Trigger Points In Trapezius Muscle Research Articles

The effect of upper trapezius trigger points dry needling on postural control in patients with chronic neck pain

ObjectiveMyofascial neck pain, which strongly affects the upper trapezius muscle, is treated by physiotherapists with dry needling. The purpose of this study was to investigate the effect of upper trapezius trigger points (TrPs) dry needling on postural control and balance in chronic neck pain. DesignRandomized controlled clinical trial. SubjectsThirty individuals with chronic neck pain (more than 3 months), aged 18–40 years, neck disability index (NDI) > 10, and pain intensity (PI) between 3 and 6 who have TrP in the upper trapezius. MethodThirty individuals were randomly assigned into 2 groups, (i) 15 receiving intervention (real dry needling), and (ii) 15 in the sham group (sham dry needling). Outcomes were range of neck movements, neck disability index, pain intensity, and the mean and standard deviation as well as maximum velocity of center of pressure displacement in the anterior-posterior and medio-lateral directions during balance task on the force plate (1 leg stance and closed eyes) before the intervention and after the fifth and fifteenth (follow-up) days. InterventionUpper trapezius dry needling was applied for 3 sessions occurring every other day in a week. ResultNo significant differences were seen between the 2 groups in mean displacement, standard deviation, or maximum velocity in the anterior-posterior and medial-lateral axis and range of motion (ROM) except for left lateral bending; however, a significant difference was observed between the 2 groups in pain intensity and neck disability index. ConclusionDry needling on the upper trapezius TrPs does not change postural control but decreases pain and disability.

Comparison of Ischemic Compression Combined With Muscle Energy Technique Versus Ischemic Compression Alone on Myofascial Trigger Points of Upper Trapezius in Breast Cancer Survivors

Background: A hyperirritable region, typically located within a taut band of skeletal muscle, is known as a myofascial trigger point. It can cause discomfort upon compression, as well as the typical referred pain, motor dysfunction, and autonomic abnormalities. TrPs may be associated with breast cancer. Symptoms of upper body dysfunction and pain are typical among breast cancer survivors. Noninvasive techniques including massage, spray and stretch, physical therapy, and transcutaneous electrical stimulation can all help reduce trigger points. Ischemic compression and Muscle energy technique (MET) is an intriguing non-invasive treatment that has showed more effect on myofascial trigger points Objectives: Aims and objective of this study was to compare the effect of ischemic compression combined with muscle energy technique and ischemic compression alone on myofascial trigger points in breast cancer survivors. To see improvement in range of cervical flexion, cervical extension and cervical lateral flexion. Method: This was Quasi-experimental study in which convenient sampling was done from breast cancer patient from breast cancer ward of PINUM and Allied hospital Faisalabad for 6 months after meeting inclusion and exclusion criteria. 20 individuals with Myofascial Trigger points were assigned into two groups: Group 1 and Group 2. Group 1 received ischemic compression combined with Muscle Energy Technique for 3 weeks and Group 2 received ischemic compression alone for 3 weeks. Evaluation of pain, range of cervical flexion, cervical extension and cervical lateral flexion was done by Numeric Pain Rating Scale, Goniometer and Neck Pain Disability Index respectively. Results: wilcoxon and Mann whitney tests were applied and results showed p value <0.01. Conclusion: According to data analysis and after applying Mann-whitney test we found that ischemic compression combined with muscle energy technique has more effect on myofascial trigger points in improving pain and range of motion than ischemic compression alone. Keywords: Breast cancer, Goniometer, Ischemic compression, Myofascial Trigger Points, ,Muscle Energy Technique, ROM

Effect of Extracorporeal Shock Wave on Upper Trapezius Trigger Points in Patients With Cervicogenic Headache: A Randomized Clinical Trial.

