upper trapezius

The purpose of the present study was to investigate the effects of single-session intramuscular electrical stimulation (IMES) on pain and dysfunction following active trigger points in the upper trapezius muscle.

Volunteers (30 females) with active trigger points in the upper trapezius muscle were randomly divided into two IMES and placebo groups. For the IMES group, a needle was inserted into the trigger point, and electrical stimulation was applied to generate a pain-free contraction. For the placebo group, the intervention procedure was exactly the same, but there was no electrical stimulation. Pain by visual analog scale (VAS), pain pressure threshold (PPT), range of motion (ROM), and disability by neck disability index (NDI) were assessed as main outcome measures before, immediately after, and one week after conducting intervention by another blinded researcher.

The VAS scales were improved in both groups but were significantly lower in the IMES group one week after treatment. The PPT and ROM scores were substantially higher in the IMES group one week after the treatment. The NDI indexes significantly reduced for both groups, with no significant differences between them.

IMES effectively improves pain, PPT, ROM, and NDI, following trigger points in the upper trapezius muscle. Further studies are required to investigate the IMES’s long-term effects.

Myofascial pain syndrome (MPS) is one of the most frequent causes of chronic musculoskeletal pain which is characterized by myofascial trigger points (MTrPs). Hence, it is of crucial importance to identify practical approaches for the treatment of these points. Upper trapezius muscle (UT) is highly susceptible to the development of MTrPs that are commonly resulted from overuse and micro-trauma.

The present study aimed to compare the effects of dry needling (DN) and low-level laser therapy (LLLT) regarding the reduction of pain and muscle thickness and improvement of the range of motion (ROM) and pressure pain threshold (PPT) in patients with latent MTrPs (LTrPs) in their UT muscles.

In total, 60 patients with LTrPs in UT muscle participated in this randomized clinical trial. The subjects were randomly divided into two treatment groups of DN and LLLT. The PPT was evaluatedby visual analog scale (VAS) and algometer while ROM and muscle thickness were assessed using goniometer and ultrasonography, respectively. It should be noted that the variables were evaluated before the first and after the sixth sessions. Finally, the collected data were analyzed using independent and paired t-tests.

Based on the results, the VAS and muscle thickness significantly reduced, while the PPT and cervical ROM increased in both groups after treatment (P<0.001). The independent t-test revealed a statistically significant improvement in the DN group in terms of PPT (9.9-14.17, P=0.009) and ROM (37.33-42.67, p=0.005), compared to the LLLTgroup. Nevertheless, no significant difference was found between the two groups regarding VAS and muscle thickness variables (P>0.05).

The DN and LLLT effectively improved symptoms in the UT muscles of patients with LTrPs. However, the DN was more effective in the improvement of ROM and PPT variables

The aim of the present study was to investigate the immediate effect of time (30 and 90 seconds) trigger point compression techniques in the latent trigger points of upper trapezius muscle. Methods and Materials: A total of 39 women, aged between 20-30 who were diagnosed with latent MTrPs in the upper trapezius muscle, participated in the present study. Participants were randomly assigned to 3 groups, 13 each, using block randomization

trigger point compression (30 sec), trigger point compression (90 sec), and control group. In all groups, the measurements were carried out before and after the intervention.

The duration of 30 and 90 sec trigger point compression techniques were observed to decrease the pain and increase the pain pressure threshold (P<0.001). Significant differences were found between the duration of 30 sec trigger point compression technique and control group in terms of pain magnitudes (P<0.001) and pain pressure threshold (P<0.01). Also, there were significant differences between the duration of 90 sec trigger point compression technique and control group regarding pain magnitudes and pain pressure threshold (P<0.001). Moreover, significant differences were observed between these 2 treatment groups in terms of pain magnitudes (P<0.05) and pain pressure threshold (P<0.001). The duration of 90 sec trigger point compression technique was observed to have more effects compared with that for duration of 30 sec.

The results of the present study indicated that each of the 2 treatments decreased pain and increased pain pressure threshold. The results introduce the duration of 90 sec trigger point compression technique as a more effective treatment compared with that of the duration of 30 sec for latent MTrPs.

Assessment of pain sensitivity, as an important criterion, is used in diagnosis of musculoskeletal impairments, which helps determine prognosis as well as the improvement rate after treatment interventions. Regarding the costs of modalities and treatment equipment used to reduce pain, having a reliable method to determine their efficacy is essential. The aim of the present study was to evaluate intra-examiner and between-day reliability of an accessible digital algometer to assess pressure pain threshold and for pain sensitivity for the first time. A total of 15 healthy young adult women aged 18-30 participated in the study. Three points of upper Trapezius muscle in both sides were tested in 3 repetitions with 30 seconds rest interval. The tests included PPT by controlled speed of increasing pressure and Visual Analogue Scale to evaluate local pain elicited by exertion of 2.5 kg/cm2 of pressure on the marked point. Trials were conducted on two consecutive days. Intra Class Correlation, Coefficient Standard Error of Measurement, and Minimal Detected Change were calculated to analyze the reliability of the measurements. Assessments revealed high to moderate intra-examiner reliability for pressure pain threshold (ICC>0.972) and pain sensitivity (ICC>0.707) and high to moderate between-day reliability for pressure pain threshold (ICC>0.974) and pain sensitivity (ICC>0.676). Although pressure algometer has an acceptable intra-examiner and between-day reliability for estimating the pressure pain threshold and pain sensitivity, a significant decrease was revealed in the mean values of PPT and increase in PS on the second day, as compared to that on the first day, (P<0.05) which could be related to local tissue trauma, learning effect, or central sensitization.

