Trigger Points Research Articles

Dental patients' tinnitus profile: prevalence, types, and associated factors with oral and maxillofacial diseases.

Maxillofacial diseases may pose a risk factor for the onset of tinnitus, and may influence the severity of its symptoms. The objective of this study was to investigate the prevalence of tinnitus among patients routinely visiting the Faculty of Dentistry and to assess the relationship between tinnitus and maxillofacial diseases. This was a prospective cross-sectional study conducted on 3,626 patients. Demographic data, information on tinnitus symptoms, temporomandibular disorder (TMD) presence, the existence of trigger points in masticatory muscles, toothache, and bruxism were evaluated. Tinnitus was detected in 385 patients, resulting in a prevalence rate of 10.61%. Of the patients, 38.4% were male and 61.6% were female, and the mean age was 42.66 ± 16.34 years. Tinnitus was categorised as normal in 47.8% of the patients and pathological in 52.2% of the patients. Bruxism was identified in 65.5% of the patients, toothache in 42.9%, TMD in 33.8%, and masticatory trigger points in 27.0% of the patients. A tendency towards tinnitus provoked by toothache was observed in 5.9% of the patients. The presence of pathological tinnitus was found to increase the risk by 1.839 times for toothache and 1.456 times for bruxism. There may be an association between oral and maxillofacial diseases and tinnitus, especially bruxism and toothache. Therefore, the evaluation of these conditions may be a routine part of tinnitus management.

Musculoskeletal evaluation of the lower pelvic complex in women with endometriosis: A case-control study

ObjectiveUse clinical pain measurement tools to investigate and compare the prevalence of pelvic loin disoders in women with and without endometriosis. Study DesignChronic pelvic pain (CPP) associated with endometriosis has diverse origins, including musculoskeletal factors. Musculoskeletal dysfunction in the pelvic region is theorized to result from sustained muscular contraction, triggered by altered visceral stimuli and adoption of antalgic postures, causing secondary damage to muscles, ligaments, and joints. CPP significantly impacts quality of life, relationships, sexuality, and mental health. However, limited data exists on musculoskeletal impacts of endometriosis and CPP. It was made a case-control study at Maternidade Escola Assis Chateaubriand from August 2017 to January 2021. Evaluated 71 women: 41 in endometriosis group (EG) and 30 in control group (CG). Data collection included sociodemographic questionnaires, musculoskeletal physiotherapeutic evaluations, pain mapping, pressure pain thresholds, kinesiophobia, and disability measurements. Statistical analysis was performed using Spearman's Rho test to determine correlations. ResultsMean age of participants was 31 years. EG exhibited lower pain threshold variations in lumbopelvic trigger points than CG (P < .05). Significant muscle flexibility differences between groups were observed; EG had reduced flexibility (P < .05). Most common pain areas were hypogastrium in EG (48.78 %) and left lumbar in CG (30 %). EG had higher kinesiophobia values (P = .009). There was a weak association between kinesiophobia-pressure threshold association observed in CG's lumbar pelvic region. ConclusionWomen with Endometriosis and CPP exhibit higher prevalence of musculoskeletal disorder, lower pain thresholds, decreased lumbopelvic muscle range of motion, higher kinesiophobia scores, and increased disability indices with low back pain compared to healthy women.

Analysis of the Propagation of Temperature and Thermal Conductivity of Sawdust Pyrolysis Process with Modeling Fea and Experiment

