Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial

Maria F M Aranha, Cristina E E Müller, Maria B D Gavião, Maria F M Aranha, Cristina E E Müller, Maria B D Gavião

Abstract

Background: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions.

Objective: The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control.

Method: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05).

Results: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032).

Conclusion: EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly.

Figures

Figure 1. Enrollment of participants and study…
Figure 1. Enrollment of participants and study design. Al = Allocated intervention; *refers to menstrual cycle period.
Figure 2. Means and standard deviations for…
Figure 2. Means and standard deviations for general pain (A), pain at the right upper trapezius (B) and at the left upper trapezius (C) in pre- and post-treatment and including the follow-up evaluation (D, E, F). Uppercase letters above the standard deviation bars refer to intragroup comparisons: A?B (P

References

    1. Simons DG, Travell JG, Simons LS. Myofascial pain and dysfunction: the trigger point manual. Baltimore: Williams & Wilkins; 1999.
    1. Gerber LH, Sikdar S, Armstrong K, Diao G, Heimur J, Kopecky J, et al. A systematic comparison between subjects with no pain and pain associated with active myofascial trigger points. PM R. 2013;5(11):931–938.
    1. Gerwin RD. Differential diagnosis of myofascial pain syndrome and fibromyalgia. J Musculoskeletal Pain. 1999;7(1):209–215.
    1. Grosshandler SL, Stratas NE, Toomey TC, Gray WF. Chronic neck and shoulder pain. Focusing on myofascial origins. Postgrad Med. 1985;77(3):149-51, 154-8.
    1. Fleckenstein J, Zaps D, Rüger LJ, Lehmeyer L, Freiberg F, Lang PM, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: results of a cross-sectional, nationwide survey. BMC Musculoskelet Disord. 2010;11(1):32–32.
    1. Skillgate E, Magnusson C, Lundberg M, Hallqvist J. The age- and sex-specific occurrence of bothersome neck pain in the general population-results from the Stockholm public health cohort. BMC Musculoskelet Disord. 2012;13(1):185–185.
    1. Rollman GB, Lautenbacher S. Sex differences in musculoskeletal pain. Clin J Pain. 2001;17(1):20–24.
    1. Stux G, Pomeranz B. Basics of acupuncture. Berlin: Springer-Verlag; 1995.
    1. Koski BL, Dunn KS, Shebuski MR. Daily activity patterns of an adult experiencing lower back pain undergoing electro-acupuncture: a case study. Pain Manag Nurs. 2009;10(4):188–196.
    1. Sun MY, Hsieh CL, Cheng YY, Hung HC, Li TC, Yen SM, et al. The therapeutic effects of acupuncture on patients with chronic neck myofascial pain syndrome: a single-blind randomized controlled trial. Am J Chin Med. 2010;38(5):849–859.
    1. Zheng Z, Guo RJ, Helme RD, Muir A, Costa C, Xue CCL. The effect of electroacupuncture on opioid-like medication consumption by chronic pain patients: a pilot randomized controlled clinical trial. Eur J Pain. 2008;12(5):671–676.
    1. Aranha MFM, Alves MC, Bérzin F, Gavião MBD. Efficacy of electroacupuncture for myofascial pain in the upper trapezius muscle: a case series. Rev Bras Fisioter. 2011;15(5):371–379.
    1. Fernández-de-las-Peñas C, Alonso-Blanco C, Miangolarra JC. Myofascial trigger points in subjects presenting with mechanical neck pain: a blinded, controlled study. Man Ther. 2007;12(1):29–33.
    1. Muñoz-Muñoz S, Muñoz-García MT, Alburquerque-Sendín F, Arroyo-Morales M, Fernández-de-las-Peñas C. Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. J Manipulative Physiol Ther. 2012;35(8):608–613.
    1. Grieve R, Barnett S, Coghill N, Cramp F. The prevalence of latent myofascial trigger points and diagnostic criteria of the triceps surae and upper trapezius: a cross sectional study. Physiotherapy. 2013;99(4):278–284.
    1. Kendall FP, McCreary EK, Provance PG. Músculos provas e funções. Brasil: Editora Manole; 1995.
    1. Tousignant M, Smeesters C, Breton AM, Breton E, Corriveau H. Criterion validity study of the cervical range of motion (CROM) device for rotational range of motion on healthy adults. J Orthop Sports Phys Ther. 2006;36(4):242–248.
    1. Florêncio LL, Pereira PA, Silva ER, Pegoretti KS, Gonçalves MC, Bevilaqua-Grossi D. Agreement and reliability of two non-invasive methods for assessing cervical range of motion among young adults. Rev Bras Fisioter. 2010;14(2):175–181.
    1. Greenspan JD, Craft RM, LeResche L, Arendt-Nielsen L, Berkley KJ, Fillingim RB, et al. Consensus Working Group of the Sex, Gender, and Pain SIG of the IASP Studying sex and gender differences in pain and analgesia: a consensus report. Pain. 2007;132(Suppl 1):S26–S45.
    1. Lin YL, Chen CY, Hammes M, Kolster BC. Atlas gráfico de acupuntura. São Paulo: Konemann Port; 2005.
    1. Zhu XM, Polus B. A controlled trial on acupuncture for chronic neck pain. Am J Chin Med. 2002;30(1):13–28.
    1. Yuan CS, Attele AS, Dey L, Lynch JP, Guan X. Transcutaneous electrical acupoint stimulation potentiates analgesic effect of morphine. J Clin Pharmacol. 2002;42(8):899–903.
    1. Sandberg ML, Sandberg MK, Dahl J. Blood flow changes in the trapezius muscle and overlying skin following transcutaneous electrical nerve stimulation. Phys Ther. 2007;87(8):1047–1055.
    1. Chou LW, Hsieh YL, Chen HS, Hong CZ, Kao MJ, Han TI. Remote therapeutic effectiveness of acupuncture in treating myofascial trigger point of the upper trapezius muscle. Am J Phys Med Rehabil. 2011;90(12):1036–1049.
    1. Kauther MD, Piotrowski M, Hussmann B, Lendemans S, Wedemeyer C. Cervical range of motion and strength in 4,293 young male adults with chronic neck pain. Eur Spine J. 2012;21(8):1522–1527.
    1. Gemmell H, Hilland A. Immediate effect of electric point stimulation (TENS) in treating latent upper trapezius trigger points: a double blind randomised placebo-controlled trial. J Bodyw Mov Ther. 2011;15(3):348–354.
    1. Rodríguez-Fernández AL, Garrido-Santofimia V, Güeita-Rodríguez J, Fernández-de-Las-Peñas C. Effects of burst-type transcutaneous electrical nerve stimulation on cervical range of motion and latent myofascial trigger point pain sensitivity. Arch Phys Med Rehabil. 2011;92(9):1353–1358.
    1. Lee H, Nicholson LL, Adams RD. Cervical range of motion associations with subclinical neck pain. Spine (Phila Pa 1976) 2004;29(1):33–40.
    1. Chaves TC, Nagamine HM, Belli JFC, Hannai MCT, Bevilaqua-Grossi D, Oliveira AS. Reliability of fleximetry and goniometry for assessing neck range of motion among children. Rev Bras Fisioter. 2008;12(4):283–289.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel