significant improvement in nROM for flexion, extension, and rotation (p < 0.05). However, ROM increase in CRG is not superior to PG (p > 0.05). ConclusionsThere was no significant difference between the two groups. We thought positive results in the PG might attributed to doing exercise. As a result, capacitive-resistive diathermy is not superior to exercise, but can be used as an adjuvant modality in myofascial trigger points treatment.

Identification of Myofascial Trigger Point Using the Combination of Texture Analysis in B-Mode Ultrasound with Machine Learning Classifiers.

Myofascial pain syndrome is a chronic pain disorder characterized by myofascial trigger points (MTrPs). Quantitative ultrasound (US) techniques can be used to discriminate MTrPs from healthy muscle. In this study, 90 B-mode US images of upper trapezius muscles were collected from 63 participants (left and/or right side(s)). Four texture feature approaches (individually and a combination of them) were employed that focused on identifying spots, and edges were used to explore the discrimination between the three groups: active MTrPs (n = 30), latent MTrPs (n = 30), and healthy muscle (n = 30). Machine learning (ML) and one-way analysis of variance were used to investigate the discrimination ability of the different approaches. Statistically significant results were seen in almost all examined features for each texture feature approach, but, in contrast, ML techniques struggled to produce robust discrimination. The ML techniques showed that two texture features (i.e., correlation and mean) within the combination of texture features were most important in classifying the three groups. This discrepancy between traditional statistical analysis and ML techniques prompts the need for further investigation of texture-based approaches in US for the discrimination of MTrPs.

Preclinical efficacy of TZG in myofascial pain syndrome by impairing PI3K-RAC2 signaling-mediated neutrophil extracellular traps

Tianhe Zhuifeng Gao (TZG) shows a satisfying therapeutic efficacy in treating arthromyodynia, which shares similar etiology to myofascial pain syndrome (MPS). We herein aim to explore whether TZG could be a potential prescription for MPS therapy. An MPS rat model was successfully established presenting with reduced pain thresholds, abnormal local switch responses, etc., which was effectively reversed by TZG treatment externally. A transcriptome sequencing based on the active MTrPs samples of rats, combined with network analysis revealed that TZG might ameliorate the progression of MPS by impairing neutrophil extracellular traps (NETs) release through inhibiting PI3K-RAC2 signaling to reduce NADPH oxidase-originated ROS. Experimentally, the expression levels of inducers, biomarkers of NETs formation and vessel injury, and p-PI3K, p-P47, and RAC2 proteins were all significantly up-regulated in affected tissues, which were markedly reversed by TZG. Our results not only shed light into broadening the clinical indications of TZG, but benefit MPS therapy.

Effectiveness of Dry Needling versus Manual Therapy in Myofascial Temporomandibular Disorders: A Single-Blind Randomized Controlled Trial.

Dry needling (DN) is an invasive physiotherapy technique employed for reducing myofascial pain. To compare the effectiveness of dry needling (DN) versus manual therapy (MT) in improving pain, active maximal mouth opening (AMMO) and cervical disability in patients with myofascial pain from temporomandibular disorders (TMDs) were investigated against these treatments. A single-blind, randomized controlled trial was carried out. Individuals (n = 50) with TMDs were randomly allocated in a 1:1 ratio to the DN (n = 25) or MT group (n = 25). Each group received three sessions, separated by 4 days, of either DN or MT. Outcomes were assessed according to pain intensity (Numeric Pain Rating Scale), AMMO (cm), disability (Neck Disability Index), and pressure-pain threshold (PPT) (digital algometry) from the active myofascial trigger points. In both groups, pain and neck disability were significantly lower at the end of treatment compared with those measured at baseline (pain: -2.52 with 95% CI: -3.43 to -1.60 for DN group; pain: -2.92 with 95% CI: -3.77 to -2.07 for MT group; disability: -3.2 with 95% CI: -4.31 to -2.09 for DN group; disability: -2.68 with 95% CI: -3.56 to -1.79 for MT group), but not were not lower after the first session, without differences between the groups. AMMO was significantly higher after the first session (0.16 with 95% CI: 0.03 to 0.29 for DN group; 0.30 with 95% CI: 0.20 to 0.41 for MT group) and at the end of treatment in both groups (0.27 with 95% CI: 0.14 to 0.41 for DN group; 0.37 with 95% CI: 0.22 to 0.52 for MT group) compared with the baseline measurements. Finally, PPT results for the masseter and pterygoid muscles were significantly higher at the end of treatment in both groups (without statistically significant differences between groups), but not after the first session. The assessed therapies, DN and MT, are equally effective in improving pain, AMMO, cervical disability, and PPT in the muscles directly involved in the temporomandibular joint biomechanics of patients with myofascial TMDs.