The study uses densified sawdust with heat propagation and thermal conductivity to achieve better pyrolysis and gasification processes. Analysis of sawdust's heat propagation and thermal conductivity during pyrolysis was developed with Finite Element Analysis (FEA). The thermal conductivity values of sawdust (k) obtained from FEA are 1.49, 1.3, 1.1, and 0.7 W/m C considering the sawdust heated with a triggering temperature (T0) 535 ºC and reaches a constant temperature of T1 = 265 ºC, T2 = 165 ºC, T3 = 115, and T4 = 95 ºC respectively after 20 minutes. The temperature distribution of sawdust heated shows between the experimental and FEA results is quite the same; however, differences on graph T1 show the experimental thermal conductivity (k) value is distinct from the simulated thermal conductivity (k) value due to a significant change that occurred as sawdust transformed into charcoal at minute 70, where the distance between point T1 and the trigger point (T0) is 40mm and after 180 minutes the sawdust had turned into charcoal completely. Furthermore, 31 grams (6.46%) of sawdust underwent pyrolysis in this experiment. The findings can aid future research and development in this field and provide valuable insight into the duration of time a bio stove utilizing compacted sawdust can produce a sustainable flame and be used as a reference for future experiments.

Effects of myofascial trigger point injection on the disease activity in patients with comorbidity of fibromyalgia and cervical myofascial pain syndrome

Aims: To investigate the effect of myofascial trigger point injection on the disease activity of FS in patients with myofascial trigger points in the coexistence of fibromyalgia syndrome (FS) and chronic cervical myofascial pain syndrome (MAS). Methods: 30 consenting patients between the ages of 18-60 who has had FS for at least for 3 months and also MPS in trapezius, levator skapula, splenius capitis, and multifidus muscles in cervical region and 15 patients with FS but without MPS were included in the present study. Patients newly diagnosed with FS, were evaluted for the presence of MPS and FS, disease activity was evaluated before administering treatment and after administration of trigger point injection tretament for cervical MPS. In the group with only FS, cervical region tender point injection was carried out. Patients were evaluated before injection and one month after injection. Severity of pain was evaluated with VAS (visual analog scale), pressure pain threshold was measured with algometer, total myalgic score (TMS) , fibromiyalgia impact questionnaire (FIQ), Pittsburgh sleep quality index (PSQI) , Beck depression inventory (BDI), Beck anxiety inventory (BAI), fatique severity scale (FSS) results were evaluated prior to and after treatment. Results: When patients were evaluted at 1st month after myofacial trigger point and cervical tender point injections statistically significant decrease was found in VAS, TMS, PSQI, FIQ, FSS, BAI and BAI scores and the number of trigger points in both FS and FS+MAS groups. (for all parameters p&lt;;0,005). However, this decrease was more evident in FS+MPS group. Conclusion: In conclusion, in the concomitance of MPS and FS, which is one of the most common causes of widespread musculoskletal pain, the treatment of MPS with trigger point injection has been shown to exert positive effects on the severity of FS, affective disorders, sleep and fatique. In the treatment of FS, thetreatment of MPS, which is one of the periheral pain generators, should be given priority.

Effectiveness of dry needling on pain & disability in athletes with iliotibial band tightness- a clinical trial

IntroductionDry needling (DN) for Myofascial trigger points (MTrP's) can be done on superficial or deep tissue levels for the management of a range of neuromusculoskeletal pain disorders. There is still much to learn about dry needling, despite the fact that it has been demonstrated to be useful for a variety of illnesses. The aim of the current study was to determine the effectiveness of DN with stretching on pain and disability in the treatment of athletes with iliotibial band (ITB) tightness. DesignA Clinical Trial. MethodsFor this study, 38 athletes both male and female, aged between 18 to 28 years, with tight iliotibial bands were divided into two groups: DN (n = 19) [Mean age (Years) 21.11 ± 2.96, Height (Cm) 171.16 ± 8.97, Weight (Kg) 63.73 ± 14.12, BMI (Kg/m2) 21.68 ± 3.53] and control group (n = 19) [Mean age 20.26 ± 2.37 (Years), Height (Cm) 166.31 ± 7.97, Weight (Kg) 56.02 ± 9.49, BMI (Kg/m2) 20.17 ± 2.39] who received ITB stretching. As outcome measures both before and after the treatment, the Visual Analogue Scale (VAS) and the Lower Extremity Functional Scale (LEFS) were used. ResultsThe difference in pain and functional scale was assessed using paired and unpaired t-tests. Post-treatment, individuals who received DN showed statistically greater improvements in pain (p = 0.000) and disability (p = 0.001) than those who received stretching. ConclusionAccording to this trial's findings, three sessions of DN with stretching are more effective at reducing pain and enhancing iliotibial band functionality.

The effect of physical therapy rehabilitation on fatigue and pain in female patients with fibromyalgia

This study aimed to examine the impact of physical therapy rehabilitation program on fatigue, pain and quality of life in female patients with fibromyalgia. It was designed as a single-blinded, randomized, pre and post-test controlled trial. Eighty female patients, aged 25 to 45, diagnosed with fibromyalgia were selected from the Kasr Al Ainy rheumatology outpatient clinic. The participants were allocated into two equal groups using a randomization procedure. Group (A) (control group, n=40) received transcutaneous electric nerve stimulation (TENS), moist heat, core muscle retraining, and manual therapy for trigger points, 3 times/week, for 4 weeks. Group (B) (study group, n=40) received the same treatments as Group A, plus aerobic exercises, flexibility exercises, and cognitive behavioural therapy (CBT), 3 times/week, for 4 weeks. Both groups were assessed before and after treatment using the Fatigue Severity Scale (FSS) and the Fibromyalgia Impact Questionnaire (FIQ). Statistically significant improvements were observed in FSS and FIQ scores for both groups post-treatment (p&lt;0.05). When the two groups were compared after therapy, the study group (B) showed significantly greater improvement in FSS and FIQ (p&lt;0.05). These findings suggest that physical therapy rehabilitation can effectively reduce fatigue, pain, and improve the quality of life for women with fibromyalgia.

Approach for contact medical device development via integrated testing, skeletal muscle modeling, and finite element analysis

Development of novel medical devices for the treatment of musculoskeletal pain associated with neuro-muscular trigger points requires a model for relating the mechanical responses of in vivo biological tissues to applied palliative physical pressures and a method to design treatments for optimal effects. It is reasonable to hypothesize that the efficacy of therapeutic treatment is proportional to the maximum tensile strain at trigger point locations. This work presents modeling of the mechanical behavior of biological tissue structures and treatment simulations, supported by indentation experiments and finite element (FE) modeling. The steady-state indentation responses of the tissue structure of the posterior neck were measured with a testing device, and an FE model was constructed using a first-order Ogden hyperelastic material model and calibrated with the experimental data. The error between experimental and FE-generated displacement-load curves was minimized via a two-stage optimization process comprised of an Optimal Latin Hypercube design-of-experiments analysis and a Bayesian optimization loop. The optimized Ogden model had an initial shear modulus (μ) of 5.16 kPa and a deviatoric exponent (α) of 11.90. Another FE model was developed to simulate the deformation of the tissue structures in the posterior neck adjacent to the C3 vertebrae in response to indentation loading, in order to determine the optimal location and angle to apply an indentation force for maximum therapeutic benefit. The optimal location of indentation was determined to be 28° lateral from the sagittal plane along the surface of the skin, measured from the centerline of the spine, at an angle of 8° counterclockwise from the surface normal vector. The optimized spatial orientation of the indentation corresponded to the average of the maximum principal strain across the deep muscle region of the model.

Pictorial Essay on Ultrasound and Magnetic Resonance Imaging of Paraspinal Muscles for Myofascial Pain Syndrome.

The paraspinal muscles of the cervical, thoracic, and lumbar spine are important pain generators because muscle strains or myofascial pain syndrome caused by trigger points are common during clinical practice. Ultrasonography is the most convenient imaging tool for evaluating these muscles due to its advantages, such as providing good delineation of soft tissues, easy accessibility, and zero radiation. Additionally, ultrasound can serve as a useful guiding tool for paraspinal muscle intervention to prevent inadvertent injuries to vital axial neurovascular structures. This pictorial essay presents ultrasound scanning protocols for the paraspinal and other associated muscles as well as a discussion of their clinical relevance. Axial magnetic resonance imaging has also been used to elucidate reciprocal anatomy. In conclusion, ultrasound imaging proves to be a valuable tool that facilitates the differentiation of individual paraspinal muscles. This capability significantly enhances the precision of interventions designed to address myofascial pain syndrome.

