Trigger Points In Trapezius Muscle Research Articles

Effects of Low Level Laser Therapy Vs Ultrasound Therapy in the Management of Active Trapezius Trigger Points

Background: Trigger point is a extremely irritable local spot of exquisite tenderness in the nodule within the tangible taut muscle band. The prevalence studies have shown that the occurrence of myofascial trigger point in the general population.
 Objective: The aim of the study was compare the effects of low level laser therapy( LLLT) Vs ultrasound therapy in the management of active trapezius trigger point.
 Methodology: The participants will be allocated into two groups using simple random sampling. One group has to be given Low level laser therapy (LLLT) and Moist Heat and other group treated with US and Moist Heat. Both group receive treatment for 3 times a week. Total number of 9 session has to be given in 21 days. The outcome measure has to be taken at the first day and end of the day. 
 Conclusion: Based on the above results we conclude that Low Level Laser Therapy can be used as a therapeutic device in the management of Active Trapezius Trigger points.

Immediate Effects of Dry Needing or Manual Pressure Release of Upper Trapezius Trigger Points on Muscle Activity During the Craniocervical Flexion Test in People with Chronic Neck Pain: A Randomized Clinical Trial.

To compare the effects of dry needling or manual pressure release on an active trigger point in the upper trapezius on craniocervical flexion test performance, pressure pain thresholds, and cervical range of motion in chronic neck pain. A parallel randomized clinical trial. Physical therapy service. Individuals with chronic neck pain. Subjects were randomized to receive dry needling (n = 25) or manual trigger point pressure release (n = 25) on upper trapezius active trigger points. Surface electromyography from the upper trapezius, splenius capitis, sternocleidomastoid, and scalene muscles during performance of the craniocervical flexion test was assessed before and immediately after the intervention as the primary outcome. Neck pain intensity, range of motion, and pressure pain thresholds were the secondary outcomes. A decrease in sternocleidomastoid activity at all stages of the craniocervical flexion test (time effect, P < 0.001) was found in both groups after the interventions, with no significant between-group difference. Pressure pain thresholds measured over the cervical spine and second metacarpal increased after dry needling when compared with manual trigger point pressure release (P < 0.05). Pain intensity decreased immediately after both treatments with moderate to large effect sizes, whereas cervical range of motion increased for both groups but with small effect sizes. A single session of dry needling or manual pressure release over upper trapezius active trigger points promotes limited effects on muscle performance during the craniocervical flexion test, pressure pain thresholds, and cervical range of motion in patients with chronic neck pain.

Trigger point therapy – ischemic compression or perhaps cupping?

Abstract Study aim: To evaluate and compare the effectiveness of single ischemic compression and cupping therapy on the most common trigger point, on the descending part of the trapezius muscle. Materials and methods: Twenty-five students (15 women and 10 men) aged 24.20 ± 1.27 years were enrolled in the study. The mobility of the cervical spine area was measured with a measuring tape. The pain pressure threshold of the trigger point of the trapezius muscle was tested using a Wagner FDX 50 Force Gage digital algometer. Each person participated in three tests with an interval of approximately one week between them. The following study protocol was followed; 1) cupping therapy, with a cup statically positioned on the trigger point for two minutes, 2) at a minimum interval of 7 days, ischemic compression performed with the thumb twice for 1 minute on each side 3) control test at an interval of another 7 days. Results: Ischemic compression resulted in a statistically significant difference in cervical spine mobility scores (except for extension) and pain pressure threshold values. After applying cups, statistically significant differences were also observed in the results of cervical spine mobility and pain pressure threshold values. No statistically significant differences were found in the effectiveness of the therapies tested. Conclusions: In the present study, single trigger point cupping and ischemic compression therapies improved cervical spine mobility and resulted in an increase in the pain pressure threshold in the trapezius muscle trigger point. These two therapies did not differ in terms of their effectiveness.