A recent study was designed to ascertain the impact of extracorporeal shock wave therapy on upper trapezius trigger points in cervicogenic headaches patients. A double-blinded randomized controlled trial study, in which 50 participants (11 male and 39 female) aged between 20-40 with cervicogenic headache were subdivided with randomization to group (A), which received traditional physical therapy and sham shock wave therapy, and group (B), which received traditional physical therapy and actual shock wave therapy. All assessments were performed by a therapist before and after the treatment program (4 wks). There was a significant difference of headache disability index, visual analog scale scores, and upper trapezius electromyographic characteristics with P value <0.05 in both groups, in favor of the shock wave group. Extracorporeal shock wave therapy could be used for clinical and research concerns because its positive effects on pain suppression, reduction of headache intensity, and restoration of muscle regular activity in cervicogenic headache patients.

Comparison of Development of Upper Trapezius Trigger Point in Computer Operators with or without Fore arm support

Background:Computer work often involves both physical and mental demands. The physical demands are characterizedby low-force exertions and static postures that are sustained for long durations. Elevated shoulder postures,prolonged static contractions and the task duration have been identified as computer-related risk factorsfor neck and shoulderproblems, so this is responsible for development of trigger points particularly in the uppertrapezius muscles in forearm-unsupported computer operators as compared to forearm-supported.The uppertrapezius (UT)is designated as a postural muscle and is highly suspected ofoveruse because it works constantlyagainst gravity to maintain an erect head and neck position. This studyaims to identify upper trapezius triggerpoints (TrPs) developed with or without forearm support (FS) in computer operators.Materials and Methods: The study took place in the worksite of computer operators in Nagpur,Maharashtra for1.5 year. With a power of 90 and significance error of 1%, a total of 40 patients were taken according to the convenientsampling and divided into two categories computer operators Group A: with FS and Group B: without FS,following signs and symptoms like Trigger point, posterolateral neck and upper back pain most common in which group assessed by using, VAS (Visual Analogue Scale) for measuring pain intensity, Trigger Point Rating Scale is used for myofascial screening. Neck Disability Index for assessing the neck-related disability due to pain taken.Result: The study was conducted on 40 people, in which 20 people with forearm support and 20 people withforearm unsupported. The result is that forearm support reduces the load on the UTand also reduces the risk ofdevelopment of upper trapezius TrPs as compared to the forearm unsupported.Conclusion: Based on the results of these studies, it has been concluded that the development of UT TrPsincomputer operators without FS is more common as compared to FS.

Efficacy of Integrated Neuromuscular Inhibition Technique on Pain and Range of Motion in Patients with Upper Trapezius Triggers Point: A Literature Review

Introduction: Myofascial Pain Syndrome (MPS) is current musculoskeletal pain disorder that affects the majority of chronic pain population. Myofascial Trigger Points (MTrPs) are hyperexcitable spots in a tight band within the skeletal muscle, which ache upon shortening, elongating and manifest referred pain. Integrated Neuromuscular Inhibition Technique (INIT) is a single coordinated technique, which is used to decrease the pain intensity, increase the function and range of motion due to the increased blood supply by intermittent pressure, muscle relaxation by strain-counter strain and tone reduction by muscle energy technique. Thus, the review of literature was suggested to explore the efficacy of techniques like INIT on pain and range of motion parameters. Aim: To evaluate the current literatures on the efficacy of INIT on pain and range of motion in patients with upper trapezius trigger point. Materials and Methods: A literature review was conducted from December 2023 to February 2024, using PubMed, the Cochrane Library, and PEDro databases to identify studies on the Integrated Neuromuscular Inhibition Technique (INIT) in patients with upper trapezius trigger points. Seven articles meeting inclusion criteria were selected for detailed analysis to evaluate INIT’s effects on pain and range of motion in this population. Results: From the initial search of PubMed, the Cochrane Library, and PEDro databases, seven articles met inclusion criteria for analysis. Among these, four studies reported positive outcomes for the Integrated Neuromuscular Inhibition Technique (INIT) in treating upper trapezius trigger points. INIT interventions consistently improved pain levels and range of motion, indicating its efficacy in managing myofascial pain syndromes in this muscle group. Conclusion: An integrated strategy, INIT is proved to be effective in reducing pain and improving quality of life in patients with non specific neck pain, stiffness, and enhancing functionality.

Comparing the Effects of Post Facilitation Stretching and Active Release Technique on Pain, Pain Pressure Threshold and Patients Satisfaction in Upper Trapezius Trigger Points

Purpose: Trigger points are localized, hyperirritable areas term as “Knots” and are palpable in taut band of muscle fibers, tendon or a ligament. To compare the effects on Post facilitation stretching and Active release technique on pain, pain pressure threshold and level of patients’ satisfaction in upper trapezius trigger points.&#x0D; Methodology: It was a quasi-experimental study with sample size of 30 and convenient sampling was used. Inclusion criteria of study were females and males of age 25 to 40 years, positive jump sign and persistent pain for more than 4 months. Study setting was the physical therapy departments of private hospitals of Faisalabad and Lahore. Study duration was 6 months. Out of 30 patients 15 were enrolled in group-A (baseline therapy and Post facilitation stretching) and remaining 15 were enrolled in group-B (baseline therapy and Active release technique). Pain pressure threshold was measured by algometer, Intensity of pain was assessed by NPRS before and after the treatment of one week and patient satisfaction was measure by PSQ-18 after the treatment. Data was analyzed by software SPSS 24. Demographic data and test statistics was presented in form of tables.&#x0D; Findings: Out of 30 patients, 33.3% were male and 66.7% were females. Wilcoxon Signed-Rank Test for within-group analysis revealed a significance difference (p≤0.05) in NPRS and PPT before and after the treatment in both groups. Mann-Whitney U test for between-group analyses showed the p&gt;0.05, which means that no significant differences was observed in results produced by Post facilitation stretching in group A and Active release technique in group B.&#x0D; Recommendations: A significantly reduction in the pain intensity and enhancement in pain pressure threshold was observed in both groups. Both Post facilitation stretching and active release techniques were equally effective in reducing intensity of pain, improving pain pressure threshold in upper trapezius trigger points and patients of both groups showed equally satisfaction level after the treatment. Informed by targeted intervention theories, the study utilized rigorous research methodologies for validation. Practitioners are advised to undergo specialized training for PFS and ART application, ensuring a tailored approach per individual needs. Policymakers should set stringent licensing standards and promote continued research to bolster the techniques' efficacy and widespread adoption.

Effects of positional release technique on myofascial trigger points of the upper trapezius in computer users having forward head posture

Background: Forward head posture is associated with the upper trapezius myofascial trigger points and cause pain, restricted range of motion, and referred pain in the arm. The positional release technique is likely to focus on evaluating the efficacy of this manual therapy approach. Objective: To determine the effects of positional release technique for myofascial trigger points of the upper trapezius with forward head posture Method: A randomized control trial study was conducted in the Physiotherapy Department of THQ Hospital Wazirabad, Pakistan, from February 2021 to June 2021 with a sample size of n=32 male participants. Participants were recruited with pain intensity of at least 3 points on the Visual Analogue Scale at baseline, at least one active TrP in the upper trapezius that was diagnosed using the method described by Travel and Simon, and computer users who spend at least 6 hours per day in a sitting posture and are between the ages of 18 and 45. All subjects were randomly and equally allocated into the Positional Release Therapy (PRT) group and a conventional Physical Therapy group. A total 12 treatment sessions were given with 3 days a week for consecutive 4 weeks. The data was collected at the baseline and after the 12th session. The outcome measures for trigger point sensitivity were pain pressure threshold (PPT), visual analogue scale (VAS), active contra lateral flexion (ACLF), cranio-vertebral angle (CVA), and neck disability index (NDI). Data analysis was done through SPSS version-27. Results: The mean age of 34.3±6.57 years. The positional release therapy post-intervention results showed more significant improvement (p≤0.05) in all outcomes PPT, VAS, ACLF, CVA, and NDI between the groups with large effect size. Conclusion: Positional release therapy (PRT) is superior to conventional therapy in decreasing pain intensity and threshold with disability in patients of upper trapezius trigger points Keywords: cranio-vertebral angle; forward head posture; neck disability index; pain pressure threshold; positional release therapy; trigger points; upper trapezius; visual analogue scale.