New insight of two kinds of M components in a multi-branch rocket triggered lightning flash

After the first and second return strokes (RSs) of a multi-branch triggered lightning flash, the M component of two different initiation mechanisms burned: (1) Upward leader (UL)-M component, (2) Downward leader (DL)-M component. The UL-M component burned immediately after the RS (about 0.5 ms after the RS). At this time, an UL developing to the cloud generated outside the main channel of the continuous current (CC). With the development of the UL, the M component is formed in the CC channel. The obvious DL process can be observed during DL-M component. The speed of DL is about 2 × 107 m/s, when DL was intercepted by CC channel, M component will generate. The current peak and electric field peak of the UL-M component were larger than those of the DL-M component. It was worth noting that the M component formed by the UL slightly developing to the ground at the head of it did not produce an electric field change at the observation point 2 (1550 m horizontally from the rocket triggered lightning point), which was a result of the combined effect of the positive charge in the branch head and the negative charge in the main channel at the same height. The reflection phenomenon of the M component was also observed in a DL-M component process. The CC in the channel after the RS plays a key role in the formation of the M component. It forms the M component by intercepting the current wave transmitted to the ground from the cloud or the lightning branch.

Immediate Effects of Instrument-Assisted Soft-Tissue Mobilization Versus Dry Needling on Trigger Point Pain and Tightness of Calf Muscles in Long-Distance Runners.

Introduction Muscle tightness is frequently identified as a potential precursor to muscle injuries. Reclaiming flexibility and enhancing range of motion (ROM) is crucial for preventing injuries and achieving improvements in performance.The present study examines the immediate effects of instrument-assisted soft-tissue mobilization (IASTM) and dry needling (DN) in reducing trigger point pain and calf tightness in long-distance runners. Methodology A total of 40 long-distance runners were recruited in the study (30 males and 10 females). The procedure was performed under the author's surveillance at the sports complex. These recruited players were placed into two groups: the IASTM (n=20) and the DN (n=20) group.The outcome measures used were the pressure algometer for assessing pain pressure threshold and the lunge test. An iPhone Measure app (Measure app, Apple App Store 2023) is used to assess ankle dorsiflexion ROM. The evaluation took place both prior to and immediately following the interventionand 48 hours after the intervention. Result The analysis within each group revealed a significant alteration in pain pressure threshold for both the IASTM and DN groups (p≤0.05), along with a relative enhancement in ankle dorsiflexion ROMobserved in the IASTM group (p≤0.05). Between-group analysis revealed a notable difference with an effect size difference of Cohen's d=1.06 (large difference) in pain pressure threshold, d=0.21 (small difference) in lunge test, and d=0.57 (medium difference) in ankle dorsiflexion ROM. Conclusion The present study concludes that both groups, IASTM and DN, showed significant effects in improving pain pressure threshold in long-distance runners. However, DN showed better results. IASTM showed significant results in enhancing the ankle dorsiflexion ROM immediately. This implies thatit can be used in conjunction with stretching to decrease pain and enhance flexibility, hence improving performance and preventing injuries.

