Agency for Healthcare Research and Quality.

The John P. Murtha Neuroscience and Pain Institute, International Spinal Intervention Society, and Center for Rehabilitation Sciences Research.

We conducted an observational study at two large military pain treatment centers among soldiers injured in Operation Iraqi Freedom. Fifty-three percent of soldiers presented with low back pain, with lumbar herniated disk being the most common diagnosis. Only 2% of patients returned to combat duty in Iraq. To improve the return-to-duty rate, better preventive measures and more aggressive treatment in forward-deployed medical units are recommended.

Objectives: Investigate lhe effects of ischémie compression |IC| tecbnicjue und passive stretching [PS] in isolation and in combination on the reduction of spontaneous electrical activity [SEA| and perceived pain in trigger points |TrPsl Ux:ated in the upper trapezius muscle.Methods: Ninety participants with TrPs in the upper trape/Jus muscle were randomly assigned to three treatment grt)ups: IC. PS. and IC + PS. TrP compression wa.s applied on the TrP tor three application.s of 60 seconds each, followed by a 30-second rest period. PS was applied lor three 45-second applications, with 3()-.second rest intervals. All patients received the same amount of therapy.Results: Significant decreases were found in pain perception and on SEA tor all study participants. The IC + PS group evidenced greater declines in pain perception and SEA when compared to the IC and PS groups.Conclusion: Because of ethieal considerations, a control group design was not possible, thereby limiting the robustness ot the ñndings. Although each technique significantly reduced pain percep-, tion and SEA, the combination of IC and PS was superior, apparently beeause of the eomplementary nature of the therapeutic interventions.