Combined Effect of Dry Needling and Strain Counter Strain Technique in Myofascial Trigger Points of Upper Trapezius

Aim: To evaluate the combined effect of dry needling and strain counter strain technique in myofascial trigger points of upper. Method: This randomized control trial study was conducted at Male and Female physiotherapy ward, Outdoor, Mayo Hospital, Lahore. 28 patients who had complain of taut band, tenderness and referred pain and fulfill the inclusion criteria were enrolled in this research via non-probability consecutive sampling which randomized later and allocated to two equal groups. Group A (n=14) was experimental group treated by Dry needling and strain counter strain with baseline treatment. Group B (n=14) was a control group treated by Strain counter strain with baseline treatment. Baseline Physiotherapy Protocol that was given to every patient: Hot pack for 10 minutes, Trapezius muscle stretching, cervical muscle strengthening exercises (2 sets of 5 repetition each). Written consent was procured by every patient. Questioner that was used for data collection was Neck disability index (NDI) and other tools were Goniometer and Visual analogue scale (VAS). Results: Descriptive statistics showed that participants having mean age of 27 in group A and 35 in group B. Participants who received dry needling and SCS showed marked improvement as compare to group B. Statistically significant improvement found in all variables that were measured following the intervention (P&lt;0.05). The pre-treatment mean score for NDI in group A was 3.50±0.519, while in group B was 3.64±0.497. After 8 weeks of treatment, the mean score in group A was 1.79±0.579, and in group B was 2.64±0.497 with the p value &lt;0.0001 is less than 0.05 showed that Combined treatment effect of dry needling and Strain counter strain and control group treatment with strain counter strain only both are statistically significant in improving pain in Trigger points of the upper trapezius. Conclusion: It was concluded from the study that the combined technique of Dry needling and strain counter strain and only strain counter strain technique with baseline treatment both are effective in reducing pain and better active range of motion outcome as p=0.000 that p&lt;0.005 showed both techniques are statistically significant but the mean value of Study group A is more than control group B, so Combined technique study group A is more effective than Strain counter strain technique with baseline treatment of control group B. Keywords: Dry needling, Strain counter strain, Visual analogue scale, Neck disability index.

EFFECTIVENESS OF INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION IN UPPER TRAPEZIUS MYOFASCIAL TRIGGER POINT -A REVIEW ARTICLE

The hypersensitive, palpable nodules known as myofascial trigger points (MTrPs) are located along muscular bundles. They frequently affect the shoulder girdle &amp; cervical muscles .The muscle most usually affected is the trapezius. Trigger points in the neck are thought to be present in 85% of patients who visit pain clinics, and they affect women more frequently than males. In this study we see the effect of Instrumented assisted soft tissue mobilisation (IASTM) on upper trapezius myofascial trigger point. Most studies in our review study reported the IASTM’s usefulness in treating upper trapezius trigger points, but additional research is required. Keywords: IASTM, Upper trapezius, trigger point , M2t blade, Myofascial pain syndrome, Neck pain.

Prevalence of Trapezius Trigger Points in Young Healthy Individuals

MTrPs are labelled as hard, discrete, and palpable nodules in a taut band of skeletal muscle. It can be further divided into 2 forms, if it is spontaneously painful (i.e., active trigger points) or painful only on compression (i.e., latent trigger points). Objectives: To determine the frequency of active and latent trigger points of trapezius in healthy individuals and to find out its association with gender. Methods: A cross sectional survey was conducted from April 2018-August 2018 after getting approval from the ethical committee of Riphah College of Rehabilitation Sciences. The sample size was 323 which were selected by non-probability (convenient sampling) technique. Data were collected through self-structured questionnaire which also included trigger points assessment form. The data were analyzed using SPSS 24. Results: The mean age of participants was 23.60±4.6years with 60(19.8%) males and 243(80.2%) females. The trapezius trigger point 2 was found more active on right side (TT2Rt side) in 91(30%) and left side (TT2Lt side) 57(18.8%). While the same was more latent in 75(24.8%) on right side (TT2Rt side) and 86(28.4%) on left side (TT2Rt side) among the participants. There was no significant association between active trigger points and gender (p&gt;0.245), as well as the association between latent trigger point and gender was not significant (p&gt;0.740). Conclusions: The frequency of trapezius trigger point is less in healthy individuals whereas the majority of the young individuals have at least one or two active or latent trigger points. There was no significant association of both active and latent trigger points with gender.