Short-term effect of frequency specific intramuscular electrical stimulation on post dry needling soreness of upper fibers of trapezius: A randomized controlled trial

ObjectivesThe purpose of this study was to compare the effect of frequency specific intramuscular electrical stimulation on post trigger point dry needling soreness. BackgroundDry needling (DN) with intramuscular electrical stimulation (DN/IMES) has been shown to be effective in reducing post needling soreness. The effect of frequency specific intramuscular electrical stimulation on post needling soreness has not been studied abundantly, but initial results are favorable. This study investigated the effect of frequency specific intramuscular electrical stimulation on post needling soreness. MethodsA convenience sample of 45 (α = 0.05, power = 95%) subjects was recruited for this study and randomly assigned to DN (n = 15), DN/IMES [f-2Hz] (n = 15) and DN/IMES [f-100Hz] (n = 15) groups. Pain Pressure Threshold (PPT) and Numeric Pain Rating Scale (NPRS) were measured before and 24 hours after the intervention. ResultBoth DN/IMES [f-2Hz and 100 Hz] groups showed statistically significant improvement in NPRS (p = 0.001 and 0.00005, respectively) and PPT (p = 0.004 and 0.0002, respectively). No statistically significant changes were observed in DN group in NPRS (p = 0.726) and PPT (p = 0.238). ConclusionBoth dry needling with Intramuscular electrical stimulation (DN/IMES [f-2Hz and 100Hz]) groups demonstrated statistically significant improvement in soreness as compared to DN group, but DN/IMES [f-100 Hz] group showed more significant improvement as compared to DN/IMES [f-2 Hz] group in reducing post needling soreness.

Novel Electrophysiological and Ultrasound Biomarkers for Trigger Point Assessment (P1-11.018)

Novel Electrophysiological and Ultrasound Biomarkers for Trigger Point Assessment (P1-11.018)

Feasibility of the application of frequency modulated continuous wave radar trigger technique in abdominal magnetic resonance imaging

Objective: To evaluate and compare the image quality of T2-weighted abdominal scans using a respiratory belt trigger (RBT) and frequency-modulated continuous wave (FMCW)-trigger (FT) techniques and to explore the feasibility of FT in abdominal magnetic resonance imaging (MRI).Methods: The study prospectively included 28 subjects, each undergoing abdominal scans with both RBT and FT. The analysis focused on 64 inconsistent trigger segments from the respiratory curves triggered by RBT and FMCW. Parameters such as inconsistent trigger type (ITT), number of inconsistent trigger points (ITPs), ratio of ITP (ITR), and single-segment ITR (SITR) were derived from these curves. Image quality was evaluated by two observers using subjective scoring, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The assessments classified image quality as either “good” or “poor.” Consistency in image quality assessment between observers was determined using the kappa test and intraclass correlation coefficient (ICC). The chi-square test, Student’s t-test, and the Mann–Whitney U test were employed to compare the categorical and continuous variables between the RBT and FT groups.Results: The observers showed a high level of agreement in image quality assessment. There were no significant differences in ITR, SITR, acquisition time, SNR, and CNR between the RBT and FT groups (all p &amp;gt; 0.05). Both subjective and objective evaluations indicated no notable difference in image quality between the two groups (p &amp;gt; 0.05).Conclusion: The FMCW trigger technique is a viable alternative to the traditional respiratory belt trigger in scenarios of relatively stable breathing. It offers potential benefits, such as reducing operational demands on technicians and improving MRI workflow efficiency.

SHORT-TERM OUTCOMES OF HOME-BASED AND OUTPATIENT PROGRAMS OF PHYSICAL THERAPY IN PATIENTS WITH FROZEN SHOULDER AND MYOFASCIAL PAIN SYNDROME