Immediate effect of stretched myofascial dry needling on the myofascial trigger point in the upper trapezius muscle: a case report

Background/Aims A myofascial trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle, that is painful on compression and can cause motor dysfunction. The authors present a case report of a 21-year-old woman with myofascial trigger points in the upper trapezius muscle who reported a pre-assessment pain score of 7 on the visual analogue scale, a pressure pain threshold of 1.32 kg/cm2 and a reduction in all cervical ranges of motion. To provide more immediate results in comparison to traditional dry needling, the upper trapezius muscle was kept in a stretched position and then dry needling was performed. Methods With the patient lying in the prone position, the therapist stretched the right upper trapezius muscle. Fast in-and-out movements of dry needling were performed to target multiple active myofascial trigger points until the first visible local twitch response occurred. Results Immediately after the procedure, the patient's pain level reduced to a score of 3 on the visual analogue scale, the patient's pressure pain threshold increased to 3.07 kg/cm2, and cervical ranges of motions increased between 10 and 20°. Conclusions Stretched myofascial dry needling is effective to treat symptoms immediately related to myofascial trigger points in the upper trapezius muscle, although further research is needed.

The immediate effects of deep transverse friction massage, high- power pain threshold ultrasound and whole body vibration on active myofascial trigger points

BackgroundThe most important clinical problem in myofascial pain syndrome (MPS) is trigger points (TrPs). The aim of the present study was to investigate the comparison of immediate effect of deep transverse friction massage (DTFM), high-power pain threshold ultrasound (HPPTUS), and whole body vibration (WBV) on treatment of active myofascial trigger points (MTrPs).Materials and Methods: sixty six men with active TrPs of upper trapezius muscle were randomly divided into three equal groups: DTFM, HPPT US, and WBV. Pain intensity based on the Visual Analogue Scale (VAS), pressure pain threshold (PPT) and active contralateral lateral flexion range of motion (CLF ROM) of the neck were evaluated before and immediately after the interventions. ResultsThe VAS, PPT and the active CLF ROM were substantially improved after intervention in all groups (P < 0.01). When the three groups were compared regarding VAS, participants in the WBV group reported significantly more reduction in pain (P < 0.01). On comparing the interventions, there were no significant differences in PPT values (P > 0.05). The CLF ROM value in HPPTUS and WBV groups have significant increase in comparison to the DTFM group. ConclusionAll three interventions can improve neck pain, PPT and ROM in participants with active TrPs in upper trapezius muscle, but due to the fact that the DTFM has more pressure on therapist fingers, and the HPPTUS technique requires proper interaction with the participants, WBV can be used as one of the effective intervention on active MTrPs of upper trapezius. Clinical trial registration numberIRCT20200518047498N1.

Comparison of Immediate Effect of High-power Pain Threshold Ultrasound and Deep Transverse Friction Massage on Active Myofascial Trigger Points

