Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity☆,☆☆,★,★★,♢,♢♢,♦
Section snippets
Participants and experimental design
Patients with cervical myofascial pain were recruited from our university's department of rehabilitation medicine. A total of 119 subjects (107 women, 12 men; age range, 30–60y) with clinically active, palpable MTrPs in a single side or both sides of the upper trapezius muscle were recruited between March and October 2000 for this study. The criteria for subject selection included (1) no neck or shoulder surgery within the past year; (2) no clinical evidence of radiculopathy or myelopathy; (3)
Stage 1: Immediate effect of ischemic compression with various pressures and durations
The data for subjects in the 6 ischemic compression groups (stage 1) are listed in table 1. Abbreviations: P1, pain threshold; P2, average of pain threshold and painGroup n Sample Sizes of MTrPs Women Men Mean Age ± SD (y) Stage 1 P1T1 8 14 8 0 49.50±11.14 P1T2 8 14 8 0 45.50±14.59 P1T3 8 14 8 0 38.11±8.24 P2T1 8 14 8 0 41.00±14.63 P2T2 8 14 8 0 46.25±14.54 P2T3 8 14 8 0 45.50±13.20 Stage 2 B1 21 35 17 4 47.86±13.68 B2 13 22 12 1 50.62±15.32 B3 9 17 8 1 46.89±14.91 B4 10 17 7 3 53.20±16.77 B5 9 16 6 3 51.00±16.19 B6 9 16 9 0 39.67±7.55
Discussion
Copper et al37 and Fricton et al38 have proposed that the incidence of MTrPs appears to be higher in women than in men, and that, among all age groups, patients 30 to 40 years old appear to have the highest prevalence of trigger points. Of our 119 subjects (age range, 30–60y), 107 were women, which indicates that the incidence of MTrPs is higher in women than in men. Patients with MTrPs in the upper trapezius muscle usually complain of neck pain, headache, muscle stiffness, restricted ROM of
Conclusions
Ischemic compression therapy with quantified pressure and duration provides alterative treatments by using either the pressure of pain threshold with a long duration of 90 seconds or the pressure of the average of pain threshold and pain tolerance with a duration of 30 seconds. It provides immediate pain relief and reduces the MTrP sensitivity of the cervical myofascial pain.
Immediate relief from cervical myofascial pain can be obtained in 6 therapeutic modalities. Hot pack plus active ROM,
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Reprint requests to Chuen-Ru Hou, PhD, Institute of Biomedical Engineering, National Cheng Kung University, No. 1, Ta-Hsueh Rd, Tainan 701, Taiwan, e-mail: [email protected].
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