A comparison of efficacy of diclofenac patch and physical therapy techniques in the treatment of patients with myofascial pain disorder of the upper trapezius

Objective: This study was conducted to find the best treatment in treating the patients of myofascial syndrome for this purpose two treatment options were compared to rule out the best option of treatment in minimizing the pain, enhancing the cervical movement and in determining the pressure pain threshold of MTrp. Material and methodology: It was a comparative study. Total 60 patients were randomly allocated to each group of treatment. We compared two treatments, treatment A of 30 patients was physical therapy and 30 patients of treatment B was diclofenac patch. For seven days, these patches were applied three times per day to the MTrP area of the upper trapezius muscle. The fix’s sufficiency and security boundaries were evaluated before it was used (day 0), three days later (day 3), and six days later (day 6). Chi square test was used for checking association of treatments and different attributes of patients. Results: There is significance association was found between demographic characteristics and treatments groups with p-values less than 0.05. There is significance difference effect between both treatments using VAS pain scale and cervical active Rom and PPT of MTRP using p-value less 0.05. These results shows that physical therapy treatment effects are batter as compare to diclofenac patch. Conclusion: Physical therapy techniques and the diclofenac patch have both been shown to be helpful but significant results are shown by Group A in treating trigger points of upper trapezius by normalizing the pathophysiological reasons of trigger points of this region. Physical therapy techniques are more helpful in reducing pain and in achieving cervical movement.

Effectiveness of ischemic compression pressure versus spray and stretch technique in the management of active myofascial trigger points of trapezius muscle.

Background: Now, a days myofascial trigger points are tremendously occurring and become a stressful part of nearly any person at any time in a lifetime. This study compares the effects of ischemic compression pressure with spray and stretch technique to treat active myofascial trigger points of the trapezius muscle in patients with neck pain.&#x0D; Methodology: A comparative interventional study was conducted at Dow University of Health Sciences from December 2016 and May 2017. Seventy patients (35 in each group) with active myofascial trigger points of trapezius were randomly assigned to group A (ischemic compression pressure) and group B (vapocoolant spray and stretch technique). Baseline and last session assessment of pain intensity, pain pressure tolerance, cervical range of motion and functional disability were measured through numerical pain-rating scale, algometer, goniometer and neck disability index, respectively.&#x0D; Results: Both groups showed significant improvement in all dependent variables of study which were neck pain, cervical range of motion and pain pressure tolerance (p-value&lt;0.05). Group A showed greater improvement in pain intensity (p-value 0.015), pressure pain threshold (p-value 0.000) and cervical range of motion flexion, left side flexion and right-side flexion (p-value 0.002, 0.000 &amp; 0.004) than group B.&#x0D; Conclusion: Both ischemic compression pressure &amp; spray and stretch technique deactivated trigger points of upper fibers trapezius muscle in patients with neck pain, but the ischemic compression pressure was superior to the spray and stretch technique.

Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial.

Objective To investigate the combined effect of extracorporeal shockwave therapy (ESWT) and integrated neuromuscular inhibition (INI) on myofascial trigger points in the upper trapezius.MethodsSixty subjects aged 18–24 years old with active myofascial trigger points in the upper trapezius were studied. Participants were assigned randomly to either group A who received ESWT one session/week, group B who received INI three sessions/week, or group C who received ESWT in addition to INI. All groups completed 4 weeks of intervention. The following main outcome measures were evaluated at baseline and after 4 weeks of intervention: pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR).ResultsWithin-group analysis revealed a significant decline in visual analog scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention (p<0.001). Multiple comparison analysis showed a substantial difference between the groups, while the major changes favored group C (p<0.05).ConclusionCombined treatment with ESWT and INI for treating myofascial trigger points in the upper trapezius is more effective than using only one of the two approaches in terms of clinical, functional, and neurophysiological aspects.

Effects of Dry Needling of the Upper Trapezius Active Trigger Points on Pain and Pain Pressure Threshold in Women With Chronic Non-Specific Neck Pain

Background and Objectives: The purpose of the present study was to examine the effectiveness of dry needling as local treatment of upper trapezius trigger points related to chronic neck pain on pain and pain pressure threshold in women with chronic nonspecific neck pain. Methods: Thirty females with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the intervention for three weeks. The outcomes were pain intensity and pain pressure threshold. Every outcome was recorded at baseline and 2 days after the fifth session. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. The results of the independent t-test showed a significant difference in measurements between the dry needling and passive stretch groups (P&lt;0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in women with nonspecific neck pain.