Introduction: The study was conducted to compare the immediate effect of high-power pain threshold ultrasound (HPPTUS) and deep transverse friction massage (DTFM) as a traditional technique on the treatment of upper trapezius active myofascial trigger points in male patients with mechanical neck pain.&#x0D; Materials and Methods: In this parallel single-blind randomized clinical trial study, 60 men with mechanical neck pain (mean age: 30.57±6.19 years) who met the inclusion and exclusion criteria were randomly assigned to HPPTUS and DTFM as the control group. A visual analog scale (VAS), pain pressure threshold (PPT), and range of motion (ROM) of cervical lateral flexion (CLF) were assessed before and after treatment.&#x0D; Results: Analysis of pre- and post-treatment findings showed that the VAS (P&lt;0.01), PPT (P&lt;0.01), and ROM of CLF (P&lt;0.01) improved significantly in both groups while ROM of CLF increased significantly more in the HPPTUS group. An indirect correlation was found between the pre-treatment ROM of CLF and ROM of CLF improvement in both groups. A significant indirect correlation was observed between pre-treatment VAS and ROM of CLF improvement in the HPPTUS group. In the DTFM group a significant indirect correlation was found between pre-treatment ROM of CLF and VAS improvement.&#x0D; Conclusion: The results showed that HPPTUS can be used as an effective treatment for active trigger points (TP). It seems that this method is more effective than deep transverse friction massage.&#x0D;

Efficacy of Deep Dry Needling versus Percutaneous Electrolysis in Ultrasound-Guided Treatment of Active Myofascial Trigger Points of the Levator Scapulae in Short-Term: A Randomized Controlled Trial.

Deep dry needling (DDN) and percutaneous electrolysis (PE) provide the benefit of the mechanical effect of the needle, and PE adds the potential advantages of the galvanic current it incorporates in myofascial trigger points (MTrPs) therapy. The aim of this study was to compare the short-term efficacy between PE and DDN on active MTrPs of the levator scapulae by considering pain intensity. A simple-blind randomized controlled trial was carried out, recruiting patients suffering from non-specific neck pain lasting more than 3 months and with active MTrPs in the levator scapulae muscle (n = 52). Patients were divided into intervention (PE; n = 26) and control (DDN; n = 26) groups and received one treatment session on the active MTrPs of the levator scapulae. Patients were assessed for pain intensity, pressure pain threshold (PPT), cervical range of motion (CROM), neck disability and post-needling soreness, immediately after treatment, at 72 h and at 14 days. In addition, pain during treatment was recorded after the procedure. There were no significant differences for pain intensity, post-needling soreness and PPT. We found significant differences in CROM, immediately after treatment (p = 0.043), and at 72 h (p = 0.045), in favor of the PE group. Significant differences were found for neck disability (p < 0.047), immediately post-treatment, in favor of the DDN group. Moreover, there were significant differences for pain during the intervention (p < 0.002), in favor of the DDN group (4.54 ± 2.21) versus the PE group (6.54 ± 2.27). PE and DDN appear to have similar short-term effects. PE proved to be a more painful treatment than DDN. Clinical trial registry: NCT04157426.

Dry needling on latent and active myofascial trigger points versus oral diclofenac in patients with knee osteoarthritis: a randomized controlled trial

BackgroundLatent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA.MethodsThis randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-month follow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up.ResultsA total of 42 patients in the dry needling group (DNG) and 35 patients in the diclofenac group (DG), respectively, completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed a significantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG.ConclusionsDry needling on latent and active MTrPs combined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretching for at least 6 months.Trial registrationRegistered in the Chinese Clinical Trial Registry (www.chictr.org.cn) in 17/11/2017 with the following code: ChiCTR-INR-17013432.

Comparison of the effectiveness between dry needling with and without needle retention in myofascial trigger points in upper trapezius muscle: A randomized comparative trial

Dry needling (DN) is commonly used to treat myofascial trigger points (MTrPs). To compare the effect between DN with and without needle retention in the treatment of MTrPs in the upper trapezius muscle. Fifty-four patients who had active MTrPs in the upper trapezius muscle were randomly allocated into the DN group or the DN with retention group. The DN group received DN only, while the DN with retention group received DN with needle retention for 30 minutes. The visual analogue scale (VAS) and pressure pain threshold (PPT) were recorded both before and after 7 and 14 days of the treatment sessions. Both groups showed a significant decrease of the VAS at 7 and 14 days (mean difference DN group -53.0, DN with retention group -57.0, p< 0.001). The PPT was also significantly improved in both groups (mean difference DN group 109.8 kPa, DN with retention group 132.3 kPa, p< 0.001). However, there were no significant differences in the VAS or PPT between the groups. Both DN and DN with retention had significant improvement of pain intensity in the treatment of MTrPs in the upper trapezius muscle at 14 days. However, pain reduction was not significantly different between the interventions.

Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study.

There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p &lt; 0.01) between the groups, for the Physical Health domain and the total score of the SF-12 questionnaire, and for all the domains of the McGill questionnaire; but no significant differences were found in the data from the WPAI-GH questionnaire. Statistically significant data (p &lt; 0.01) were found for mechanosensitivity in the abdominal area and limbs, but not for the lumbar assessment, within the group, with very few significant intergroup differences. The frequency of active MTrPs is higher in the groups of women with primary dysmenorrhea and during the menstrual phase, with the prevalence of myofascial trigger points of the iliococcygeus muscle being especially high in all examination groups (&gt;50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea.

Efficacy of Extracorporeal Shock Wave Therapy on Active Trigger Point in the Upper Trapezius Muscle

Introduction: To demonstrate the effectiveness of extracorporeal shock wave therapy (ESWT) in treating active trigger points to relieve pain and increase range of motion (ROM) and improve the function of the cervical region in fewer sessions.&#x0D; Materials and Methods: In this single-group, pretest-posttest study, 15 participants with active myofascial trigger points (MTrPs) in the upper trapezius muscle took part. Before and after each treatment, visual analog scale (VAS), pressure pain threshold (PPT), neck disability index (NDI) questionnaire, and range of active contra lateral flexion (CLF) were assessed. Participants were given three treatments over a week, with at least a two- day break between them, and then all outcomes were evaluated.&#x0D; Results: The general results of this study demonstrate a significant reduction in pain perception in terms of VAS (P=0.0001), increased pressure pain threshold (P=0.0001), increased CLF of ROM (P=0.0001), and improved neck function by reduction of NDI (P=0.0001), after the third session of ESWT intervention in participants with MTrP in the upper trapezius muscle.&#x0D; Conclusion: It reveals that ESWT has positive effects on pain reduction, cervical range of motion, and cervical function in participants treated with MTrPs in the upper trapezius muscle.

Comparison of immediate and delayed effects of superficial and deep dry needling in patients with upper trapezius myofascial trigger points

BackgroundDry needling is one of the most common treatments for this condition. In this study the immediate and delayed effects of superficial dry needling (SDN) and deep dry needling (DDN) on upper trapezius muscle function and patients' pain and disability was evaluated. MethodsIn this quasi-experimental study, 47 women with active MTrPs were randomly divided into SDN and DDN groups and received one session treatment. Pain and disability were assessed before and one week after intervention with visual analogue scale (VAS) and neck disability index (NDI) questionnaire. Muscle activity was assessed by surface electromyography (sEMG) before, immediately and one week after intervention. ResultsBoth groups showed significant decrease in VAS (p < 0.001) and NDI (p < 0.001) after one week, however no significant difference were found between the groups (p > 0.05). A significant increase in sEMG activity was observed only in DDN group after one week (p < 0.007), but there were no significant differences in sEMG activity in SDN group after intervention and between the two groups (p > 0.05). ConclusionBoth SDN and DDN could be effective in reducing pain and disability in patients with active MTrPs of upper trapezius muscle. Regarding muscle function DDN seems to be more effective. So that based on evaluation of the therapist in some cases with not significant muscle dysfunction SDN as a gentle and less invasive method could be used but for long term effectiveness and in those with significant muscle dysfunction DDN could be used.