Integrated neuromuscular inhibition technique versus spray and stretch technique in neck pain patients with upper trapezius trigger points: a randomized clinical trial

ABSTRACT Objective This study aimed to investigate the difference between the integrated neuromuscular inhibition technique (INIT) and spray and stretch technique in patients with neck pain and upper trapezius active trigger points. Methods: A convenience sample of 60 patients with neck pain and active trigger points were recruited from physiotherapy students and allocated randomly to three groups INIT plus stretching exercise spray and stretch technique plus stretching exercise, and stretching exercise only. Treatment was three times per week for four weeks. Pain intensity by visual analogue scale (VAS), pain pressure threshold (PPT), neck disability by Arabic neck disability index (ANDI), and muscle amplitude in the form of root mean square (RMS) by electromyography (EMG) were measured at baseline and after four weeks. Results: Between groups analysis; the results revealed statistical significant difference between three groups after four weeks of intervention as p =0.0001. Within the group analysis, post hoc tests reported improvement at all variables in both INIT and spray and stretch technique groups with mean differences 64.5 and 65.1 in VAS, 20 and 18.15 in ANDI, −1.45 and −0.81 in PPT, and 2.47 and 1.88 in muscle amplitude, respectively. But there was no statistically significant difference in stretching only group in all variables except VAS. Conclusion Both INIT and spray and stretch techniques had a clinical and statistical effects on pain, function, PPT, and RMS. According to results, there were statistical significant differences between INIT and spray and stretch groups at post-treatment in all variables except VAS with more favor to INIT group, but there were no clinical differences between INIT and spray and stretch groups.

Comparative Effects of Strain Counterstrain and Ischemic Compression Technique in Patients with Upper Trapezius Trigger Points

Background: The trigger points are hyperirritable spots found usually in the muscle fascia or within the taut bands of skeletal muscles that is painful on compression. Ischemic compression technique uses the application of sustained pressure with sufficient force and for long enough so as to slow down the flow of blood and releasing tension out of the muscle. Strain counterstrain (SCS), also known as positional release, is a passive positional treatment that relieves musculoskeletal pain and dysfunction by indirect hand manipulation. Objectives: The aim of this study was to compare the effects of ischemic compression technique and strain counterstrain technique on pain, neck lateral flexion and disability in patients with upper trapezius trigger points. Methodology: The RCT was conducted on 36 male and female participants aging 25-45 having maximum of 5 trigger points in the upper trapezius bilaterally. The patients were divided equally to ischemic compression and strain counterstrain group by lottery method. The treatment was given for 3 days a week for 4 weeks. The NPRS, NDI and cervical lateral flexion were used as outcome measure. The assessment of the outcome measures was done on baseline, after 2nd week and after 4th week. The data was analyzed by SPSS version 26 using appropriate tests depending upon the normality by keeping the level of significance at 0.05. Results: Out of 36 participants (Mean age 32.96 ± 5.91), 20 were male and 16 were female, 3 participants lost to follow up. The within group analysis of NPRS and NDI done by Friedman test and that of cervical flexion done by repeated measures ANOVA showed that the both the interventions has produced significant (p&lt;0.05) effects on pain, neck disability and range of motion, but the between group analysis of NPRS and NDI done by Mann-Whitney test and that of Cervical ROM done by Independent samples t-test showed that none of the two technique produced significant results (p&gt;0.05) as compared to the other in subjects with upper trapezius trigger points. Conclusion: A 4-week intervention of the ischemic compression and strain counterstrain produced significant results in reducing the intensity of pain, the cervical disability and improving the cervical range of motion, but the intergroup comparison showed that both the ischemic compression and strain counterstrain were equally effective and none of them produced significant results as compared to others on patients with upper trapezius trigger points. Keywords: Ischemic Compression Technique; Strain Counterstrain; Upper Trapezius Trigger Points.

