Trigger Points In Upper Trapezius Muscle Research Articles

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

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

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<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 <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<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.

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.

Effects of Eldoa Technique with Conservative Treatment on Pain Threshold of Active Trigger Points in Upper Trapezius and Levator Scpulae

Background: The muscles that sustain body posture and the neck posture both have an impact on the cervical muscle, which is also frequently injured. The upper trapezius muscle is most frequently affected by trigger points, which is a common and prevalent condition. Aim: To assess the effectiveness of ELDOA exercises at the cervical spine and treating trigger points in the trapezius and levator scapulae. Methodology: The Ibn-e-Siena Hospital and Research Institute in Multan conducted a quasi-study. The participants were divided into two groups using a coin flip as a sampling method with the study sample size of 26. The Goniometer, Numeric Pain Rating Scale and Neck Disability Index were used to collect data from patients between the ages of 18 and 40. Results: An independent t-test was applied. Mean age ranged from 24.70±5.75 in the experiment group and 25.18±5.61 in the control group. The patients have radiated pain in control group was 3 (30%), trapezius trigger point7(70%) andlevator scapulae 3(30%) while in experimental group, pain radiating 6(60%), trapezius trigger point6(60%) and levator scapulae 4(40%). The post-results data revealed that the p values for the NPRS, Algometry and NDI significant differences were 0.025, 0.025, and 0.00, respectively. Conclusion: The results of the current investigation, the ELDOA approach considerably reduced discomfort, cervical ranges, and neck impairment brought on by trigger points. Keyword: Neck pain, Trigger Point, Skeletal Muscle, Myofascial Pain, Active Soft Tissue Release,

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.

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.

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.

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.

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

Effectiveness of strain-counterstrain technique versus digital ischemic compression on myofascial trigger points

Background and Aim: Neck pain is a typical disorder among people from diverse populations. Myofascial trigger points are located on upper trapezius with a high incidence. These trigger points are commonly found in individuals with mechanical neck pain. This study was conducted to compare the effectiveness of strain-counterstrain and digital ischemic compression on pain, range of cervical lateral flexion and the Neck Disability Index (NDI) score in individuals with Myofascial trigger points of upper trapezius. Materials and Methods: Fifty-five subjects between the age group of 25–45 years clinically diagnosed with neck pain associated with myofascial trigger points were enrolled after ethical approval. Subjects were randomly allocated into Group A (n = 28) (Strain-counterstrain) and Group B (n = 27) (Ischemic compression) for 5 sessions in a week. Outcomes were measured using numerical pain rating scale for pain, NDI for disability and cervical lateral range of motion (ROM) using a goniometer. Results: The intragroup comparison was done using Wilcoxon signed-rank test whereas the intergroup comparison was done using the Mann–Whitney test for data that were not normally distributed. The level of significance was determined by P 0.05). Conclusion: Both techniques were equally effective in reducing pain, improving ROM of cervical lateral flexion, and NDI score in individuals with myofascial trigger points of upper trapezius.

Correlation Between Trapezius Trigger Points and Head/Neck Posture In Subjects With Frozen Shoulder

Objective: To find out correlation between head/neck posture and trigger points in upper trapezius muscle in frozen shoulder subjects. Method: A total of 48 subjects (28 females and 20 males) between the age group 40-60 years with stage 2 of frozen shoulder were selected for the assessment of head/neck posture and trigger points in upper trapezius. Outcome assessment for head/neck posture included cranial vertical angle (CVA), cranial rotation angle (CRA); upper trapezius trigger points were explored through palpation. Both the readings were compared and analysed by Pearson correlation test using SPSS (version 20). Result: Poor correlation between CVA and upper trapezius trigger points-(r=0.1647) whereas correlation between CRA and trigger points in upper trapezius-(r=-0.0972) in subjects with frozen shoulder which was statistically insignificant. Conclusion: There is weak influence of head/neck posture and trigger points in upper trapezius. i.e. there is no greater/smaller deviational change in the forward head posture (FHP) in association with trigger points in upper trapezius in frozen shoulder subjects.

