Treatment Of Myofascial Trigger Points Research Articles

Dry Needling in Overhead Athletes with Myofascial Shoulder Pain: A Systematic Review.

The treatment of myofascial pain in athletes requires a set of rehabilitation techniques that aim to be effective quickly. In this context, dry needling (DNY) has shown interesting results due to its ability to reduce pain in the short term. Thus, the aim of this study was to investigate the role of DNY in managing myofascial shoulder pain in overhead athletes. PubMed, Scopus and Web of Science were screened up to March 2024, to identify studies that met the following inclusion criteria: overhead athletes with shoulder pain with a DNY approach for myofascial trigger points (MTrPs), RCT, case-control study, feasibility study as the study design. Exclusion criteria were studies that did not include athletes, studies that did not focus on the treatment of MTrPs with DNY, other reviews, no full-text availability and papers written in a language other than English. Out of 399 articles, 165 were excluded as duplicates. Of the 234 articles screened, only 6 articles met the inclusion criteria. A total of 6 studies were included in the systematic review. Initial results showed that DNY improved pain rapidly and in the short term; however, there is still no consensus on the minimum number and the interval between treatments. Major findings reported a rapid potential decrease in perceived pain, shoulder disability and an increase in muscle strength; in this scenario, DNY might be a valid solution in a sports rehabilitation setting.

Electrical dry needling versus a non-invasive multicomponent intervention in the treatment of myofascial trigger points in patients with chronic low back pain: A randomised clinical trial

Objective To compare the effects of electrical dry needling with a non-invasive multi-component intervention in patients with chronic low back pain. Design A randomised single-blind clinical trial. Setting Outpatient Physiotherapy Clinic; home. Participants Sixty-four patients with chronic low back pain aged 30–65 years. Interventions Six-week electrical dry needling on myofascial trigger points, and a non-invasive multicomponent intervention (home exercise programme, stretching and ischemic compression). Main measures Pain (Visual Analogue Scale), disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), kinesiophobia (Tampa Scale of Kinesiophobia), quality of life and sleep (Short Form 36-item Health Survey and Pittsburgh Sleep Quality Index), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion (finger-to-floor distance), and pressure pain threshold (algometer) were assessed at baseline, after 6 weeks, and after 2 months. Results ANOVA showed statistically significant differences in group-by-time interaction for most pain pressure thresholds of myofascial trigger points (P < 0.05), for disability (Roland-Morris Disability Questionnaire: F = 6.14, P = 0.016; and Oswestry Disability Index: F = 7.36, P = 0.009), for trunk anteflexion (F = 10.03, P = 0.002) and for habitual sleep efficacy (F = 6.65, P = 0.012), use of hypnotics (F = 4.77, P = 0.033) and total score of quality of sleep (F = 8.23, P = 0.006). Conclusions In comparison to a non-invasive multicomponent intervention, electrical dry needling has more positive effects on disability, pain intensity, kinesiophobia, and reducing patients’ sensitivity to myofascial trigger points pressure, at post-treatment and at 2 months. Clinical Trial Registration number NCT04804228. Registered on May 28th, 2021. Available at https://clinicaltrials.gov/ct2/show/NCT04804228

Shock waves as treatment of mouse myofascial trigger points.

An abnormal increase in spontaneous neurotransmission can induce subsynaptic knots in the myocyte called myofascial trigger points. The treatment of choice is to destroy these trigger points by inserting needles. However, 10% of the population has a phobia of needles, blood, or injuries. Therefore, the objective of this study is to verify the usefulness of shock waves in the treatment of myofascial trigger points. Two groups of mice have been developed for this: healthy muscles treated with shock waves; trigger points affected muscles artificially generated with neostigmine and subsequently treated with shock waves. Muscles were stained with methylene blue, PAS-Alcian Blue, and labeling the axons with fluorescein and the acetylcholine receptors with rhodamine. Using intracellular recording the frequency of miniature endplate potentials (mEPPs) was recorded and endplate noise was recorded with electromyography. No healthy muscles treated with shock waves showed injury. Twitch knots in mice previously treated with neostigmine disappeared after shock wave treatment. Several motor axonal branches were retracted. On the other hand, shock wave treatment reduces the frequency of mEPPs and the number of areas with endplate noise. Shock waves seem to be a suitable treatment for myofascial trigger points. In the present study, with a single session of shock waves, very relevant results have been obtained, both functional (normalization of spontaneous neurotransmission) and morphological (disappearance of myofascial trigger points). Patients with a phobia of needles, blood, or injuries who cannot benefit from dry needling may turn to noninvasive radial shock wave treatment.