The aim: is to compare short-term results of home-based and outpatient programs of physical therapy among patients with frozen shoulder and concomitant thoracic myofascial pain syndrome.&#x0D; Materials and methods. The study involved 80 patients. The range of motion in the shoulder joint affected by capsulitis was assessed. A numerical pain scale was used to assess pain sensations when pressing on trigger points. Functional limitations in the shoulder were measured by means of the Oxford Shoulder Score (before and 1.5 months after the end of the physical therapy). Participants were divided into two groups: home-based group (HG) and outpatient group (ОG). All the patients were consulted by a physical therapist. ОG patients received end-range mobilization with the assistance of a physical therapist 5 times a week to improve shoulder joint mobility. Most of ОG participants received 15 procedures (3 weeks). Patients HG performed therapeutic exercises without any assistance at home. (twice a day, 3 weeks). In terms of trigger points therapy, the patients performed ischemic compression without any assistance.&#x0D; Results. Patients of both groups demonstrated positive dynamics of the studied indicators. Comparison of the short-term results of the therapy according to range of motion and pain showed better indicators in the ОG. Comparison of the initial results of the groups in Oxford Shoulder Score items did not reveal any significant differences. Total score was 18.2±6.5 points in ОG and 17.6±7.5 points in HG (p=0.715). Me (25%; 75%) values were 17.5 (12.5; 23.8) and 18 (13; 23.5) points, respectively. Comparison of the final results of the groups in Oxford Shoulder Score items revealed significant differences. Total score was 47 (47; 48) points in ОG and 33 (31; 35.75) points in HG (p&lt;0.001). x̅±SD values were 46.5±2.6 and 32.8±4.4 points, respectively.&#x0D; Conclusions. Short-term results of the outpatient program in terms of pain indicators, mobility of the shoulder joint and functional limitations were better as compared to the home-based program of physical therapy in patients with frozen shoulder and concomitant thoracic myofascial pain syndrome.

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.

Association between smartphone addiction and myofascial trigger points

BackgroundThe purpose of this study was to clarify the relationship between smartphone addiction and miyafascial trigger points in university students.MethodsA cross-sectional study of university students was conducted for the purpose of this study. The participants were assessed based on age, gender, dominant side, the amount of time they spent on their smartphones, the purpose of their use, and their posture. The Smartphone Addiction Scale Short Form (SAS-SF) was used to determine addictes and non-addicts. The cut-off value of SAS-SF is 31 and above for male and 33 and above for female.ResultsThere were 136 participants in the study. The posture score for addicts and non-addicts ones was not significantly different (p > 0,05), but the number of trigger points, maximal bending posture and trigger points in the right levator scapula and right cervical erector muscles were significantly higher in the smartphone addict participants (p < 0,05).ConclusionsSmartphone addiction in university students is associated with postural changes and trigger points in the bilateral levator scapula and right cervical erector muscles. Public health programs should be developed to raise awareness about smartphone addiction, encourage screen breaks, and emphasize physical activity and exercise regularly.

Effectiveness of palpation technique training and practice using a muscle-nodule-palpation simulator.

[Purpose] Extant techniques for palpating nodules, a diagnostic criterion of myofascial trigger points, lack high reliability. Therefore, this study aimed to investigate the effects of training and practice using a novel muscle-nodule-palpation simulator. [Participants and Methods] Sixteen university students (age range: 19-22 years) were randomly assigned to the training (n=8) and control (n=8) groups and used the muscle-nodule-palpation simulator to determine the position and orientation of the muscle nodule embedded in the model. During the experiment, only the participants in the training group were allowed to practice nodule detection while viewing the model through its transparent material. Subsequently, both groups underwent a performance evaluation. [Results] The training group exhibited greater improvement in performance than the control group. The means and standard errors of the improvement in the proportion of successful localization of the muscle nodule were 0.14 ± 0.06 for the control group and 0.42 ± 0.09 for the training group. [Conclusion] Training using the muscle-nodule-palpation simulator improved palpation technique for nodule localization.

