Orthopedic & Muscular System: Current Research
Open Access

Abstract

The Effectiveness of Different Physical Therapy Techniques for Relieving Pain and Increasing Neck Range of Motion in Patients with Diagnosed Latent Myofascial Trigger Points

Eglė Lendraitienė, Dovilė Bagdonaitė, Daiva Petruševičienė, Vilma Dudonienė and Vitas Lendraitis

Aim:

 Researchers are demonstrating increasing interest in latent myofascial trigger points (LMTP) because of their significantly higher prevalence, compared to active myofascial trigger points (AMTP). Even though LMTP are quite prevalent and are important for muscle function, their effect is essentially under-researched due the lack of studies in the area. The aim is to compare the effectiveness of different physical therapy techniques for relieving pain and increasing neck range of motion in patients with diagnosed latent myofascial trigger points.

Population:

The study included 27 volunteers (group I – 15 subjects, and group II – 12 subjects) with at least one LMTP in the upper part of the trapezius muscle and without any health problems that could affect the results of the study.

Methods:

Prior to the physical therapy, immediately after it, and one week after its completion, algometric measurements were performed in order to determine which pressure force provoked pain. Also, a 10-point visual analogue pain scale (VAS) was applied in order to determine the severity of pain that could be caused by 4 kg/cm2 pressure. Goniometric measurements were performed to evaluate changes in the range of motion when performing neck flexion, extension, and lateral flexion.

Results:

In subjects who underwent ischemic compression procedures (group I), the pain threshold increased significantly from 2.27 ± 0.28 kg/cm2 at baseline to 3.01 ± 0.33 kg/cm2 immediately after physical therapy, and to 2.63 ± 0.3 kg/cm2 at one week after physical therapy (p<0.05). Meanwhile, pain intensity statistically significantly decreased from 5.20 ± 0.56 points at baseline to 3.20 ± 0.78 points immediately after physical therapy, and to 4.53 ± 0.74 points at one week after physical therapy (p<0.05). The range of flexion in the neck statistically significantly increased both immediately and at one week after physical therapy, whereas no changes in the range of motion were observed during extension or lateral flexion. In subjects who underwent taping procedures (group II), the pain threshold increased significantly from 2.13 ± 0.43 kg/cm2 at baseline to 2.30 ± 0.36 kg/cm2 immediately after physical therapy, and to 2.33 ± 0.46 kg/cm2 at one week after physical therapy (p<0.05). Meanwhile, pain intensity statistically significantly decreased only immediately after physical therapy - from 5.33 ± 0.78 points to 5 ± 0.74 points (p<0.05). No changes in the range of motion during neck flexion, extension, or lateral flexion were observed. The comparison of the groups showed that pain intensity in group I subjects (i.e., in those who underwent ischemic compression procedures) was statistically significantly lower immediately after physical therapy and at one-week follow-up. There were no statistically significant differences in the range of motion during neck flexion, extension, or lateral flexion between the groups.

Conclusion:

Ischemic compression proved to be a more effective physical therapy technique than taping in reducing pain in latent myofascial trigger points.