Is Exercise Rehabilitation an Effective Adjuvant to Clinical Treatment for Myofascial Trigger Points? A Systematic Review and Meta-Analysis.

To systematically evaluate the effect of exercise rehabilitation as an adjuvant to clinical treatment for myofascial trigger points (MTrPs). ESBCO, PubMed, Science Direct, Web of Science, China Knowledge Network (CNKI), and Wanfang databases were comprehensively searched from database inception date through July 2022. Randomized controlled trials comparing MTrPs treatments that included exercise rehabilitation with a single clinical treatment. Two researchers independently screened articles using inclusion/exclusion criteria, scored methodologic quality, and extracted data including patient demographics, interventions, and outcomes. We included 14 RCTs (N = 734). Results showed short-term (mean difference [MD], -2.25; 95% confidence interval [CI], -4.08 to -0.41; Z = 2.40; P = 0.02) and long-term (MD = -0.47; 95% CI: -0.80 to -0.17; Z = 3.05; P = 0.02) adjuvant exercise rehabilitation treatments were superior in reducing musculoskeletal pain intensity to single clinical treatment in controls, but long-term versus short-term effectiveness was not significantly different. The exercise rehabilitation group more effectively increased the range of motion (ROM) (standardized mean difference [SMD], 1.04; 95% CI: 0.32 to 1.77; Z = 2.84; P = 0.005) and decreased dysfunction (SMD = -0.93; 95% CI: -1.82 to -0.05; Z = 2.06; P = 0.04) than controls; no significant difference was observed in the pressure pain threshold (PPT) between two groups. Exercise rehabilitation as an adjuvant to clinical treatment for MTrPs was moderately effective in relieving pain intensity, increasing ROM, and improving dysfunction versus single clinical intervention. These findings must be validated by larger, higher-quality studies.

Dry needling in the treatment of myofascial trigger points and painful shoulder dysfunctions: narrative review of the literature

Dry needling in the treatment of myofascial trigger points and painful shoulder dysfunctions: narrative review of the literature

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.

Autonomic nerve regulation in joint hypermobility patients with myofascial trigger points by Musculoskeletal Interfiber Counterirritant Stimulation (MICS).

Joint hypermobility (JH) conditions suggest dysfunction in the autonomic nervous system (ANS) (dysautonomia), associated with multifactor non-articular local musculoskeletal pain, and remains a complex treatment. This study aims to determine the effects of musculoskeletal interfiber counterirritant stimulation (MICS) as an innovative treatment of myofascial trigger points (MTrPs) on the upper trapezius muscle in JH patients. We evaluate the ANS activity by wavelet transform spectral analysis of heart rate variability (HRV) in sixty women, equally divided: MTrP, MTrP+general joint hypermobility (GJH), and MTrP+joint hypermobility syndrome (JHS). The protocol phases were rest, stimulation, and recovery, with clinical and home treatment for three-days. All groups show a significantly decreased in pain perception during and post-treatment, and an increased parasympathetic ANS activity under MICS in the GJH and JHS groups. The variables low-frequency (LF) vs. high-frequency (HF) showed significant differences during the protocol phases, and the LF/HF ratio maintained a predominance of sympathetic activity (SA) throughout the protocol. The new MICS technique reduces the pain perception and modulates the ANS activity by an increase in vagal tone, and a decrease in sympathetic tone. This modulation was followed by an increase in the HRV in JH patients after treatment with MICS. Clinical Trials: RBR-88z25c5.

The Effectiveness of Dry Needling in Patients with Hip or Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Background: Osteoarthritis is one of the most common degenerative joint diseases. The main symptoms of the osteoarthritis have been linked to the presence of myofascial trigger points in the soft tissues. Dry needing (DN) is the most investigated technique for the treatment of myofascial trigger points. Thus, the aim of this study was to evaluate the effectiveness of DN in pain and physical function in patients with osteoarthritis in the short-, medium- and long-term. Methods: PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in September 2022. Randomized controlled trials involving DN compared to non-pharmacological interventions, sham techniques or no additional treatment were selected. Quality of the studies was assessed with PEDro scale and risk of bias with Cochrane Collaboration tool. Meta-analyses were conducted using fixed or random effects models according to the Cochrane handbook for systematic reviews of interventions. Results: Seven studies were included in the meta-analysis involving 291 patients with osteoarthritis. The methodological quality of the included studies ranged from fair to high. DN showed significant improvements in pain intensity (SMD = −0.76; 95% CI: −1.24, −0.29; I2: 74%) and physical function (SMD = −0.98; 95% CI: −1.54, −0.42; I2: 75%) in the short-term. No differences were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence to very low. Conclusions: Very low-quality evidence suggests a positive effect of DN for reducing pain intensity and improving physical function in the short term in patients with osteoarthritis. Further investigation is needed to determine a medium- and long-term effects.