A Comparative Study - Effectiveness of Instrument Assisted Soft Tissue Mobilization Versus Ischemic Compression on Pain and Range of Motion in College Going Students with Upper Trapezius Trigger Points

Background: Trapezitis is one of the common inflammatory conditions seen among college going students due toprolonged faulty posture, overuse, stressful neck movement, etc. Students with trapezitis frequently report pain,restricted range of motion, and trouble doing regular tasks. The majority of college-bound youngsters have triggerpoints over their trapezius muscles.Need of study: There Is few Literatures or Research Work Available on This and No Comparison Is Done onAbove Techniques.so this study was done to compare both the techniques.Objective: To compare the effectiveness of IASTM and ischemic compression in trapezius trigger points in collegegoing students.Methodology: In this study, 45 participants were recruited based on inclusion and exclusion criteria. They weredivided in 2 groups. group-A(n=23) (IASTM) and group-B(n=22) (IC). Each intervention was administered tothem for a period of 2 weeks, 3 sessions per week in respective groups. Pre and post assessment was taken usingfollowing outcome measures VAS, NDI and cervical range of motion.Result: Data was analysed by SPSS21, t-test was applied. Statistically significant improvements observed in bothgroups but more pronounced in group A(IASTM). VAS (3.0504) P (0.0042), NDI (6.20) P&lt;0.0001.Conclusion: The results suggested that IASTM gives better result than ischemic compression in relieving trapezius triggerpoints in college going students.

Effect of Active Release Technique and Muscle Energy Technique on Cognition and Trigger Point of Upper Trapezius in District Level Pistol shooters - An Annotated Bibliographic Review

[Purpose] Currently, these days general population of 45% and 54% is affected by mechanical neck pain at somepoint in their life that can also lead to severe disability. During air-pistol competitions heightened stress woulddeteriorate shooters abilities to maintain gun stability, thereby resulting in inferior performance. In order tostabilise the gun muscular work of shooter’s shoulder and forearm are majorly involved to improve performancein Air Pistol Olympic Shooting and it is widely agreed that the ability to stabilize the gun is crucial for performancein pistol shooting .[Relevance] Therefore,an effective intervention and exercise protocol that reduces pain as wellas release the trigger points of upper trapezius must be devised so that incidence of muscle tightness at shoulderand neck can be lowered in shooters at training level. The aim of the study was to review the current availableliterature on effect of active release technique and muscle energy technique on cognition and trigger points ofupper trapezius in district level pistol shooters.[Participants] Nine full text articles were included for this review.[Methods] A literature search was performed using Google Scholar with the term active release technique,muscleenergy technique,cognition and upper trapezius trigger points. The articles were checked thoroughly and werereviewed.[Results] Significant improvement in cognition and cervical flexion ROM which was restricted earlierand gradual decrement in pain at trigger points was also observed in group receiving muscle energy technique.[Conclusion] Muscle energy technique proved beneficiary in improving cognition and reducing pain andrestricted ROM due to trigger points,so can be used as an adjunct to conventional physiotherapy management.[Implications] Integrating muscle energy technique in management of upper trapezius trigger points would showbetter results than conventional exercises alone for cases of upper trapezius trigger points presence alongwithaffected cognition in pistol shooters.