Myofascial Pain Syndrome (MPS) is a common disorder of musculoskeletal system. About one third of the people with musculoskeletal disorders have been diagnosed as having MPS. It is a painful condition caused by trigger points. A variety of treatment approaches are used to cure MPS and its associated disorders. This study aimed to investigate the effects of single session Intramuscular Electrical Stimulation (IMES) through dry needling on pain and Range Of Motion (ROM) following trigger points in upper trapezius.
Material and Sixteen volunteers with active trigger points in upper trapezius were randomly divided into two groups: 1) the IMES treatment group (8 females) and 2) placebo group (8 females). In the IMES group, trigger points of the affected side were injected through dry needling, then a burst current (2 Hz) was applied on the muscle while the electrical stimulation steadily increases to form a pain free contraction for the patient. In placebo group, the procedure was exactly the same but there was no applied electrical stimulation through dry needling. Pain sensation by Visual Analog Scale (VAS) and cervical flexion ROM were measured before treatment, immediately after treatment and one week later by another blinded researcher.
VAS scores showed improvement in both groups at the end of the treatment session and also one week later. There was no significant difference between the groups; IMES and placebo in terms of the VAS after treatment session. However, the pain scores were substantially decreased in the IMES group one week after the intervention. The ROMs were significantly lower in placebo group one week after treatment. There was no significant correlation between improvement and duration of symptoms.
Both IMES and placebo methods might be effective in relieving symptoms of patients with the MPS in upper trapezius; however, patients following the IMES treatment showed higher level of improvement during one week after the intervention. Further relevant studies with higher number of volunteers and different treatment protocols are necessary to get high quality evidence.

The aim of this study is to compare the effects of laser therapy and shock wave therapy for symptoms treatment among patients with MPS in the upper trapezius muscle.

In a clinical trial study, 46 patients were selected based on the clinical criteria and physiathrist diagnosis. Subjects were randomized into two groups as follows: Twenty individuals were assigned to exercise‑medication‑laser therapy group, and 26 to exercise‑medication‑shock wave therapy group. The pain was assessed based on visual analog scale (VAS), neck disability index (NDI), and SPADI in three stages: Before treatment, subsequently after treatment, and a month after treatment.

One man and 19 women, age group of 45.3 ± 7.7 years, were assigned into laser therapy group. Two men and 24 women, average age group of 42.3 ± 10.4 were assigned into shock wave therapy group. A significant difference was found among our study groups before treatment and after starting treatment for VAS, NDI, and SPDI indices, that is, two methods of treatments were effective (P < 0.001). However, among these two treatment methods, laser therapy provided higher effect on VAS and NDI as compared to the radial shock wave method (P < 0.05) in 2 weeks from starting the treatment (consequent to treatment).

According to this study results, we can conclude that shock wave and laser therapy results on similar effect in long‑term for relieve of pain and eliminating symptoms in patients with myofascial but laser provides a faster optimal results.

The purpose of this study was to investigate the effect of kinesio-taping on the range of motion of cervical lateral flexion point in subjects with trigger point in upper trapezius muscle.
A total of 32 subjects with myofascial trigger point in upper trapezius participated in this randomized controlled trial (RCT). The subjects were randomly assigned to two groups: Kinesio-taping (n=16) and KT placebo (n=16). The ipsilateral and contralateral cervical lateral flexion range of motion was measured before and immediately after treatment in both groups using a standard goniometer. Paired t test was used to determine any significant difference in the range of motion after treatment sessions compared with pretreatment score in the control and experimental group. Analysis of covariance (ANCOVA) was calculated to determine the significance of differences between two groups in posttest scores, with pretreatment scores used as covariates in the analysis.
Statistical analysis (paired t test) revealed no significant increase in cervical lateral flexion range of motion in both ipsilateral and contralateral side immediately after KT application in both groups compared with pretreatment score (P>0.05). In the ANCOVA, while controlling for pretest scores, no significant difference was found between the two groups (KT and placebo) after treatment sessions (P>0.05)
Application of kinesio-taping cannot immediately produces an improvement n cervical lateral flexion in subjects with trigger point in upper trapezius muscles.