myofascial pain syndrome

Muscle energy technique versus strain counterstrain in treatment of upper trapezius myofascial pain syndrome: a double-blinded randomized controlled trial

Haytham Ibrahim Morsi, Bassem Galal Eldin El Nahass, Mona Mohamed Ibrahim

Haytham Ibrahim Morsi, Bassem Galal Eldin El Nahass, Mona Mohamed Ibrahim – Muscle energy technique versus strain counterstrain in treatment of upper trapezius myofascial pain syndrome: a double-blinded randomized controlled trial – Fizjoterapia Polska 2025; 25(2); 294-303

DOI: https://doi.org/10.56984/8ZG00E1X350

Abstract

Aim. The aim of this study was to examine the superiority of effectiveness of muscle energy technique (MET) combined with physical therapy (PT), strain counterstrain (SCS) combined with PT, and PT alone in terms of pain intensity, pain pressure threshold (PPT), cervical range of motion (CROM), and neck disability for patients with upper trapezius myofascial pain syndrome (MPS). Materials and methods. Fifty-four patients with upper trapezius MPS were randomly allocated into three equal groups. Group A received MET combined with the PT program, which included therapeutic ultrasound and isometric neck strengthening exercises. Group B received SCS combined with the same PT program, and Group C received the same PT program alone, for three sessions per week for four consecutive weeks. In addition, postural corrections and ergonomic advice were given to all three groups. The outcome measures were assessed pre- and post-treatment and included pain intensity, PPT, CROM, and neck disability, which were evaluated using the visual analogue scale, pressure threshold meter, CROM device, and neck disability index (Arabic version), respectively. Results. A 3×2 mixed model multivariate analysis of variance (MANOVA) test demonstrated significant improvement (p < 0.01) and significant between-group differences for post-treatment mean values (p < 0.05) in all the outcome measures in the three groups. Additionally, significant differences were found for post-treatment mean values in the pairwise comparison in favor of Group A and Group B as compared to Group C (p < 0.05) in all the outcome measures. Conclusion. Both techniques combined with PT are more effective than PT alone for patients with upper trapezius MPS.

Key words:

muscle energy technique, myofascial pain syndrome, physical therapy, strain counterstrain

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Impact of acupuncture dry needle versus progressive pressure technique on pain severity and pressure pain threshold in patients with lower back myofascial pain syndrome: A randomized clinical trial

Ghada Mohamed Rashad Koura, Saud Mashi Alrawaili, Amr Moustafa Yehia Mohammed, Sara Awad Gharama Alasmri, Raghad Mudawi Yahya Asiri, Ahmed Mohamed Fathi Elshiwi

Ghada Mohamed Rashad Koura, Saud Mashi Alrawaili, Amr Moustafa Yehia Mohammed, Sara Awad Gharama Alasmri, Raghad Mudawi Yahya Asiri, Ahmed Mohamed Fathi Elshiwi – Impact of acupuncture dry needle versus progressive pressure technique on pain severity and pressure pain threshold in patients with lower back myofascial pain syndrome: A randomized clinical trial. Fizjoterapia Polska 2022; 22(3); 44-50

Abstract
Background. Chronic lower back pain contributes to the global disability burden, and continues to be a factor in the number of years spent disabled; Myofascial pain syndrome (MPS) is an inflammatory condition that may cause chronic localized pain and stiffness. Repetitive movements and incorrect posturing habits contribute to MPS advancement by formation of trigger points (TrPs) on the muscles.
Purpose. To investigate the impact of acupuncture dry needle versus progressive pressure technique on pain severity and pressure pain threshold (PPT) in patients with lower back MPS.
Methods. A randomized clinical trial. Thirty patients suffering from lower back MPS with the presence of TrPs on iliocostalis lumborum, quadratus lumborum, piriformis, and gluteus medius muscles were divided into two equal groups. Group (A) received acupuncture dry needle over TrPs followed by stretching exercise for 2 weeks (n = 15), and group (B) received progressive pressure technique over the same TrPs followed by stretching exercise for 2 weeks (n = 15). Pain severity and PPT at the TrPs were evaluated before and after treatment.
Results. There were statistically significant improvements in pain severity and PPT at the TrPs of the four muscles within both groups (p < 0.05), except the PPT at iliocostalis lumborum that showed a non-significant difference within group (A) (p > 0.05). Comparing both groups pre- and post-treatment showed statistically non-significant differences in all outcome measures (p > 0.05).
Conclusion. Both acupuncture dry needle and progressive pressure technique were effective in reducing pain severity and increasing PPT in patients with lower back MPS.

Keywords
acupuncture dry needle, progressive pressure technique, pain severity, pressure pain threshold, myofascial pain syndrome

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Effects of selected work-related factors on the prevalence of musculoskeletal disorders

Małgorzata Chochowska, Joanna Jutrzenka-Jesion, Dorota Hojan-Jezierska

M. Chochowska, J. Jutrzenka-Jesion, D. Hojan-Jezierska – Effects of selected work-related factors on the prevalence of musculoskeletal disorders. Fizjoterapia Polska 2020; 20(2); 42-51

Streszczenie

Objective. The evaluation of low level laser therapy (LLLT) and ultrasound (US) efficacy in treatment of chronic nonspecyfic low back pain (NLBP) and their impact on the reduction of the level of soft tissue tenderness to palpation and the improvement in spinal mobility.
Material and methods. 120 patients suffering from NLBP were included in the study (groups: I, II, III, 30 people in each one). All patients received 10 treatment sessions, including: 1) personalized kinesiotherapy (10 sessions x 30min); 2) self-therapy (twice a day x 30min); 3) patient education (10 sessions x 30min). Group I was a control group. Group II additionally received 10 applications of LLLT, and group III received 10 applications of US. Patients were examined twice: on the first day of therapy and after three weeks of treatment. Evaluation was done by means of examining lumbar spine mobility in all planes and evaluating soft tissue tenderness to palpation in 24 control points (CP), which were exposed to LLLT (group II)/US (group III) according to the Andrzejewski-Kassolik Scale (AKS).
Results. All groups participating in the study gained a statistically significant improvement (p < 0,05; Wilcoxon Test) with regards to decrease in the level of soft tissue tenderness to palpation according to the AKS, in 23 out of 24 control points (CP). In groups II and III a statistically significant improvement (p < 0,05; Wilcoxon Test) in lumbar spine mobility was gained (except L/R rotation). Moreover, following the end of therapy there was a significantly improvement in spinal mobility (p < 0,05; U-Mann-Whitney test) compared to the control group: in group II in 5 out of 8 tested ranges of movement and in group III in 3 out of 8 tested ranges of motion; and also between groups III and II in 2 out of 8 tested ranges of motion.
Conclusions. 1) The application of personalized kinesiotherapy and education in the area of pain prevention contributes to the improvement in the condition of those with chronic NLBP. 2) The additional application of LLLT and US decreases the level of soft tissue tenderness to palpation, as well as increases spinal mobility in people with chronic NLBP. 3) Slightly better results were obtained following the application of US, however it cannot be explicitly concluded either of these applications is the more effective approach.

Słowa kluczowe: low back pain, myofascial pain syndrome, lasertherapy, ultrasound, range of motion improvement

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