Comparison of Immediate and Carry Over Effects of Kinesiotaping and Rigid Taping on Pain due to Latent Trigger Points of Upper Trapezius in Individuals with Forward Shoulder Posture: A Randomized Control Trial

Comparison of Immediate and Carry Over Effects of Kinesiotaping and Rigid Taping on Pain due to Latent Trigger Points of Upper Trapezius in Individuals with Forward Shoulder Posture: A Randomized Control Trial

Microcurrent electrical neuromuscular stimulation to improve myofascial neck pain and stiffness

Myofascial pain syndrome can cause not only the pain, but also the muscle stiffness by the densification of excessive hyaluronic acid in muscle and fascia. The first aim of this study was to evaluate the therapeutic effects of microcurrent electrical neuromuscular stimulation on chronic myofascial pain syndrome of upper trapezius muscles and the second aim was to evaluate the viscoelastic change of myofascial trigger points and neighboring tissues with ultrasonoelastography using acoustic radiation force impulse (ARFI) imaging. This study was designed as a prospective, randomized, double-blinded, placebo-controlled trial. The patients with chronic neck pain who visited the outpatient clinic voluntarily were included in this study. Total 40 minutes’ microcurrent electrical therapy using a Granthe Advance (8 Hz, 25 μA, Cosmic Co., Seoul, Korea) or sham stimulation was applied on both upper trapezius muscles daily for 2 weeks, total 14 times. All MENS and control groups took the standard care including postural education, and self-exercise. All participants visited total 3 times; baseline, 2 weeks and 4 weeks follow-up. At every visit, we evaluated the usage of analgesics, existence of trigger points of upper trapezius, Visual Analogue Scale (VAS), pressure pain threshold, neck range of motion (ROM), and viscoelasticity by shear wave velocity using ultrasonoelastography. There was no significant difference in baseline characteristics. MENS significantly improved pressure pain threshold on upper trapezius muscles ( P = 0.001). Also, MENS significantly reduced shear wave velocity ( P = 0.001) on upper trapezius muscles and patients rated pain intensity ( P = 0.024). The detailed values were summarized in Table 1 . Our findings demonstrate that the microcurrent electrical neuromuscular stimulation improved pressure pain threshold, pain intensity and shear wave velocity in chronic myofascial pain syndrome on upper trapezius muscles. Therefore, MENS can be a useful treatment tool for the myofascial pain syndrome.

Electrical impedance of the torso is associated with the pressure pain threshold on myofascial trigger points in patients with chronic neck pain: A cross-sectional study.

Myofascial trigger points are dysfunctional structures present in skeletal muscles and are related to sensory, motor, and autonomic changes. Despite scientific advances in recent decades in the measurement of musculoskeletal pain, evaluation of this clinical phenomenon is supported with instruments that, although valid and reliable, have a considerable degree of subjectivity. To correlate electrical impedance of the upper limbs and torso with pain intensity, functional capacity, catastrophizing, pressure pain threshold, and skin temperature on myofascial trigger points in the upper trapezius muscle of patients with neck pain. A single-blind cross-sectional study. Twenty-eight volunteers of both genders were included in the study, were aged 18-45 years, and had chronic neck pain and myofascial trigger points in the upper trapezius. The volunteers were assessed using the Numeric Rating Scale, the Neck Disability Index, the Pain-Related Self-Statement Scale, algometry, infrared thermography, and electrical bioimpedance. The following significant results were observed: a negative association between the pressure pain threshold on myofascial trigger point in the right upper trapezius and electrical impedance of the torso at 5 kHz (rs=-0.392, p= 0.032), 50kHz (rs=-0.406, p= 0.026), 250 kHz (rs=-0.388, p= 0.034), and to the frequency 500 kHz (rs=-0.444, p= 0.014). Electrical impedance of the torso is associated with the pressure pain threshold of myofascial trigger points on the upper trapezius of individuals with neck pain. Thus, individuals with a lower pressure pain threshold have higher electrical impedance values of the torso and vice versa.

Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes With Unilateral Shoulder Impingement Syndrome.

Chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points (MTrPs), particularly in the upper trapezius (UT) muscle. Dry needling (DN) is a treatment of choice for myofascial pain syndrome. However, local lesions and severe postneedle soreness sometimes hamper the direct application of DN in the UT. Therefore, finding an alternative point of treatment seems useful in this regard. To compare the efficacy of UT versus infraspinatus (ISP) DN on pain and disability of subjects with shoulder pain. The authors hypothesized that ISP DN could be as effective as the direct application of DN in UT MTrP. Single-blind randomized clinical trial. Sports medicine physical therapy clinic. A total of 40 overhead athletes (age = 36 [16]y; 20 females and 20 males) with unilateral shoulder impingement syndrome were randomly assigned to the UT DN (n = 21) and ISP DN (n = 19) groups. An acupuncture needle was directly inserted into the trigger point of UT muscle in the UT DN group and of ISP muscle in the ISP DN group. DN was applied in 3 sessions (2-day interval between each sessions) for each group. Pain intensity (visual analog scale), pain pressure threshold, and disability in the arm, shoulder, and hand were assessed before and after the interventions. Pain and disability decreased significantly in both groups (P < .001) and pain pressure threshold increased significantly only in the ISP group (P = .02). However, none of the outcome measures showed a significant intergroup difference after treatments (P > .05). Application of DN for active MTrPs in the ISP can be as effective as direct DN of active MTrPs in the UT in improving pain and disability in athletes with shoulder pain, and may be preferred due to greater patient comfort in comparison with direct UT needling.

Short-term effects of kinesio taping on trigger points in upper trapezius and gastrocnemius muscles

BackgroundKinesio taping is a possible therapeutic modality for myofascial pain, nevertheless, very scarce research has been performed on this subject. ObjectiveTo evaluate the immediate and short-term effect of kinesio taping application on myofascial trigger points (MTrPs) and pressure pain thresholds (PPTs) in the upper trapezius and gastrocnemius muscles. MethodsTwo randomized, single-blinded, controlled trials were simultaneously executed on the upper trapezius and gastrocnemius muscles. Different participants in each study were randomly assigned to an active intervention (N = 15) or control (N = 15) group. Kinesio taping was applied on the gastrocnemius or upper trapezius muscles by positioning three “I” strips in a star shape (tension on base) directly above the MTrPs in the active intervention group and a few centimeters away from the MTrPs in the controls. ResultsThe second evaluation on both sides showed lower PPT values than the first evaluation in the control group, denoting that the spots were more sensitive. The third evaluation showed even lower values. The active intervention group showed a contralateral side pattern similar to the controls. However, on the side of the kinesio taping application, the PPT values of the second evaluation were higher (the spots were less sensitive) and after 24 h returned to the original values. The difference between the PPT measurements on the MTrPs’ side of the active intervention group vs. the controls (time-group interaction) was significant (F (2,56) = 3.24, p = 0.047). ConclusionsWe demonstrated that a kinesio taping application positioned directly above the MTrPs may prevent an increase in sensitivity (decrease in PPT) immediately after application and prevent further sensitization up to 24 h later. The fact that two different muscles were similarly affected by the kinesio taping application, confirmed that the results were not in error. Further studies are needed to directly test the effect of a kinesio taping application on post-treatment soreness.

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

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

Additional Effect of Static Ultrasound and Diadynamic Currents on Myofascial Trigger Points in a Manual Therapy Program for Patients With Chronic Neck Pain: A Randomized Clinical Trial.

To assess the additional effect of static ultrasound and diadynamic currents on myofascial trigger points in a manual therapy program to treat individuals with chronic neck pain. A single-blind randomized trial was conducted. Both men and women, between ages 18 and 45, with chronic neck pain and active myofascial trigger points in the upper trapezius were included in the study. Subjects were assigned to 3 different groups: group 1 (n = 20) was treated with manual therapy; group 2 (n = 20) was treated with manual therapy and static ultrasound; group 3 (n = 20) was treated with manual therapy and diadynamic currents. Individuals were assessed before the first treatment session, 48 hours after the first treatment session, 48 hours after the tenth treatment session, and 4 weeks after the last session. There was no group-versus-time interaction for Numeric Rating Scale, Neck Disability Index, Pain-Related Self-Statement Scale, pressure pain threshold, cervical range of motion, and skin temperature (F-value range, 0.089-1.961; P-value range, 0.106-0.977). Moreover, we found no differences between groups regarding electromyographic activity (P > 0.05). The use of static ultrasound or diadynamic currents on myofascial trigger points in upper trapezius associated with a manual therapy program did not generate greater benefits than manual therapy alone.