To Compare the Effectiveness of Positional Release Technique Versus Kinesio Taping in Patients with Upper Tapezius Trigger Points

Background: Muscles of the neck and shoulder region always function as a unit, and there is no movement in theupper extremity that would not be reflected in the neck musculature. Neck muscles show a strong tendency todevelop hyper tonus and spasm. The principal muscle to carry the load is trapezius which may get tender pointor spasm more frequently. The study aimed to find the effects of Positional Release Technique (PRT) and KinesioTaping (KT) in Upper Trapezius Trigger Points (Trigger points).Method: A total of 30 patients were taken with mean age of 26.16 and were allocated into two groups, Group APositional Release Group and Group B Kinesio Taping Group. Pain intensity level, Range of Motion (ROM) anddisability was measured using numeric pain rating scale (NPRS), Universal goniometer and neck disability index(NDI), respectively at baseline, 1st week after treatment and at the end of treatment.Conclusion: There was significant improvement in both PRT and KT groups. Statistical comparison of the resultshowed that Group A had greater improvement in pain and ROM as compared to Group B. PRT along withStandard PT treatment and therapeutic exercises appeared to be more effective than KT to reduce pain and increaseROM in patients with upper trapezius Trigger points.

Ultrasound-Guided Combined Greater Occipital Nerve Block at the C2 Level with Trapezius Trigger Point Injection and Supraorbital-Supratrochlear Nerve Block: More Effective on Allodynia and Disability in Chronic Migraine.

Chronic migraine (CM) patients with cutaneous allodynia (CA) show a poor response to treatment. Long-term studies have yet to be conducted to demonstrate the efficacy of blocks on CA. This study evaluated the improvement in allodynia and disability in CM treated with ultrasound (US)-guided blocks. In this prospective, non-randomized comparative study, 60 CM patients with CA were evaluated for the clinical effectiveness of the therapy using the numeric rating scale (NRS), headache impact test-6 (HIT-6), brush allodynia test, and allodynia symptom checklist (ASC-12). At the first visit, tenderness in the nerve or trapezius muscle was confirmed in the intervention group. US-guided greater occipital nerve block (GONB), GONB, and trapezius muscle injection (TPI), or GONB, TPI, and peripheral trigeminal nerve block (PTNB), respectively, were performed four times once a week for a month. Initial and third-month assessments were performed. The ASC-12 scores decreased in the GONB+TPI+PTNB and GONB groups more than the GONB+TPI group (mean rank, respectively, 26.86, 27.40, 38.39; P = 0.018). The decrease in HIT-6 scores was greater in the GONB+TPI+PTNB group than in the GONB group (mean rank, respectively, 21.98, 39.95, P < 0.017) in the first month. In the third month, the GONB+TPI+PTNB group scored HIT-6 significantly lower than GONB and GONB+TPI (mean rank: 18.84, 38.73, 35.61; P < 0.001). GONB+TPI+PTNB was more successful in alleviating allodynia and disability.

Effects of Intramuscular Electrical Stimulation on Pain and Dysfunction Following Upper Trapezius Trigger Points

Introduction: The purpose of the present study was to investigate the effects of single-session intramuscular electrical stimulation (IMES) on pain and dysfunction following active trigger points in the upper trapezius muscle.&#x0D; Materials and Methods: Volunteers (30 females) with active trigger points in the upper trapezius muscle were randomly divided into two IMES and placebo groups. For the IMES group, a needle was inserted into the trigger point, and electrical stimulation was applied to generate a pain-free contraction. For the placebo group, the intervention procedure was exactly the same, but there was no electrical stimulation. Pain by visual analog scale (VAS), pain pressure threshold (PPT), range of motion (ROM), and disability by neck disability index (NDI) were assessed as main outcome measures before, immediately after, and one week after conducting intervention by another blinded researcher.&#x0D; Results: The VAS scales were improved in both groups but were significantly lower in the IMES group one week after treatment. The PPT and ROM scores were substantially higher in the IMES group one week after the treatment. The NDI indexes significantly reduced for both groups, with no significant differences between them.&#x0D; Conclusion: IMES effectively improves pain, PPT, ROM, and NDI, following trigger points in the upper trapezius muscle. Further studies are required to investigate the IMES’s long-term effects.

Pressure Pain Threshold of the Upper Trapezius Trigger Point: A Systematic Review with Meta-Analysis of Baseline Values and Their Modification after Physical Therapy.