Positional release therapy and therapeutic massage reduce muscle trigger and tender points

ObjectiveTo determine if positional release therapy (PRT) or therapeutic massage (TM) was more effective in the treatment of trigger and tender points in the upper trapezius muscle. BackgroundTrigger points in the upper trapezius muscle are common and can be painful. Trigger points are commonly treated using TM however, PRT is a novel treatment that deserves further investigation. MethodsSixty healthy male (24) and female (36) participants, (age = 27.1 ± 8.8 years, wt = 75.2 ± 17.9 kg, ht = 172.8 ± 9.7 cm) presenting with upper trapezius pain and a trigger point were recruited and randomized into either the TM or PRT group. Upper trapezius trigger points were found via palpation. Pain level was evaluated using a visual analog scale (VAS) and pain pressure threshold (PPT) was assessed using a pressure algometer. Muscle thickness was measured by B-mode ultrasound, while muscle stiffness was measured by shear-wave elastography (SWE). Participants were measured at baseline, posttreatment and again 48 h later. ResultsBoth treatments were effective in treatment of pain and muscle stiffness. Although no statistical group differences existed, treatment using PRT showed decreased pain averages and decreased pressure sensitivity at both post treatment, and 48 h later. Neither treatment was able to maintain the reduced muscle stiffness at the 48-h measure in males. ConclusionBoth treatments showed a significant ability to reduce pain and acutely decrease muscle stiffness. Although not statistically different, clinically PRT is more effective at decreasing pain, and decreasing pressure sensitivity. Neither treatment method produced a long lasting effect on muscle stiffness in males.

Acupuncture-like versus conventional transcutaneous electrical nerve stimulation in the management of active myofascial trigger points: A randomized controlled trial

PurposeMyofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. The transcutaneous electrical nerve stimulation (TENS) is a non-expensive, safe, feasible modality, used recently for the treatment of MPS with promising but limited results. The purpose of this study was to determine the efficacy of acupuncture-like TENS (AL-TENS) vs conventional TENS (C-TENS) in the treatment of active myofascial trigger points. MethodsThis randomized controlled trial study was carried out with 60 consecutive patients with active trapezius trigger points referred to Physical Medicine and Rehabilitation Clinic. Participants randomly assigned to receive AL-TENS, C-TENS or sham TENS (S-TENS). The Visual Analogue Scale (VAS), Pressure Pain Thresholds (PPTs), and neck range of motion (ROM) were measured at baseline, after the first treatment sessions, after the final treatment session, and 3 months after the end of the last treatment session. Patients function was evaluated by Disabilities of the Arm, Shoulder, and Hand (DASH) at baseline, after the final treatment sessions, and 3 months after the end of intervention. ResultsThe interaction effect of time and group was significantly different when evaluating VAS (df = 4.65, F = 2.50, p = 0.038) and DASH (df = 2.63, F = 7.25, p < 0.001) in favor of active groups, as well as neck total lateral bending in favor of AL-TENS group compared other two groups (df = 4.16, F = 5.23, p = 0.001). Both VAS and DASH improved significantly at all follow-ups in AL-TENS and C-TENS groups. Of note, significant immediate improvement in all outcomes was observed only with AL-TENS. ConclusionsAccording to the present study, both AL-TENS and C-TENS were superior to placebo in pain reduction and functional improvement. Although both TENS techniques have similar efficiency on pain reduction, functional and pain perception improvement, the AL-TENS was the superior approach when evaluating neck lateral bending ROM.

Electromyographic Patterns of Masticatory Muscles in Relation to Active Myofascial Trigger Points of the Upper Trapezius and Temporomandibular Disorders.