Effectiveness of polarized polychromatic light therapy on myofascial trigger points in chronic non-specific low back pain: a single blinded randomized controlled trial

BackgroundPhototherapy has been used for the treatment of chronic low back pain. However, the effect of linear polarized polychromatic light (PL) has not been examined on myofascial trigger points in patients with chronic non-specific low back pain (NSLBP).ObjectivesTo investigate the effectiveness of PL on pain intensity, pain sensitivity of active myofascial trigger points (MTrPs) in gluteus medius (GM) and quadratus lamborum (QL) muscles, back disability, and lumbar range of motion in chronic NSLBP.MethodsForty-two participants of both genders with chronic NSLBP were randomly allocated into two equal groups: group A (Linear polarized polychromatic light (PL): 21 participants received polarized light therapy in the range of red and near-infrared rays on myofascial trigger points of bilateral GM and QL muscles for 5 min/point followed by stretching and strengthening exercises for 4 weeks. Group B (Sham PL): 21 participants received the same program but with sham linear polarized polychromatic light therapy. Numeric pain rating scale, pressure algometer, and Roland-Morris Disability Questionnaire were used to measure pain intensity, pain sensitivity (as represented by pain pressure threshold (PPT) of MTrPs of the target muscles and back disability respectively. Further, lumbar flexion, extension, and bilateral rotation were examined with a tape measure, while bilateral side bending were examined with a universal goniometer.ResultsAfter the intervention program, significant improvements (p < 0.05) in pain intensity, PPT of MTrPs of left GM (Effect Size (ES): 1.23) and bilateral QL muscles (ES Rt QL: 0.9; Lt QL: 1.56) were found in group A in comparison with group B. Nevertheless, the two groups displayed similar improvements (p > 0.05) in lumbar range of motion and back disability.ConclusionLinear polarized polychromatic light therapy in the range of red and near-infrared rays improves pain intensity and pain sensitivity of myofascial trigger points in chronic NSLBP.Trial registrationPACTR, PACTR202111577053926. Registered 22 June 2019-Prospectively registered.

Preparatory Brain Activity and Anticipatory Postural Control in Cervical Myofascial Trigger Point

Introduction: Neck pain is a highly prevalent disorder in developed countries. A myofascial trigger point (MTrP) is distinguished under the name of the fundamental excessive menstruation for it and certain reason for musculoskeletal dysfunction. MTrP refers to a sensitive spot in a taut band whose stretch and compression can induce pain. Modifications in the motor cortex, sensory input, irritability, and integration are the adaptive mechanisms to pain. Accordingly, this study aimed to investigate the preparatory brain activity and anticipatory postural control in chronic neck pain.&#x0D; Materials and Methods: The study participants included 25 women with an active MTrP in the upper trapezius muscle and 25 healthy women in the control group. We recorded the brain activities from Cz, Pz, and Fz regions and muscle activities of both sides of the upper trapezius, anterior deltoid, cervical and lumbar paraspinal, sternocleidomastoid, and medial head of the gastrocnemius. The participants had to flex their arms in reply to the second sound stimulus, followed by the first sound. Then, their reaction time and brain activity were evaluated.&#x0D; Results: Significant differences between the two groups were detected in brain activities’ measurements and the onset of muscle activation (P&lt;0.001). The exception was the onset of gastrocnemius muscle activation (P&gt;0.05).&#x0D; Conclusion: The current study suggests that active MTrP induces latency and lengthens the muscle reaction time; thus, the production of suitable motion after the stimulus will be affected. Brain alteration after pain damages movement changes and postural control mechanism.

Relationships Between Active Myofascial Trigger Points and Depressive Symptoms and Physical and Clinical Characteristics of Individuals With Shoulder Pain: A Cross-sectional Study