Myofascial trigger points (TrP) are diagnosed upon the presence of clinical signs among which hypersensitivity is considered one of the most important. The detection of the pressure pain threshold (PPT) is used to quantify the degree of hypersensitivity. However, there is a lack of normative data about how hypersensitive a TrP is. Therefore, the objective was to quantify the PPT for myofascial TrP in the upper trapezius muscle and its modification after manual or instrumental physical therapy interventions. A systematic review and meta-analysis were conducted among three databases (MEDLINE, Cochrane Library, and PEDro). Two independent reviewers conducted the electronic search and assessed the methodological quality of the included studies. Eleven studies with a high-risk bias indicated that the PPT at TrP sites was 105.11 kPa lower (95% CI: -148.93; -61.28) at active TrP sites (Chi-squared = 1.07, df = 1 (p = 0.30), I2 = 7%) compared to the PPT of the upper trapezius muscles of healthy subjects. In addition, the PPT of TrP was also lower than the reference values coming from the pain-free population. Moreover, the PPT increased after both manual and instrumental treatment by 28.36 kPa (95% CI: 10.75; 45.96) and 75.49 kPa (95% CI: 18.02; 132.95), respectively. The results of the present study show that TrP has a decreased PPT when compared to healthy muscles and that physical therapy may increase the PPT. However, the clinical relevance of this decreased PPT needs to be further elucidated. Further, the high risk of bias in all the retrieved studies undermines the validity of the results.

Combined Effects of Shock Wave Therapy and Muscle Energy Technique on Active Trigger Points of the Upper Trapezius Muscle

Objective: We investigated the combined effect of Radial Shockwave Therapy (RSWT) and muscle energy technique (MET) on pain, range of motion (ROM), and neck function in people with active trigger points (ATrPs) of the upper trapezius muscle. Materials &amp; Methods: Fifty-four participants with ATrPs of the upper trapezius muscle were randomly divided into three groups. Group A (n=18) received only MET, group B (n=18) received only RSWT, and group C (n=18) received both RSWT and RSWT. Pain intensity using the Visual Analog Scale (VAS), pressure pain threshold (PPT), neck function using the Neck Disability Index (NDI) questionnaire, and lateral-flexion range of movement (LF ROM) were measured before and after the intervention. The participants were treated for three sessions in one week with at least two days of rest between sessions. Results: All three intervention groups showed pain reduction (p&lt;0.001), an increase in PPT (p&lt;0.001), counter-lateral flexion (CLF) (p&lt;0.001), and also improvement in neck function (p&lt;0.001). The combined group showed a more obvious improvement than the other two groups in PPT (p&lt;0.001). There was no difference between the three groups in terms of VAS and NDI scores and CLF (p&gt;0.05). Conclusion: The results of this study showed that all three interventions used in the upper trapezius trigger points therapy were effective; however, the combined group showed a significant difference in PPT. Therefore, combined therapy is superior to MET and RSWT alone in improving pressure pain relief in individuals with upper trapezius trigger points.

A Comparative Study of Immediate Effects of Myofascial Release Technique and Positional Release Technique on Trapezitis among the College Students

Background: Trapezitis is one of the common inflammatory conditions seen among college going students due to prolonged faulty posture, overuse, stressful neck movement, etc. Students with trapezitis usually complaints of pain, decreased range of motion and difficulty in activities of daily living. Objectives: To compare the immediate effects of Myofascial Release Technique and Positional Release Technique on pain intensity, cervical range of motion, and neck disability index in trapezitis among college students. Methodology: A total of 100 students with trapezitis meeting the inclusion and exclusion criteria were allocated into two groups to receive single session of Myofascial Release Technique and Positional Release Technique respectively. Pre and Post intervention scores of VAS, CROM and NDI were measured. Results: Post intervention score of pain intensity in terms of VAS, cervical range of motion and NDI score showed extremely significant improvement within the groups (p&lt;0.0001). While comparing between two groups, there was no statistical significance. Conclusion: Myofascial Release Technique and Positional Release Technique both are effective in the treatment of trapezius trigger points associated with postural neck pain. KEYWORDS: Trigger Points, Students, Myofascial Release Technique, Positional Release Technique, Active Trigger Point, Latent Trigger Point, Trapezitis.