The presented study aimed to analyze and compare the electromyographic patterns of masticatory muscles in subjects with active myofascial trigger points (MTrPs) within upper trapezius, patients with temporomandibular disorders (TMDs) and healthy adults. Based on the diagnostic criteria of MTrPs according to Travell & Simons and the Research Diagnostic Criteria for Temporomandibular Disorders, 167 people were qualified for the study. Subjects were divided into 3 groups: with active MTrPs in the upper trapezius, with diagnosed temporomandibular disorders (TMDs) and healthy adults. Measurements of the bioelectric activity of the temporalis anterior (TA) and masseter muscle (MM) were carried out using the BioEMG III ™. Based on statistical analysis, significantly lower values of TA resting activity were observed among controls in comparison to MTrPs (1.49 μV vs. 2.81 μV, p = 0.00) and TMDs (1.49 μV vs. 2.97 μV, p = 0.01). The POC index values at rest differed significantly between MTrPs and TMDs (86.61% vs. 105%, p = 0.04). Controls presented different electromyographic patterns within AcI in comparison to both MTrPs (4.90 vs. −15.51, p = 0.00) and TMDs (4.90 vs. −16.49, p = 0.00). During clenching, the difference between MTrPs and TMDs was observed within MVC TA (91.82% vs. 116.98%, p = 0.02). TMDs showed differences within AcI in comparison to both MTrPs group (−42.52 vs. 20.42, p = 0.01) and controls (−42.52 vs. 3.07, p = 0.00). During maximum mouth opening, differences between MTrPs and TMDs were observed within the bioelectric activity of masseter muscle (16.45 μV vs. 10.73 μV, p = 0.01), AsI MM (0.67 vs. 11.12, p = 0.04) and AcI (13.04 vs. −3.89, p = 0.01). Both the presence of MTrPs in the upper trapezius and TMDs are related to changes in electromyographic patterns of masticatory muscles.

Granisetron vs. lidocaine injection to trigger points in the management of myofascial pain syndrome: a double-blind randomized clinical trial.

Granisetron and lidocaine injections have been used for the management of myofascial pain syndrome. This study was aimed to compare the efficacy of granisetron and lidocaine injections to trigger points of upper trapezius in the management of myofascial pain syndrome. We performed a double-blind randomized clinical trial in an outpatient clinic of physical medicine and rehabilitation at a teaching hospital. A total of 40 patients aged≥18 with neck pain due to myofascial pain syndrome were included. They had pain for at least one month with the intensity of at least 30mm on a 100mm visual analog scale. Each participant received a single dose of 1mL lidocaine 2% or 1mg (in 1mL) granisetron. The solutions were injected into a maximum of three trigger points of the upper trapezius. We instructed all patients to remain active while avoiding strenuous activity for three or four days, and to perform stretch exercise and massage of their upper trapezius muscles. We assessed the patients before the interventions, and one month and three months post-injection. The primary outcome was the Neck Disability Index and the secondary outcome was the Neck Pain and Disability Scale. Both interventions were successful in reducing neck pain and disability (all p-values<0.001). However, the neck pain and disability responded more favorably to lidocaine than granisetron (p=0.001 for Neck Disability Index, and p=0.006 for Neck Pain and Disability Scale). No significant side-effect was recognized for both groups. Both lidocaine and granisetron injections to trigger points are effective and safe for the management of the syndrome and the benefits remain at least for three months. However, lidocaine is more effective in reducing pain and disability. The injections are well-tolerated, although a transient pain at the site of injections is a common complaint. One mL of lidocaine 2% is more effective than 1mg (in 1mL) granisetron for injecting into the trigger points of the upper trapezius in myofascial pain syndrome.

Immediate Effects of Dry Needling and Myofascial Release on Local and Widespread Pressure Pain Threshold in Individuals With Active Upper Trapezius Trigger Points: A Randomized Clinical Trial

ObjectiveThis study sought to compare the immediate effects of a single session of dry needling (DN), myofascial release (MR), and sham DN on pressure pain threshold (PPT) and neck pain intensity in individuals with chronic neck pain. MethodsThis was a randomized trial with a blinded outcome assessor. Forty-four individuals with chronic neck pain and unilateral myofascial trigger points in the upper trapezius muscle (UTM) were randomized to receive DN (n = 15), MR (n = 14), or sham DN (n = 15). The PPT over the UTM (ipsilateral and contralateral sides) and the proximal head of the radius (ipsilateral and contralateral to the treated side) and neck pain were assessed immediately and 10 minutes after the intervention. ResultsThere was no significant Group × Time interaction for PPT in the UTM on the treated side (F = 0.63, P = .641) or the contralateral side (F = 1.77, P = .144). However, there was a main effect of time on both the treated side (F = 4.917, P = .001) and the contralateral side (F = 4.70, P = .015), with DN and MR increasing PPT at the UTM. No significant Group × Time × Side interaction was found for PPT at the proximal head of the radius (F = 1.23, P = .276). Within-group analysis revealed a significant increase in PPT on the ipsilateral and contralateral sides in both DN and MR. Neck pain decreased after DN (P < .001), MR (P < .001), and sham DN (P = .008). ConclusionA single application of DN or MR generated local and distant hypalgesic responses superior to placebo. Future trials are needed to examine whether these findings occur in long-term follow-ups.