ObjectiveThe purpose of this study was to evaluate relationships between the presence and number of active myofascial trigger points (MTPs) in shoulder muscles and physical and demographic characteristics, depressive symptoms, pain and function, range of motion (ROM), and strength in individuals with shoulder pain. MethodsFifty-eight individuals were assessed for physical and demographic characteristics, depressive symptoms, shoulder pain and function, MTPs (upper and lower trapezius, infraspinatus, and supraspinatus), shoulder ROM and strength test, and pain during ROM and strength test. Relationships were verified using point-biserial (rpb), Spearman correlation test, and multiple linear regression analysis. ResultsWe found weak to moderate (P < .05) correlations between presence and number of MTPs and depressive symptoms (rpb, 0.28-0.32), pain during ROM (rpb, 0.36-0.40), pain during strength test (rpb, 0.29-0.38), and shoulder function (rpb, –0.29 to 0.33) and strength (rpb, 0.26-0.34). MTPs in the infraspinatus contributed 10% (R² = 0.10; P < .05) to depressive symptoms; in the upper and lower trapezius contributed 27% (R² = 0.27; P < .05) to pain during internal rotation ROM; in the upper trapezius contributed 15% (R² = 0.15; P < .01) to pain during internal rotation strength test and 14% to pain during internal rotation ROM (R² = 0.14; P < .01); and in the supraspinatus contributed 17% (R² = 0.17; P < .01) to pain during external rotation ROM. ConclusionThis study found that MTPs in individuals with shoulder pain contributed to depressive symptoms and pain during internal and external rotation ROM and internal rotation strength test.

The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Trial

Abstract Objective To determine the effectiveness of scapular proprioceptive neuromuscular facilitation (PNF) techniques in patients with subacromial impingement syndrome (SIS). Methods 36 patients were randomized and a 6-week exercise program was applied to both groups 2 days a week. PNF group also received rhythmic initiation and repeated stretch PNF techniques in 2 scapula diagonals. Pain and function were primary outcomes. Active range of motion (ROM), pain pressure threshold (PPT), active myofascial trigger points (MTrPs), scapular dyskinesis, anxiety and depression status were secondary outcomes. Results The improvement in function, internal rotation ROM, PPT, active MTrPs and patient satisfaction was significantly greater in PNF group than exercise group (p&lt;0.05). Scapular dyskinesis improved only in PNF group (p&lt;0.05). Significant improvement in pain, function, ROM, PPT, active MTrPs, anxiety and depression was found in both groups (p&lt;0.05). Conclusions Both scapular PNF techniques and standard exercise program are effective in the treatment of SIS. However, scapular PNF techniques can be added to the exercise program to further improve function, ROM, PPT, active MTrPs, scapular dyskinesis, and patient satisfaction.

A Comparative Study of Effectiveness between Myofascial Release and Pressure Release on Pain and Ankle Range of Motion in Adults with Soleus Myofascial Trigger Points

Study Design: Experimental study design.&#x0D; Background: Myofascial release and Pressure release are the two techniques used for the treatment of active myofascial trigger points. To our knowledge there are no prospective, randomized studies in the literature investigating the comparison between the effects of 2 different manual therapy techniques (myofascial release and pressure release) on myofacsial trigger points of soleus.&#x0D; Purpose of the study: To determine the effects of Myofascial release and Pressure release techniques on pain and ankle range of motion in patient with soleus myofascial trigger point.&#x0D; Method: 30 subjects having active myofascial trigger points in soleus muscle were randomly assigned to either control group or experimental group. Readings were taken for Pain using Numeric Rating Scale (NRS) and ankle dorsiflexion range of motion (ROM) with goniometer before treatment and immediately after treatment.&#x0D; Results: Data analysis was performed using SPSS software 17 version. In both the group significant improvement occurred in NRS score and ROM. Between groups analysis revealed that there was no significant difference in NRS score and ROM between both groups.&#x0D; Conclusion: Both manual therapy techniques i.e. Myofascial release and Pressure release were found to be effective in reducing pain and increasing ankle dorsiflexion range of motion. However the subjects treated with myofascial release and pressure release showed similar benefit in terms of reduction of pain on NRS and improved ROM. Hence it’s concluded that Myofascial release and Pressure release both are effective therapeutic option in the treatment of myofascial trigger point.

Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain

BackgroundChronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of nonspecific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain.MethodsThis is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 6 sessions will be administered once a week for 6 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength and lumbar mobility will be recorded at 6 weeks (post-immediate) and 2 months after the end of treatment.DiscussionWe believe that an approach including electrical dry needling to chronic low back pain dysfunction will be more effective in these patients. The results of this study will inform clinicians on which type of treatment is more beneficial for patients with chronic low back pain.Trial registrationClinicalTrials.gov NCT04804228. Registered on 14 January 2021