इंटरनेशनल जर्नल ऑफ फिजिकल मेडिसिन एंड रिहैबिलिटेशन
खुला एक्सेस
आईएसएसएन: 2329-9096
आईएसएसएन: 2329-9096
AMR Suresh*, Dimple Kashyap, Tapas Priyaranjan Behera, Anoop Kumar Tarsolia
Purpose: Myofascial pain syndrome (MPS) is one of the most common musculoskeletal pain diseases and is characterized by myofascial trigger points, taut bands, and local twitch responses. The myofascial trigger points arise from overuse, overload, emotional stress or severe traumas. Although patho-physiology of MPS has not been completely understood, recent studies suggest that injured muscle fibers caused by overuse provide less oxygen and nutrition, and these deficiencies cause involuntary contractions. Myofascial pain symptoms usually involve muscle pain with specific “trigger” or “tender” points. The pain is aggravated with activity or stress. In addition to the local or regional pain, untreated and chronic cases might lead to symptoms like depression, fatigue and behavioral disturbances. There are various treatments for myofascial trigger points such as dry needling, local injection, ischemic compression, stretching, massage, and others. Of these methods, dry needling or local injection which physically stimulates trigger points is efficient for MPS by reducing muscles shortening and increasing blood flows. Ischemic compression helps tissue recovery by reperfusion after transient blood flow occlusion. The purpose of this study is to compare the effectiveness of ischemic compression therapy and ultrasound therapy on perception, pain and tolerance threshold of latent myofascial trigger point in upper trapezius.
Materials and method: 30 subjects with complaints of pain of the neck/ trapezius for a duration of up to 3 months were recruited on a conveniently random sampling based on the inclusion criteria and diagnostic criteria listed by travel and Simons and were randomly divided into two groups, Group A (N=15, 13 females and 2 males) received conventional ultrasound therapy and Group B(N=15, 13 females and 2 males) received ischaemic compression therapy for a period of seven days and threshold of feel, pain and tolerance (TF,TP and TT) were recorded on a daily basis pre and two minutes post treatment using Phyaction-787 stimulator- Galvanic mode and the readings were recorded in milliampere (mA) unit and the data is analysed statistically to compare the effects between Group A and group B.
Results: There is an immediate effect on TF, TP and TT on each day following treatment with ultrasound therapy and ischaemic compression therapy. Using paired t-test, pre and post treatment for Group A and Group B the results are statistically significant at P<0.001. However when compared for the difference between ultrasonic therapy and ischaemic compression therapy using paired t-test on the data, the results are not significant at P<0.001 indicating that there is no statistical significance in TF,TP and TT between ultrasound and ischaemic compression therapy.
Conclusion: Both ultrasound and ischaemic compression are equally effective in treating trigger point. Both groups showed increase in TF, TP and TT thus subsequently there is reduction in pain sensitivity in trigger point. However ischaemic compression may be a preferred therapy for myofascial trigger point in a physical therapy setup as it is easily available, accessible, cost effective and non-dependent on any modality.