Effectiveness of Myofascial Release in Improving Pain, Pain Pressure Threshold and Disability as Compared with Standard Care in Upper Trapezius Myofascial Trigger Points

Abstract

Background and Objective: Pain in the neck region is very common in the area of the upper trapezius muscle. In adults and women population the prevalence of neck pain is very high. It varies with a mean point prevalence of 13% to the lifetime prevalence of 50%. Muscles are very painful after the injury feeling like stiffness and spasm in the muscles. Many of the physiotherapy protocols like MWD, heat modalities, tens, spray, ultrasound, stretch, muscle energy technique (post isometric relaxation); many others included the use of deep friction massage (DFM) and ischemic compression are used in inactivation trigger points in previous studies. But these studies did not find evidence of functional improvements after the treatment. The aim of this study is therefore, to check the effectiveness of Myofascial Release in improving pain, pain pressure threshold and disability as compared with Standard Care in Upper Trapezius Myofascial Trigger Points. Study Design: Experimental comparative study Study Setting: Department of Rehabilitation Sciences. Outcome Measures: VAS, PPT, NPADS, CROM Materials & Method: The intervention in group A given was U. S and TENS followed by stretching. The patient was in a sitting position. The depth of ultrasound was 1.5 w/cm2 (1 MHz) with a duration of 5 minutes. The parameter for TENS was used as a negative monophasic impulse, low intensity (<10μA), frequency(<10HZ) short duration(10-40μs). This was followed by stretching of upper trapezius 3 repetitions and 90sec hold. Group B DTFM 10 minutes followed by 90-sec stretching. Results: Within-group A and B there is a significant difference in Pain, PPT, NPADS and CROM as P<0.01 while in between the group there is no significant difference in Pain, PPT, NPADS and CROM as P >0.563, P>0.238, P>0.634 and P>743 respectively. Conclusion: This present study concluded that MFR and combination of both TENS and ultrasound are equally effective in treating myofascial trigger points statistically. But clinically myofascial release seems to be more effective in pain relief as well as in improving function.