The Effects of Conventional Physical Therapy with and Without Dry Needling on Pain, Range of Motions and Functional Disability in Patients with Shoulder Impingement Syndrome

Dry needling is a technique in which thin monofilament-based needles are inserted into soft tissues, especially trigger points in muscles. It is being used in a range of neuromuscular pain syndromes such as shoulder impingement syndrome in current study. In physical therapy, it is narrowly referred to as an intramuscular procedure for the treatment of myofascial trigger points (MTrPs). Objective: To compare the conventional physical therapy with and without dry needling on pain, range of motion, and functional disability in patients with shoulder impingement syndrome. Methods: It was randomized controlled trial conducted on 66 patients of shoulder impingement syndrome based on inclusion criteria and divided randomly allocated equally in two groups of 33 in each of conventional therapy and dry needling group. The outcome measures used were numeric pain rating scale for pain, DASH for hand arm function and shoulder ranges of motion. The SPSS 25.0 was used to analyse data. The descriptive statistics was applied, and inferential statistics was applied based on findings of tests of normality. Results: The results showed that the post interventional pain score was 1.43±1.37, 32.11 for conventional group and for experimental group that of 1.60±1.02, 34.89 with non-significant difference 0.544, while DASH score was 27.02±13.22, 38.85 for conventional group and for experimental group that of 19.92±11.20, 28.15 with significant difference 0.024. The results for flexion, abduction, internal and external rotation were non-significant with p value &gt;0.05. Conclusions: It was concluded that although there was significant improvement in pain, range of motion and function in both of dry needling and conventional groups, however, pain and shoulder ranges improved equally in both groups without a statistically significant difference while that of disability improved significantly in dry needling group

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.

Effect of high intensity laser in the treatment of myofascial trigger points in symptomatic knee osteoarthritis: A randomized single-blinded controlled trial

Background: Osteoarthritis (OA) is one of the most prevalent causes of musculoskeletal pain and disability among the middle age and elderly population. It significantly affects the overall quality of life of the affected individuals. Objectives: To find out the impact of high intensity laser therapy (HILT) on myofascial trigger points (MTrPs) in symptomatic knee OA. Methods: This is a single-blinded pre–post randomized experimental trial. A total of 40 patients, both male and female, falling within the age group of 35-55 years, BMI 25–29.9 Kg/Cm2, diagnosed with bilateral knee osteoarthritis (grade 2), were recruited as participants of the study. All the participants were clinically evaluated for the signs and symptoms of myofascial pain, tenderness over the vastus medialis muscle and the medial head of the gastrocnemius muscle. The participants were randomly allocated into two groups with n=20 in each group. The participants of the experimental group received high-power laser therapy and underwent exercises on the MTrPS of the vastus medialis and the medial head of the gastrocnemius muscle. The participants of the control group received placebo laser "sham laser" and underwent exercises for the vastus medialis and the medial head of the gastrocnemius muscle. A blood cortisol level test, pressure algometer, digital electronic goniometer, and the KOOS-PS questionnaire were used to measure the pain level, pain threshold, knee ROM, and knee function. Outcome assessment was done at Day 0 and post intervention at the end of 4 weeks. Results: The MANOVA test revealed that both groups improved significantly in all parameters at week 4, with the HILT group improving more than the sham group in blood cortisol levels, pressure algometer measures, knee passive ROM, and KOOS scores (P &lt; .05). Conclusion: HILT is an efficient approach in the treatment of MTrPs in knee OA.

Effects of Repeated Injection of 1% Lidocaine vs. Radial Extracorporeal Shock Wave Therapy for Treating Myofascial Trigger Points: A Randomized Controlled Trial.

