Myofascial Pain Syndrome Of Upper Trapezius Research Articles

Comparison between effects of instrument-assisted soft tissue mobilization and manual myofascial release on pain, range of motion and function in myofascial pain syndrome of upper trapezius - A randomized controlled trial.

Myofascial pain syndrome (MPS) is a muscle pain disorder characterized by the presence of Myofascial Trigger Point (MTrP) within a taut band, local tenderness, referral of pain to a distant site, restricted range of motion, and autonomic phenomena. The upper trapezius is the muscle most often affected by MTrPs. Manual myofascial release (MFR) and Instrument-Assisted Soft Tissue Mobilization (IASTM) are techniques of soft tissue release that are used to resolve MPS. Fifty six percent of physiotherapists complain of pain in multiple areas due to the massage and manual therapy that they have to perform. The objective of this study is to find whether IASTM is better than manual MFR in treating patients with MPS in upper trapezius. This study was a single-blinded randomized controlled trial that included 31 participants, both males and females between the age groups of 18-50 years. Participants were randomly divided into two groups. Three sessions were given over a period of one week for both groups. Group A received IASTM along with conventional treatment and Group B received Manual MFR along with the conventional treatment. The outcome measures evaluated were pain, cervical range of motion, pain pressure threshold (PPT) of trigger points, and the neck disability index. Pre- and post-measurements were taken and the analysis was done. Both the treatment methods significantly reduced pain, improved PPT, range of motion, and function. The effects between the groups showed that IASTM was significantly better than manual MFR to reduce pain. The improvement in PPT, range of motion and function were equal in both the groups. IASTM and manual MFR both are effective individually as treatment procedures for pain, PPT, range of motion, and function. Neither of the treatment options can be considered better that the other. The clinician can decide based on the availability of the instrument, training, patient's preference, and his/her comfort whether which of the two treatment methods should be used.

Effect of extracorporeal shockwave therapy on myofascial pain syndrome of upper trapezius: A systematic review

Neck pain is highly prevalent condition, with myofascial pain syndrome (MPS) affecting 95% of people. Extracorporeal shockwave therapy (ESWT) being novel idea for this condition provides non-intrusive, less time consuming and tolerable sound electro physical therapy. The aim of the systematic review was to find and summarize the effectiveness of ESWT associated with different parameters on MPS of upper trapezius. Data were extracted from e-search engine, PubMed, research gate, semantic scholar, magonlinelibrary, Cochrane Library, Google scholar, and MedlinePlus. Systematic review design was done according to Problem, Intervention, Comparison, outcome, and time format, and systematic review was conducted according to PRISMA statement. List of keywords were searched and definite inclusion criteria were developed prior. Total 15 studies met the inclusion criteria. Descriptive analysis was done to find effectiveness of ESWT. Significant effectiveness of ESWT is found for the patients with MPS of upper trapezius. High-density focused ESWT is more significant results than others with pulses delivered minimum of 1000 per session. However, more high quality studies need to be done to conclude effectiveness of radial and combined ESWT.

Effects of Intramuscular Electrical Stimulation on Symptoms Following Trigger Points; A Controlled Pilot Study

Introduction: Myofascial Pain Syndrome (MPS) is a common disorder of musculoskeletal system. About one third of the people with musculoskeletal disorders have been diagnosed as having MPS. It is a painful condition caused by trigger points. A variety of treatment approaches are used to cure MPS and its associated disorders. This study aimed to investigate the effects of single session Intramuscular Electrical Stimulation (IMES) through dry needling on pain and Range Of Motion (ROM) following trigger points in upper trapezius. Material and Methods: Sixteen volunteers with active trigger points in upper trapezius were randomly divided into two groups: 1) the IMES treatment group (8 females) and 2) placebo group (8 females). In the IMES group, trigger points of the affected side were injected through dry needling, then a burst current (2 Hz) was applied on the muscle while the electrical stimulation steadily increases to form a pain free contraction for the patient. In placebo group, the procedure was exactly the same but there was no applied electrical stimulation through dry needling. Pain sensation by Visual Analog Scale (VAS) and cervical flexion ROM were measured before treatment, immediately after treatment and one week later by another blinded researcher. Results: VAS scores showed improvement in both groups at the end of the treatment session and also one week later. There was no significant difference between the groups; IMES and placebo in terms of the VAS after treatment session. However, the pain scores were substantially decreased in the IMES group one week after the intervention. The ROMs were significantly lower in placebo group one week after treatment. There was no significant correlation between improvement and duration of symptoms. Conclusion: Both IMES and placebo methods might be effective in relieving symptoms of patients with the MPS in upper trapezius; however, patients following the IMES treatment showed higher level of improvement during one week after the intervention. Further relevant studies with higher number of volunteers and different treatment protocols are necessary to get high quality evidence.