Efficacy of Combination Therapies on Neck Pain & Muscle Tenderness in Patients With Upper Trapezius MTrPs

King Saud University

Status: Completed

Conditions: Myofascial Trigger Point Pain

Treatments: Behavioral: MET; Behavioral: Conventional Intervention; Behavioral: ICT

Study type: Interventional

Funder types: Other

Identifiers

NCT03840473

RRC-2017-007

Details and patient eligibility

About

Myofascial pain syndrome thought to be the main cause of neck pain and shoulder muscle tenderness in the working population is characterized by myofascial trigger points (MTrPs). This study aimed to examine the immediate and short-term effect of the combination of two therapeutic techniques for improving neck pain and muscle tenderness in patients with upper trapezius Myofascial Trigger points.

Full description

Purpose: Myofascial pain syndrome, thought to be the main cause of neck pain and shoulder muscle tenderness in the working population, is characterized by myofascial trigger points (MTrPs). This study aimed to examine the immediate and short-term effect of the combination of two therapeutic techniques for improving neck pain and muscle tenderness in male patients with upper trapezius active MTrPs.

Methods: This was a pretest-posttest single-blinded randomized controlled trial. Sixty male subjects with mechanical neck pain due to upper trapezius active MTrPs were recruited and randomly allocated into group A, which received muscle energy technique (MET) and ischemic compression technique (ICT)along with conventional intervention; group B, which received all the interventions of group A except ICT; and group C, which received conventional treatment only. Baseline (Pr), immediate post-intervention (Po), and 2-week follow-up (Fo) measurements were made for all variables. Pain intensity and pressure pain threshold (PPT)were assessed by a visual analog scale (VAS) and pressure threshold meter, respectively. All three groups received their defined intervention plans only. Repeated-measures analysis of variance was used to perform intra- inter-group analyses. Cohen's d test was used to assess the effect size of the applied interventions within the groups.

Enrollment: 60 patients

Sex: Male

Ages: 19 to 38 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male subject diagnosed with non-specific neck pain and muscle tenderness over the upper trapezius muscle due to an active MTrP
• Age19-38 years
• Presence of a maximum of 1-2active MTrPs in a unilateral upper trapezius muscle The number of TrPs in upper trapezius is not limited to two; it may be one or may be more than two (satellite TrPs) also. However, due to time constraints of the study sessions allowed for treatment of up to 2 active MTrPs only.

Exclusion criteria

• Diagnosed with fibromyalgia syndrome according to the American College of Rheumatology criteria;
• Had active MTrPs in the bilateral upper trapezius muscles
• Had a history of whiplash injury or cervical spine surgery
• Were diagnosed with cervical radiculopathy or myelopathy determined by their primary health care physician
• Had accepted myofascial pain therapy within the 1 month before the study
• Showed poor cooperation.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 3 patient groups

MET+ICT+Conventional intervention

Experimental group

Description:

Hot packs (75°C) for 20 minutes and supervised active stretching exercises for upper trapezius muscle (slow, 5 repetitions per session, 10-second hold and 10-second relaxation between two repetitions) followed by ICT (90-second hold-time) and MET (5-second hold-time, 3-second relaxation by exhalation while reaching the new barrier).

Treatment:

Behavioral: ICT

Behavioral: Conventional Intervention

Behavioral: MET

MET+Conventional Intervention

Experimental group

Description:

Hot packs (75°C) for 20 minutes and supervised active stretching exercises for upper trapezius muscle (slow, 5 repetitions per session, 10-second hold and 10-second relaxation between two repetitions) followed by MET (5-second hold-time, 3-second relaxation by exhalation while reaching the new barrier).

Treatment:

Behavioral: Conventional Intervention

Behavioral: MET

Conventional Intervention

Active Comparator group

Description:

Received hot packs (75°C) for 20 minutes and supervised active stretching exercises for upper trapezius muscle (slow, 5 repetitions per session, 10-second hold and 10-second relaxation between two repetitions) only.

Treatment:

Behavioral: Conventional Intervention