Background and Objectives: This study tested the hypothesis that treatment of myofascial trigger points (MTrPs) in the upper trapezius muscle (UTM) with repeated injection of 1% lidocaine results in better alleviation of muscular stiffness and soreness as well as improved metabolism in the hypercontracted MTrP area than treatment with radial extracorporeal shock wave therapy (rESWT). Materials and Methods: A single-blinded, prospective, randomized controlled trial was conducted on patients suffering from MTrPs in the UTM. Thirty patients were treated with repeated injection of 2 mL of 1% lidocaine (three injections; one injection per week). Another 30 patients were treated with rESWT (three treatment sessions; one treatment session per week; 2000 radial extracorporeal shock waves per treatment session; positive energy flux density = 0.10 mJ/mm2). The primary outcome measure was pain severity using the VAS score. The secondary outcome measures included muscle elasticity index, pressure pain threshold and neck disability index. Evaluation was performed at baseline (T1), 15–30 min after the first treatment in order to register immediate treatment effects (T2), before the second treatment (i.e., one week after baseline) (T3) and one week after the third treatment (i.e., four weeks after baseline) (T4). Results: There were no statistically significant differences in the primary and secondary outcome measures between the patients in the lidocaine arm and the patients in the rESWT arm at T1 and T4. Within the arms, the mean differences of all outcomes were statistically significant (p < 0.001) when comparing the data obtained at T1 with the data obtained at T3 and the data obtained at T4. Conclusions: The results of this pilot study suggest that the use of rESWT in patients with MTrPs in the UTM is safe and leads to reduced pain and improved muscle elasticity, pressure pain threshold and neck disability index, without adverse effects. Larger trials are necessary to verify this. Clinicians should consider rESWT instead of injections of lidocaine in the treatment of MTrPs in the UTM.

Is Instrumental Compression Equally Effective and Comfortable for Physiotherapists and Physiotherapy Students than Manual Compression? A Comparative Cross-Sectional Study

The objective of this work is to compare the homogeneity of instrumental and manual compression during the simulation of a pressure release technique, measured with a dynamometer, as well as to evaluate the comparative degree of comfort by physiotherapists and physiotherapy students when performing this technique. Methods: A comparative cross-sectional study was carried out with physiotherapists (lecturers with clinical experience) and 4th year students of the Physiotherapy Degree at Universidad San Jorge. The amount of pressure performed and how it was maintained during 80 s with both techniques was analysed using a digital dynamometer. The degree of comfort was evaluated using a modified numeric rating scale, with higher values representing a higher degree of discomfort. Results: A total of 30 subjects participated. Significant differences were found between the techniques in terms of maintaining a constant pressure level for 80 s (p = 0.043). A statistically significant difference was found between both techniques in the period from 45 to 80 s. Regarding the degree of discomfort, the value obtained from the students’ responses was 4.67 (1.35) for the manual technique and 1.93 (0.88) for the instrumental technique. In the case of physiotherapists, the comfort was 4.87 (2.13) for the manual technique and 3.33 (1.54) for the instrumental technique. Conclusion: The sustained manual compression necessary in manual pressure release techniques in the treatment of myofascial trigger points can be performed with assistive tools that guarantee a uniform compression maintained throughout the development of the technique and are more comfortable for physiotherapists.

Application of Combined Laser and Compression Therapy on the Pain and Level of Disability on Trigger Points in Upper Trapezius Muscle

Introduction: Musculoskeletal disorders are among the main causes of disability in modern life. Myofascial trigger points are very common among musculoskeletal disorders and may occur through ordinary common activities. This study aimed to determine the combined effects of laser therapy and Ischemic Compression (IC) on the treatment of Myofascial Trigger Points (MTrPs) at the upper trapezius muscle. Materials and Methods: Twenty men with at least one active trigger point at their upper trapezius muscle voluntarily participated in this study. Trigger points were under treatment of laser irradiation (6 Joules per point) and also ischemic compression. Treatment approaches were applied over the pain point every other day for 5 sessions in 10 days. Neck disability index, pain intensity by visual analog scale, pressure pain threshold by algometry, and cervical lateral flexion by goniometer were assessed and recorded before the intervention, and immediately after the last session. Results: At the end of treatment, statistically significant improvements were seen in the neck disability index, VAS value, pressure pain threshold, and cervical lateral flexion. VAS values of the treatment and control groups were compared with the baseline (P&lt;0.001). Conclusion: Application of combined laser and compression therapy was effective on the pain and level of disability of patients with trigger points in the upper trapezius muscle.

