Effect of Therapeutic Sequence of Hot Pack and Ultrasound on Physiological Response Over Trigger Point of Upper Trapezius

Abstract

Background:Musculoskeletal pain is a common problem among athletes. Apart from sport injuries, the myofascial pain syndrome is another important problem that affects performance of the athlete.Objectives:The aim of this study was to evaluate the effects of therapeutic sequences of the hot pack in combination with ultrasound on the physiological responses over the latent myofascial trigger point (LMTrP) of upper trapezius muscle.Materials and Methods:Thirty subjects with a latent myofascial trigger point (LMTrP) in both sides of the upper trapezius muscle participated in the study (age 27.33 ± 4.34 years, weight 58.11 ± 7.47 kg, height 161.50 ± 5.82 cm, pressure pain threshold 2.28 ± 0.24 kg/cm2, pain intensity 7.17 ± 2.25 VAS). All subjects received both treatments (hot pack followed by ultrasound: HP + US; and ultrasound followed by hot pack: US + HP) by randomization with a 24 to 48-hour interval between sessions. Outcome measures, including the tissue blood flow (TBF), pressure pain threshold (PPT), supra-thermal threshold (STT) and visual analog scale (VAS) were evaluated at baseline, immediately, after 30 minutes and after 60 minutes.Results:The TBF and PPT significantly increased from baseline in both treatment conditions (i.e. HP + US and US + HP), while the HP + US condition showed a trend toward significant difference in VAS and STT in 45°C.Conclusions:The application of HP and US treatment induces physiological responses (especially, TBF and PPT) on the LMTrP. This finding provides the direction toward the management of MTrPs condition.

Immediate effects of 850 nm Diode Laser on patients with Cervical Myofascial Pain Syndrome: a Randomized-controlled trial

“…19 Additionally, Rickards came to the conclusion that TENS, a quickfix painkiller, and laser, a short-term remedy, could both help myofascial trigger patients. 20 Previous randomized trials assessed the immediate effects of hot packs combined with ultrasonography 21 and revealed that the TrPs significantly improved when TENS was used in conjunction with heated packs, myofascial release, and active ROM exercises. 22 Exercise has also been shown to reduce the severity of myofascial pain in individuals, and it seems that combining stretching and strengthening activities has the greatest benefit.…”

Effects of combination therapy and infrared radiation on pain, physical function, and quality of life in subjects with knee osteoarthritis: A randomized controlled study

“…45,46 Thermal therapies are physiologically known to increase tissue metabolism, collagen elasticity, capillary blood flow, and reduce muscle spasm. 47,48…”

The effectiveness of routine physiotherapy with and without neuromobilization on pain and functional disability in patients with shoulder impingement syndrome; a randomized control clinical trial

“…The routine Physiotherapy consisted of pulsed Short Wave Diathermy (SWD) with frequency 27.12 MHZ [ 16 ], Ultrasonic Therapy (US) with frequency 1.0 MHZ and intensity 1.45w/cm 2 [ 17 ] and Transcutaneous Electrical Nerve Stimulator (TENS) 2–200 HZ with output current < 20 Ma width 200 μ seconds along with continuous mode. Exercises were comprised of shoulder strengthing and stretching exercises that were performed for 5 s with 10 repetitions for both experimental and care groups as shown in Table 1 [ 18 ].…”