Comparison of the Effects of Dry Needling and Low-Level Laser on the Latent Trigger Points of Upper Trapezius

Background and Aims: Myofascial pain syndrome (MPS) is one of the most frequent causes of chronic musculoskeletal pain which is characterized by myofascial trigger points (MTrPs). Hence, it is of crucial importance to identify practical approaches for the treatment of these points. Upper trapezius muscle (UT) is highly susceptible to the development of MTrPs that are commonly resulted from overuse and micro-trauma. In this regard, the present study aimed to compare the effects of dry needling (DN) and low-level laser therapy (LLLT) regarding the reduction of pain and muscle thickness and improvement of the range of motion (ROM) and pressure pain threshold (PPT) in patients with latent MTrPs (LTrPs) in their UT muscles. Materials and Methods: In total, 60 patients with LTrPs in UT muscle participated in this randomized clinical trial. The subjects were randomly divided into two treatment groups of DN and LLLT. The PPT was evaluated by visual analog scale (VAS) and algometer while ROM and muscle thickness were assessed using goniometer and ultrasonography, respectively. It should be noted that the variables were evaluated before the first and after the sixth sessions. Finally, the collected data were analyzed using independent and paired t-tests. Results: Based on the results, the VAS and muscle thickness significantly reduced, while the PPT and cervical ROM increased in both groups after treatment (P&lt;0.001). The independent t-test revealed a statistically significant improvement in the DN group in terms of PPT (9.9-14.17, P=0.009) and ROM (37.33-42.67, p=0.005), compared to the LLLT group. Nevertheless, no significant difference was found between the two groups regarding VAS and muscle thickness variables (P&gt;0.05). Conclusion: The DN and LLLT effectively improved symptoms in the UT muscles of patients with LTrPs. However, the DN was more effective in the improvement of ROM and PPT variables.

Immediate effect of kinesio tapping V.S ischaemic compression on myofascial trigger points of trapezius muscle

Introduction: Myofascial pain syndrome is the most common cause of myofascial pain which is mainly due to myofascial trigger points. The myofascial trigger points are spots of hyperirritability located in the muscle as a taut band which on palpation or compression is tender and has referral pain. Some studies state that trigger points may form as a result from or be irritated by overuse, faulty posture, trauma, mechanical over load or psychological stress. We in our study have aimed to compare the immediate effect of Kinesio tapping with Ischaemic compression on trigger points in trapezius muscle. Materials and Methods: 30 subjects were included in the study, which were divided in Group A (Kinesio Taping) and Group B (Ischemic Compression). Outcome measure was assessed on the basis of NPRS and Cervical Spine ROM based on Pre and Post procedure readings according to the respective groups. Conclusion: Kinesio tapping and ischemic compression both treatment are effective individually to relive pain and increase lateral flexion range of cervical spine and work effectively on different individuals to get the same result.

A Comparative Study on the Effects of Trigger Point Release vs Myofascial Release for Myofascial Trigger Points of Upper Trapezius in Smartphone Users

Background/aim: The increasing use of smartphone in daily life has brought about numerous musculoskeletal problems. Impairments in the neck is the most common when compared to other parts of the body. The aim of this study was to compare the effects of two different manual treatment techniques in two separate groups, i.e., trigger point release and Myofascial release (MFR) on the trigger points (TrPs) in the upper trapezius muscle in smartphone users. Both group received Ultrasound therapy. The smartphone addiction scale -short version was administered to all participants to determine the level of addiction and those who scores were high were included in the study. The set criteria in the study included the pain intensity on the visual analogue scale (VAS) neck disability using the Neck Disability Index and Cervical Range of motion side flexion using cervical goniometer. Subjects and methods: This clinical trial study assessed the outcome measures within and between groups before, after the intervention and a follow up was done after 15 days. The target population were smartphone users between the age group of 18 to 35 years. 106 subjects (48 males, 53 females) participants who had been selected from among the eligible participants of 176 and who had TrPs in their upper trapezius muscle. Results: The effect of Trigger point release and Myofascial release on patients of each groups with TrPs in the upper trapezius muscle resulted in increased cervical lateral flexion (P &lt; 0.001), decreased pain intensity on VAS (P &lt; 0.001) and decreased decrease in Neck disability (P &lt; 0.001) within the groups and between the group there was no significance. Conclusion: Both manual techniques Trigger point release and Myofascial release reduced the symptoms of TrPs in the upper trapezius in both the groups equally, neither technique being superior to the other.

