Effect of Variants of Positional Release Technique vs. Ischemic Compression Technique on trigger point in Myofascial Pain Syndrome: A randomized controlled trial

Abstract

Myofascial pain syndrome is a group of symptoms whose origin might be sensory, motor or autonomic. These symptoms usually results from painful spots in the fascia of the skeletal muscle known as myofascial trigger points (MTrP's). The efficacy of a number of manual techniques as well as combination therapies on MTrP's has been investigated through a number of research studies. Thus, the hypothesis of this study was to see if variants of Positional Release Technique yielded better results than the variants of ischemic compression technique or vice versa on MTrP in cases of Myofascial Pain Syndrome. The primary objective was to determine whether any modifications in the treatment duration of conventional parameters of two most effective soft tissue manipulation techniques i.e. the Positional Release Technique (PRT) and the Ischaemic Compression Technique (ICT) have any effect on the pain pressure threshold. 60 subjects with active MTrP over the upper trapezius were randomly allocated into three subgroups-A1, A2 and A3 for PRT group or group A and B1, B2 and B3 for ICT groups or group B.A1, A2 and A3 differed from each other in terms of starting position where in for A1 the starting position was flexed trapezius; for A2 it was extended or stretched trapezius and for A3 the muscle was moved from flexion to extension throughout the treatment duration. Whereas Group B was divided into B1, B2 and B3. For B1 the treatment duration was 30 seconds, for B2 it was 60 seconds whereas for B3 it was 90 seconds respectively. The intervention was given six days a week for two weeks. Although improvement was seen in all the variants of the PRT and ICT groups, the subjects from the 90 sec variant of ICT group i.e. B3 showed maximum and statistically significant improvement in the pain pressure threshold scores post intervention. The present study concluded that among the two most used soft-tissue manipulation techniques i.e. Positional Release Technique and Ischaemic Compression Technique,the 90 sec variant of Ischaemic compression technique yielded clinically significant results in terms of improving pain pressure threshold in cases of Myofascial Pain Syndrome with active trigger points.

Effect of ischemic compression on myofascial pain syndrome: a systematic review and meta-analysis

“…Manual therapy includes a wide variety of techniques, such as chiropractic, massage, mobilization, muscle energy, and counter stain techniques [ 12 ]. Among them, ischemic compression, also known as manual pressure release [ 13 ] or trigger point release massage [ 14 , 15 ], is a type of manual therapy that is commonly applied for MPS treatment [ 16 , 17 ]. Ischemic compression is characterized by continuous compression or sustained pressure at several times to the trigger point or approximate regions commonly with a duration of 30–90 s (Specifically 30, 60 or 90 s) [ 18 ].…”