Dry Needling and Management of Trigger Points with Low Back Pain: An Evidence to Practice Review

Low back pain is a common health concern. The development of myofascial trigger points due to low back pain can cause debilitating pain and loss of functional movement in patients. Dry needling is a minimally invasive procedure that has shown to be useful in the treatment of myofascial trigger points when used with other forms of treatment. However, the literature surrounding dry needling and myofascial trigger points in patients with low back pain is lacking. The guiding systematic review and meta-analysis sought to analyze the effectiveness of dry needling for patients with low back pain. The review utilized eight databases for randomized controlled trials and selected 11 of 784 articles for analysis based on inclusion and exclusion criteria. A 6-subgroup meta-analysis was conducted on these studies, and 6 of the 11 studies were found to have high risk of bias. The included studies used both pain measurements and functional measurements including the visual analogue scale (VAS), Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ). The studies did not include objective functional measurements. Overall researchers found a clinically meaningful decrease in outcome scores in the short-term, but there were no significant differences in pain or functional outcomes through long-term follow-up. This seems to correlate with the current literature on dry needling and its inflammatory effects on the body, suggesting that dry needling alone does not provide any long-term effect on myofascial trigger points in patients with low back pain. Dry needling should be combined with other treatments and high-quality rehabilitation to provide longer-lasting results and better treatment outcomes for patients with low back pain.

Effect of Manual Therapy Interventions on Range of Motion Among Individuals with Myofascial Trigger Points: A Systematic Review and Meta-Analysis.

Patients with myofascial trigger points (MTPs) frequently manifest restricted range of motion (ROM) during physical evaluation. Multiple manual therapy interventions have been developed for the treatment of MTPs, but their effect on ROM has not been clarified through a systematic review and meta-analysis. Thus, this systematic review aimed to assess the effect of manual therapy interventions on ROM among individuals with MTPs. A systematic search was conducted in PubMed, Web of Science, Cochrane, Scopus, and Clinical Trials.gov. Articles analyzing the effect of manual therapy interventions on ROM were included. The risk of bias was assessed with the Cochrane Risk of Bias (RoB) 2 tool. The DerSimonian-Laird method was used to compute the pooled effect size (ES) and its 95% confidence interval (95% CI) for ROM. A total of 13 randomized controlled trials were included in this systematic review and meta-analysis. The pooled ES for ROM was 0.52 (95% CI: 0.42-0.63). The pooled ES for ROM evaluated in centimeters was 0.36 (95% CI: 0.14-0.59), and the pooled ES for ROM evaluated in degrees was 0.57 (95% CI: 0.47-0.68). Manual therapy interventions may be an effective approach for improving ROM among individuals with MTPs.

The effect of dry needling of myofascial trigger points on muscle stiffness and motoneuron excitability in healthy subjects.

Myofascial trigger points (MTrPs) are hypersensitive nodules in a taut band (TB) of skeletal muscle. Dry needling (DN) is an invasive technique recommended for the treatment of MTrPs. However, to our knowledge, no studies have investigated the influence of the DN technique on modification of muscle stiffness and neurophysiological properties of MTrPs. The objective was to examine the effect of DN on muscle stiffness and motoneuron excitability of a latent medial MTrP (nodule and TB) of the soleus muscle in non-injured subjects. A double-blinded randomised controlled trial of 46 subjects with latent medial MTrPs of the soleus was conducted, in which all received one session of DN. The intervention group (n = 23) were subjected to DN into the MTrP (the nodule), while the control group (n = 23) were subjected to DN into the TB. Assessment was carried out at baseline (pre-test), after the intervention (post-test) and 1 week after the intervention (follow-up). Biomechanical variables (muscle resistive force at 10°/s and 180°/s, muscle extensibility and strength), as measured with an isokinetic dynamometer, and neurophysiological variables (H-reflex), were recorded. There were no statistically significant differences in biomechanical or neurophysiological assessments between groups. Considering the intra-group analysis, subjects in the intervention group exhibited increased maximal isometric voluntary force to ankle plantarflexion (MIVFp) at both post-intervention and follow-up assessment (p < 0.0125; 0.2 < d < 0.5), while no changes were found in the control group. One session of DN targeting latent MTrPs did not change muscle stiffness, muscle extensibility or motoneuron excitability. Further research on subjects with muscle tone disorders should be considered to better address the impact of DN on muscle tone. NCT02575586 (ClinicalTrials.gov).