Trigger Point Release versus Instrument Assisted Soft Tissue Mobilization on Upper Trapezius Trigger Points in Mechanical Neck Pain: A Randomized Clinical Trial

Abstract Background: Mechanical neck pain is a widespread sig-nificant health problem with a huge burden on the individual and economy. Finding a noninvasive effective treatment that's non exhaustive for the therapist and non painful for the patient is highly needed. Aim of Study: This study investigated and compared the effects of instrument assisted soft tissue mobilization (IASTM) using m2t blade and trigger point release (TPR) in terms of neck lateral flexion and rotation range of motion on upper trapezius (UT) myofascial trigger points (MTrPs) in mechanical neck pain. Methods: Forty patients between 18 and 55 years were randomized to one either group A or B. Group A received one session of TPR and passive stretching while group B received one session of IASTM using M2t blade and passive stretching. Tape measurement was used to evaluate patients pretreatment, post treatment and at follow-up. Results: Within group analysis, there was a significant increase in neck lateral flexion and rotation at immediate post treatment and at follow-up in both groups (p 0.05) Conclusion: IASTM using M2t blade and TPR were effective in treating patients with mechanical neck pain and UT MTrPs.

PENGARUH PEMBERIAN ISCHEMIC COMPRESSION DAN STRETCHING UNTUK MENGURANGI NYERI MYOFASCIAL TRIGGER POINT OTOT UPPER TRAPEZIUS PADA PEGAWAI KLAIM BPJS DI RUMAH SAKIT GRANDMED LUBUK PAKAM TAHUN 2020

Background: Myofascial Trigger point syndrome is a local pain trigger point characterized by irritation, inflammation, and swelling. The main problem is that when the emphasis is made, it creates a hypersensitive pain. Myofacial trigger point occured by adhesions, increase by malnutritions and oxygen to ischemic. The problems are pain on muscle cervical contraction and spasm, tenderness, tightness, stiffness, decrease muscle strength.Physiotherapy modalities that can be used for Myofascial Trigger point syndrome are Ischemic Compression and Stretching exercise. Objectives: The study aims to determine influence of Ischemic Compression and Stretching exercise in patients with the myofascial trigger point syndrome with pain of the Upper Trapezius muscle Trigger Point at the Grandmed Lubuk Pakam Hospital. Research method: uses quasi experiments with one group pre test and post test. Samples for this research are 20 respondents got Ischemic Compression and Stretching exercise intervention. Respondents divided into two variable, dependent variable got stretching and ischemic compression method and independent variable is measure for pain in myofascial trigger point syndrome. Results: Hypotheses test results with the Wilcoxon saigned rank test result obtained by P-value ≤ α (0.000 &lt; 0.05). Mean of pain based on Numeric rating scale before intervention (pre test) is 4,60 and after interventiom (post test) is 2,00. Conclusion:According to experimental decisions, there is an influence Ischemic Compression and Stretching exercise to decrease pain in the Myofascial trigger point syndromeof the upper trapezius muscle trigger point at the Grandmed Lubuk Pakam Hospital.

