Efficacy of conventional ultrasound therapy on myofascial pain syndrome: a placebo controlled study

Abstract

Summary objectives:Myofascial pain syndrome (MPS) is a complex pain syndrome characterized with trigger points (TP) in skeletal muscles. We aimed to assess the efficacy of ultrasound (US) therapy, which is one of the main devices used in physical medicine and rehabilitation, for the treatment of TP in MPS. Methods: Fifty nine patients (49 females, 10 males) with active TP on the upper trapezius fibers were randomized into the treatment (n=30) and the control groups (n=29). The treatment group received conventional US therapy for 6 minutes, on 1.5 Watt/cm 2 dose with 1 MHz frequency for 15 days whereas a placebo US therapy was administered to the control group. Prior to the treatment, immediately and 3 months later pain severity during rest and physical activity was assessed with visual analog scale (VAS), TP tenderness was measured with 0-5 scale, pressure pain threshold (PPT) was analyzed with algometer and the depression level was evaluated with Beck's depression questionnaire (BDP) by a clinician blinded to the groups. Results: The mean age of the patients were 37.43±9.07 and 35.83±5.68 years, in the treatment and control groups, respectively. Compared to the pre-treatment values VAS, 0-5 scale and BDP scores decreased (p<0.01) along with an increase in PPT (p<0.01) in both groups at the follow-up visits. 0-5 scales and BDP scores were significantly lower and PPT was significantly higher in the treatment group, compared to the control group (p<0.001). conclusion: Our results revealed that US treatment is effective on MPS.Keywords: Myofascial pain syndrome; placebo ultrasound; ultrasound. Özet amaç:Miyofasiyal ağrı sendromu (MFAS), çizgili kas içinde tetik noktalar ile karakterize bir kompleks ağrı sendromudur. Ça-lışmamızda, fizik tedavide kullanılan temel cihazlardan biri olan ultrasonun (US) tetik nokta tedavisindeki etkinliği araştırıldı. Gereç ve Yöntem: Trapez kası üst liflerinde saptanan tetik noktalara bağlı MFAS tanısı konulan 59 hasta (49 kadın, 10 erkek) randomize olarak tedavi (n=30) ve kontrol grubu (n=29) olarak iki gruba ayrıldı. Tedavi grubuna 15 gün boyunca, günde bir kez 6 dakika süreyle 1.5 Watt/cm 2 dozunda, 1 MHz devamlı konvansiyonel US tedavisi, kontrol grubuna ise aynı sürede plasebo US tedavisi uygulandı. Tedavi öncesi, tedavi sonrası ve tedaviden üç ay sonra vizüel analog skala ile olguların istirahat ve aktivite sırasındaki ağrı düzeyi, sıfır-beş skalası ile tetik nokta hassasiyeti, algometre ile tetik nokta üzerindeki basınç ağrı eşiği ve Beck depresyon ölçeği ile depresyon düzeyleri, tedavi grubunu bilmeyen bir klinisyen tarafından değerlendirildi. Bulgular: Olguların yaş ortalaması tedavi grubunda 37.43±9.07, kontrol grubunda 35.83±5.68 idi. Tedavi öncesi değerlerle karşılaştırıldığında, tedaviden sonra ve üç ay sonraki kontrollerde her iki grupta da ağrı yakınmaları, tetik nokta hassasiyeti ve depresyon düzeyinde anlamlı bir azalma (p<0.01), basınç ağrı eşiğinde anlamlı artış (p<0.01) saptanmakla birlikte, grupların birbiriyle karşılaştırılmasında ağrı, tetik nokta hassasiyeti ve...

Effectiveness of ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis

“…One article without reporting outcomes of pain or function was excluded 8. Finally, 10 studies were included,11–13,19–25 which were published between 1997 and 2015. The 10 studies were fully analyzed, approved by both reviewers, and the data were extracted.…”

“…The 10 studies were fully analyzed, approved by both reviewers, and the data were extracted. In the end, eight studies11,13,19–23,25 were enrolled in quantitative synthesis because the other two studies12,24 did not provide data of effect size.…”

“…The 10 included RCTs11–13,19–25 involving a total of 428 MPS patients are summarized in Table 1. The mean age of patients among studies was from 21 to 49 years.…”

“…The parameter of US was used with pulsed mode (four studies),12,20,22,24 continuous mode (four studies),11,23–25 and unclear mode (three studies) 13,19,21. The course of the treatment was once in three studies13,19,20 and six to 15 sessions in the other seven studies 11,12,21–25…”

“…The risk of bias was low for three studies,23–25 unclear for four studies,11,19,21,22 and high for three studies12,13,20 (Figure 2 and Table 1). Thus, the overall risk of bias from the evidence in this meta-analysis is high.…”