Archive for category Fibromyalgia

Summary

Background:

Trigger points are a common cause of severe and  disabling pain in chiropractic practice. While trigger points may be  found in any skeletal muscle the majority are found in the upper  trapezius. Relatively few studies have investigated non-invasive  treatments for upper trapezius trigger points. Common manual therapy  treatments utilized for upper trapezius trigger points in chiropractic  include manual pressure and myofascial release. The purpose of this  study was to compare the effect of a single treatment of ischaemic  compression and activator trigger point therapy on active upper  trapezius trigger points.

Methods:

Fifty-two subjects with active upper trapezius  trigger points met the participation criteria and were randomised to an  ischaemic compression or activator trigger point therapy group. The  primary outcome measure was Patient Global Impression of Change.  Secondary outcome measures were an 11-point numerical rating scale for  change in pain, and change in pressure pain threshold using an algometer  for trigger point sensitivity. While the treating clinician and  subjects were not masked to treatment assignment, the examiner was blind  to treatment assignment until data analyses were completed. An  independent t-test was used to compare the groups at baseline on the  continuous variables. The Mann—Whitney U-test was used to compare the  groups at baseline on the non-continuous variables. Relative risk ratios  of improvement for the primary and secondary outcome measures were  calculated with 95% confidence intervals for clinical significance.

Results:

Seventy volunteers were screened  with 25 subjects randomised to the ischaemic compression group and 27 to  the activator trigger point therapy group. There was no significant  difference between the groups in any of the baseline variables. On the  primary outcome measure both groups improved (78% of those in the  activator group and 72% in the ischaemic compression group). Relative  risk for improvement of 1.00 suggested that those treated with the  Activator instrument were no more likely to improve than those treated  with ischaemic compression (95% CI = 0.73—1.37). For the secondary  outcome measure of pain reduction 41% of those treated with the  Activator instrument improved compared to 36% of those in the ischaemic  compression group. Those treated with the Activator instrument were 13%  more likely to improve than those treated with ischaemic compression.  However this relative risk of 1.13 in favour of the activator group was  not significant (95% CI = 0.57— 2.26). For the secondary outcome of  reduction in trigger point sensitivity 32% of those in the ischaemic  compression group improved compared to 30% in the activator group. Those  treated with ischaemic compression were 8% more likely to improve;  however, the relative risk of 1.08 was not significant (95% CI =  0.48—2.44). As risk of improvement on the outcome measures between the  groups was not significantly different, number needed to treat was not  calculated.

Conclusion:

Based on the primary outcome  measure the results suggest that both ischaemic compression and  Activator trigger point therapy have an equal immediate clinically  important effect on upper trapezius trigger point pain.


Clin Chiropr. (2008) 11(4):175-181.

Author information: Gemmel H, Allen A. Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth, BH5 2DF, United Kingdom.

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Abstract

Objective:

To determine the immediate effect of activator trigger point therapy (ATrPT) and myofascial band therapy (MBT) compared to sham ultrasound (SUS) on non-specific neck pain, cervical lateral flexion and pain pressure threshold of upper trapezius trigger points.

Design:

Randomised, placebo-controlled clinical trial.

Setting:

Anglo-European College of Chiropractic (AECC) in Bournemouth, England.

Subjects:

Forty-five subjects between 18 and 55 years of age with non-specific neck pain of at least 4 on an 11-point numerical rating scale (NRS), an upper trapezius trigger point (TrP) and decreased cervical lateral flexion to the opposite side of the active upper trapezius TrP were recruited from the AECC student body.

Methods:

The subjects were randomly assigned to one of three treatment groups: activator trigger point therapy, myofascial band therapy or sham ultrasound (control group). Neck pain level was determined using a numerical rating scale, degree of lateral flexion (LF) was determined using a cervical range of motion (CROM) goniometer and pain pressure thresholds (PPT) were measured with a pain pressure algometer. All subjects attended one treatment session and outcome measures were repeated within 5 min after treatment.

Results:

A one-way ANOVA indicated there was no statistically significant difference between the groups at baseline in age, pain level, lateral cervical flexion or pain pressure threshold ( p > 0.05). For the primary outcome measure of pain reduction the odds of a patient improving with activator trigger point therapy was 7 times higher than a patient treated with myofascial band therapy or sham ultrasound (95% CI:1.23—45.03). The number needed to treat (NNT) with activator trigger point therapy for one patient to improve was 3 (95% CI: 1.4—10.6).

Conclusion:

Activator trigger point therapy appears to be more effective than myofascial band therapy or sham ultrasound in treating patients with non-specific neck pain and upper trapezius trigger points.


Clin Chiropr. (2008) 11(1):23-29.

Author information: Blikstad A, Gemmell H. Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth BH5 2DF, UK.

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The authors suggest Activator Methods care as a natural way to treat fibromyalgia and chronic myofascial pain.

Synopsis

The symptoms include chronic, widespread musculoskeletal pain,  accompanied by multiple tender or trigger points, painful or restricted  movement, and persistent fatigue. For an estimated 26 million Americans,  the underlying condition is fibromyalgia syndrome (FMS) or myofascial  pain syndrome (MPS) or both, in the form of FMS/MPS Complex.

Despite the widespread occurrence of .these conditions, the  average FMS or MPS patient suffers for five years and spends thousands  of dollars on medical bills before receiving an accurate diagnosis. And,  even then, effective treatment may still prove elusive, as few doctors  are trained to understand or respond to these conditions.

Fibromyalgia & Chronic Myofascial Pain Syndrome offers the  first comprehensive patient guide for managing these conditions. You’ll  start by learning what FMS and MPS are, evaluating your own symptoms,  and identifying the tender and/or trigger points that are crucial for  treating them. The manual covers chronic pain, sleep problems, and other  “Internal affairs,” shows you how you can use your mind to counteract  physical symptoms and the numbing effects of “fibrofog,” and provides an  extensive set of healing tools-including information on the latest  medications, a nutritional program, and tips for using bodywork and  other less commonly known treatments. Its comprehensive survival  strategies include suggestions for coping with family and work  situations, getting support, and dealing with the health care system.


Reference: Devin J. Starlanyl, M.D.; Mary Ellen  Copeland, M.S., M.A.; Fibromyalgia & Chronic Myofascial Pain  Syndrome – A SURVIVAL MANUAL; New Harbinger Publications, Inc pages 144,  244-246

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