A Comparison of the Effects of Dry Needling and Postural Correction Education on Pain, Pain Threshold, and Functional Disability on the Active Upper Trapezius's Trigger Points: A Randomized Controlled Trial (Pilot Study)

Introduction: Myofascial trigger points in upper trapezius have been reported as a common symptom of patients with neck pain. The aim of this study was to compare the effects of dry needling and postural correction reeducation on pain, pain threshold, and functional disability in patient with upper trapezius trigger points. Materials and Methods: This pilot study was a single-blind, randomized clinical trial. The 15 participants were randomly assigned to 3 groups; the first group received dry needling and conventional physiotherapy, the second group received postural correction (PC) and conventional physiotherapy, and the third group (control) received only conventional physiotherapy. Interventional effects were examined in three aspects including pain pressure threshold, neck pain, and functional disability using an algometer, visual analogue scale (VAS), and the Neck Disability Index (NDI), respectively. Patients were evaluated at the three stages of before the treatment, immediately after the treatment, and 6 weeks after the last treatment session. Results: Despite the significant effects of the three treatment methods on increased pain threshold, and reduced severity of pain and functional disability (P 0.05). However, significant differences were observed between the two interventional groups ‎and the control group (P < 0.05) 6 weeks after the treatment. The statistical test power of VAS on the last session and 6 weeks after the treatment was, respectively, 68% and 79%. Conclusion: Due to the positive effects of dry needling and postural correction reeducation and the significant difference of these groups with the control group 6 weeks after the treatment, the use of these treatment methods is recommended in individuals with upper trapezius trigger points.

Effects of Conventional Physical Therapy with or without Strain Counterstrain in Patients with Trigger Points of Upper Trapezius; a Randomized Controlled Clinical Trial

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt;&lt;strong&gt;Â Â &lt;/strong&gt;Non-specific neck pain has potential contributing factors. One of the factors being emphasized in the modern era is the Myofascial trigger points in the upper trapezius muscle. These could be treated by strain counterstrain method whose effectiveness needs to be evaluated. Hence, the objective of the study was to compare the effects of conventional Physical therapy with or without strain counterstrain in patients with trigger points of upper trapezius muscle.&lt;/p&gt;&lt;p&gt;Â &lt;strong&gt;Patients and Methods&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;It is randomized controlled clinical trial.&lt;/p&gt;&lt;p&gt;48 patients with treatment group A (24 patients) and control group B (24 patients).&lt;/p&gt;&lt;p class="Default"&gt;48 patients with treatment group A (24 patients) and control group B (24 patients).&lt;/p&gt;&lt;p&gt;Patients with non-specific neck pain, having active myofascial trigger points in upper trapezius muscle presented to physical therapy department. Effects of interventions were recorded on neck disability index, visual analogue scale and cervical range of motion goniometer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt; of this study using repeated measure ANOVA demonstrated that within group from day 1 to 7, there was mean reduction of pain by 32.13 (26.99, 37.27) in conventional physical therapy group with Strain counterstrain group (group A) and conventional physical therapy only group (group B) by 12.62 (8.28, 16.96). Less significant improvement was seen within groups for day 1, 4 and 7 in cervical range of motion. There was significant improvement seen in pain, neck disability index and neck range of motions on day 7 between group A and B measured by independent sample t test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt;&lt;strong&gt;Â Â &lt;/strong&gt;Conventional physical therapy with strain counterstrain was found effective in reducing pain, functional disability and improving range of motion at cervical region.&lt;/p&gt;