The analgesic and disability improvement effects of trigger points electroacupuncture on chronic low back pain patients: an uncontrolled before-and-after study

Low back pain (LBP) is the most common cause of disability in patients aged 45 to 65. Traditional medicine plays an important role in the treatment of this disease. Especially, electroacupuncture at 100 Hz is effective in the improvement of pain and symptoms. In addition, clinical and research evidence shows that trigger points acupuncture is effective in LBP treatment. However, these studies have small sample sizes, so their reliability is not high. Thus, our study aims to evaluate the effect of trigger points electroacupuncture (TrP-EA) at 100 Hz on chronic LBP patients with larger sample sizes. 37 patients diagnosed with chronic LBP received TrP-EA at 100 Hz for 4 weeks. Outcome measures were the visual analogue scale (VAS), roland morris questionnaire (RMQ), and Oswestry low back pain disability index (ODI). Compared with the pre-treatment baseline, VAS, RMQ, and ODI improved dramatically after 1 week of treatment (p&lt;0.01), 2 weeks of treatment (p&lt;0.01), 3 weeks of treatment (p&lt;0.01) and 4 weeks of treatment (p&lt;0.01). The results suggest that TrP-EA at 100 Hz had analgesic efficacy and may have the potential to improve disability in patients with chronic LBP.

The analgesic and disability improvement effects of trigger points electroacupuncture on chronic low back pain patients: an uncontrolled before-and-after study

Low back pain (LBP) is the most common cause of disability in patients aged 45 to 65. Traditional medicine plays an important role in the treatment of this disease. Especially, electroacupuncture at 100 Hz is effective in the improvement of pain and symptoms. In addition, clinical and research evidence shows that trigger points acupuncture is effective in LBP treatment. However, these studies have small sample sizes, so their reliability is not high. Thus, our study aims to evaluate the effect of trigger points electroacupuncture (TrP-EA) at 100 Hz on chronic LBP patients with larger sample sizes. 37 patients diagnosed with chronic LBP received TrP-EA at 100 Hz for 4 weeks. Outcome measures were the visual analogue scale (VAS), roland morris questionnaire (RMQ), and Oswestry low back pain disability index (ODI). Compared with the pre-treatment baseline, VAS, RMQ, and ODI improved dramatically after 1 week of treatment (p&lt;0.01), 2 weeks of treatment (p&lt;0.01), 3 weeks of treatment (p&lt;0.01) and 4 weeks of treatment (p&lt;0.01). The results suggest that TrP-EA at 100 Hz had analgesic efficacy and may have the potential to improve disability in patients with chronic LBP.

Effect of Myofascial Therapy and Pelvic Relaxation Exercise Combined with Phonophoresis using Diclofenac Sodium gel in Myofascial Pelvic Pain Syndrome

Objective of The Study: To determine the effect of myofascial therapy and pelvic relaxation exercise combined with phonophoresis using Diclofenac sodium gel in subjects with myofascial pelvic pain syndrome (MPPS). Background of The Study: Myofascial pain syndrome is a disease that is characterized by hypersensitive point called trigger points found in one or more muscles and connective tissue. Myofascial Pelvic Pain Syndrome (MPPS) is a source of chronic pelvic pain in women. This pain can be continuous or episodic. This study is designed to compare the effects of interventions namely myofascial therapy and pelvic relaxation exercise combined with phonophoresis using Diclofenac sodium in subjects with MPPS. Methodology: This experimental study was conducted among 20 subjects at Faculty of Physiotherapy, Dr. M.G.R Educational and Research Institute. Study duration was 4 weeks. Subjects were selected by simple random sampling method. The subjects were selected based on Inclusion and exclusion criteria.Outcome measures included were visual analogue scale (VAS), Pelvic pain impact questionnaire (PPIQ), SF-36 questionnaire. Procedure: 20 female subjects with myofascial pelvic pain syndrome were randomly divided into two groups. Group A (n=10) subjects were treated with myofascial therapy. Group B (n=10) subjects were treated with pelvic relaxation exercise. Treatments for both the groups were given for 3 days in a week for 4 weeks. Results: On comparing the pre and post values within experimental group, it shows statistically significant improvement on visual analogue scale score (P ≤ 0.05) andPPI questionnaire score (P ≤ 0.05) and also in pre and post test values of experimental groups, it reveals significant difference on short form survey – 36 score (P ≤ 0.05)