Immediate effects of myofascial release and cryo-stretching in management of upper trapezius trigger points – A comparative study

Background: Myofascial release has beneficial effects on trigger points. Many studies have been done on myofascial release but a comparative study with cryo-stretching is lacking. Aims and Objectives: To find the effectiveness of cryo-stretching on trigger points and compare between myofascial release and cryo-stretching. Materials and Methods: 54 participants were included in the study and were allocated into two groups: Myofascial release (deep transverse friction, cross-hand technique) and cryo-stretching (static stretch, isometric contraction). Pre and post-assessments were taken for pain using VAS, pressure threshold by digital algometer and cervical lateral flexion using a universal goniometer. Results: Analysis was done using unpaired t-test and Mann Whitney U test for comparison of ROM and pressure threshold and pain respectively between the two groups. Differences between the two groups were statistically insignificant (p > 0.05). Paired t-tests and Wilcoxon’s test for within-group study showed significant improvement for VAS PPT, and ROM in both groups. Conclusion: The study found that both MFR and cryo-stretching were effective in management of upper trapezius trigger point. Keywords: Myofascial release, Trigger points, Cryostretch, Trapezius.

Can addition of low level laser therapy to conventional physical therapy be beneficial for management of pain and cervical range of motion in patients with trigger point of upper trapezius?

Objective: Trigger points commonly develop in upper trapezius muscle. These might be associated with neck pain arising from trigger points of trapezius. This study was conducted to compare the effectiveness of conventional physical therapy (CPT) with and without low level laser therapy (LLLT) on pain and cervical range of motion (ROM) in patients with trigger point of upper trapezius muscle.&#x0D; Methodology: An RCT was conducted with a sample size of 62 patients. The study was completed within 9 months after approval of synopsis. Data were collected from Health Care Physiotherapy, Sports, Spine &amp; Rehabilitation Center, Faisalabad (Pakistan). Patients were randomly allocated into two equal groups; 31 patients of Group-1 received low-level laser therapy with CPT, while Group-2 (n=31) patients received CPT as the only treatment protocol. Patients pain level was assessed using Numeric Pain Rating Scale (NPRS) and cervical ROM was measured by goniometry at baseline and subsequently at 2nd and 4th week follow-ups.&#x0D; Results: Results of the study obtained by applying repeated measures ANOVA showed that there was mean reduction in pain scores from day 1 to week 4 in within group analysis of LLLT + CPT Group (Group=1) and within group analysis of CPT Group (Group=2) (p &lt; 0.05). Statistically significant improvement was observed in all mean cervical ROMs especially for lateral flexion ROM for both groups in within group analysis (p &lt; 0.05). Statistically significant improvement was seen in NPRS score at week four between Group-1 and 2, measured by independent sample t-test with p &lt; 0.05. Whereas, independent sample t-test results showed no significant improvement in cervical ROMs at week four between Group-1 and 2 (p ˃ 0.05).&#x0D; Conclusion: Conventional physical therapy and low level laser therapy used in combination are more effective than conventional physical therapy alone in patients of trigger points of upper trapezius.&#x0D; Citation: Waseem I, Tanveer F, Fatima A. Can addition of low level laser therapy to conventional physical therapy be beneficial for management of pain and cervical range of motion in patients with trigger point of upper trapezius? Anaesth pain &amp; intensiv care 2019;23(2):__&#x0D; DOI: https://doi.org/10.35975/apic.v24i1.&#x0D; Received – 4 September 2019,&#x0D; Reviewed – 31 December 2019, 26 January 2020,&#x0D; Revised – 18 March 2020,&#x0D; Accepted – 9 May 2019

Instrument-assisted soft tissue mobilisation versus stripping massage for upper trapezius myofascial trigger points.

ObjectiveThis study investigated the effects of instrument-assisted soft tissue mobilisation (IASTM) versus stripping massage (SM) on myofascial trigger points in the right upper trapezius.MethodForty patients (34 women and 6 men), aged 18–23 years, with active trigger points in the right upper trapezius were divided into two equal groups (A and B). Group A (n = 20) received IASTM using an M2T blade twice a week for four weeks in addition to stretching exercise. Group B (n = 20) received SM twice a week for four weeks in addition to stretching exercise. The visual analogue scale, a pressure algometer, and the Arabic version of the Neck Disability Index were used to evaluate patients' pre- and post-treatment statuses.ResultsWithin-group analysis showed significant differences between pre- and post-treatment values of all outcome measures in both groups. In contrast, between-group analysis did not show any significant differences between the two groups in pre- or post-treatment values of any outcome measures.ConclusionIASTM and SM are effective methods for improving pain and function in patients with upper trapezius trigger points.