Combining Patient Education With Dry Needling and Ischemic Compression for Treating Myofascial Trigger Points in Office Workers With Neck Pain: A Single-Blinded, Randomized Trial

ObjectiveThe purpose of this study was to compare immediate and short-term effects of combining dray needling (DN) + patient education vs ischemic compression (IC) + patient education for treating myofascial trigger points (MTP) in office workers with neck pain. MethodsThis was a single-blinded, randomized trial. Thirty-two participants were randomly assigned to either DN + patient education or IC + patient education group. Both groups received 2 treatment sessions with a 48-hour time interval. Pain intensity, cervical range of motion, Neck Disability Index, and satisfaction were measured. ResultsPain intensity and neck disability level decreased, whereas the cervical range of motion (side-bending and rotation) increased in both groups. Analysis of variance revealed a significant interaction of group × treatment only for pain intensity, indicating a greater reduction in the IC group. Satisfaction generally increased in the follow-up assessment in both groups. ConclusionBoth intervention groups had some positive immediate and short-term effects after 2 treatment sessions. However, IC + patient education was more effective than DN + patient education in the treatment of MTPs in office workers with neck pain.

Effect of Physical Exercise Programs on Myofascial Trigger Points-Related Dysfunctions: A Systematic Review and Meta-analysis.

Myofascial pain syndrome is one of the primary causes of health care visits. In recent years, physical exercise programs have been developed for the treatment of myofascial trigger points, but their effect on different outcomes has not been clarified. Thus, this study aimed to assess the effect of physical exercise programs on myofascial trigger points. A systematic search was conducted in Pubmed, Web of Science, and Scopus. Articles analyzing the effect of physical exercise programs on pain intensity, pressure pain threshold, range of motion, and disability were included. Risk of bias was assessed using the Cochrane RoB2 tool. The DerSimonian-Laird method was used to compute the pooled effect sizes (ES)and their 95% confidence interval (95% CI) for pain intensity, pressure pain threshold, range of motion, and disability. A total of 24 randomized controlled trials were included in this systematic review and meta-analysis. The pooled ES were -0.47 (95% CI = -0.61 to -0.33) for pain intensity, 0.63 (95% CI = 0.31 to 0.95) for pressure pain threshold, 0.43 (95% CI = 0.24 to 0.62) for range of motion, and -0.18 (95% CI = -0.45 to 0.10) for disability. Physical exercise programs may be an effective approach in the treatment of pain intensity, pressure pain threshold, and range of motion among patients with myofascial trigger points.

Relación entre dismenorrea y síndrome de dolor miofascial. Perspectiva desde la fisioterapia. Estudio piloto aleatorizado

The term dysmenorrhoea defines different symptoms that women can feel during menstruation, the most common being intense pain. Myofascial pain syndrome (MPS) is the combination of signs and symptoms caused by myofascial trigger points (MTP), at their site or at a distance. Therefore, the objective of this study is to evaluate the efficacy of a treatment for MTP in the abdominal, hip adductor and pelvic floor muscles, from a physiotherapeutic approach, regarding the following outcome measures: pain, sexual function, quality of life, strength and mobility in patients suffering from dysmenorrhoea. Materials and methodsRandomized pilot study. Participants were divided into two groups: A (n = 6), where dry needling and manual therapy was applied to the abdominal, hip adductor and pelvic floor muscles; and B (n = 7), where the participants received thermotherapy and stretching of these muscles. The outcome measures studied were menstrual pain, sexual function, quality of life, hip abduction range of motion, strength of the affected muscles, pelvic floor muscle endurance and finding myofascial trigger points. All the treatments were provided by the same physiotherapist, while a different physiotherapist carried out the evaluations blinded to each patient's group. Resultsin group A, a clinically (1.6 less in VAS) and statistically significant reduction (p = 0.018) in pain was observed in comparison with group B (.4 in VAS, p > 0.05). Quality of life also improved in the first group (p< 0.05). No further significant differences were found in the remaining outcome measures. Conclusionsa significant improvement was observed with regards to pain and quality of life in group A. Thus, we consider that specific treatment for MPS could be more clinically effective.We conclude that this research should be continued with a larger sample of participants, in order to clarify the efficacy of the physiotherapy treatment suggested for the remaining outcome measures.