Myofascial Pain Syndrome Focused on the Upper Trapezius Muscle: A Comparative Randomized Controlled Trial of the Court-Type Traditional Thai Massage versus the Thai Hermit
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Abstract:
Myofascial pain syndrome is a common problem that can develop at any age. This study compares the efficacy of the court-type traditional Thai massage (CTTM) to the Thai hermit exercise (THE) in improving the cervical range of motion (CROM) and reducing pain in the upper trapezius muscle. In this study, 46 patient subjects were randomized into 2 groups, with 1 group administered CTTM and the other administered THE. Prior to and following the experiment, their demographic characteristics, pain levels and CROM were measured using a visual analog scale (VAS) and a goniometer, respectively. Data was then analyzed using descriptive statistics, percentage, mean, and standard deviation, as well as inferential statistics. The findings indicate that subjects in both groups demonstrated significantly lower pain and significantly better CROM (P < 0.05). In terms of comparative treatment between the CTTM and THE groups, the results were not found to differ in the range of motion, but a clear difference in pain level measured by VAS was found, in which CTTM provides a better way of reducing pain at the trigger point than THE (P < 0.05). From the findings, it can be concluded that both CTTM and THE are comparably efficacious therapies for myofascial pain in the upper trapezius muscle.Keywords:
McGill Pain Questionnaire
Myofascial pain syndrome
Neck pain
Objective: Massage has been used for several thousand years, both for therapeutic and relaxation purposes. Massage is known to be effective in relieving pain, stress, anxiety, and therefore improving health for both patients and ordinary people. Access to massage is still very limited at present. One way to improve the access is via the use of massage chairs. Several types of massage chairs have been developed but customers still feel that their performances are too mechanical, unlike the massage performed by human masseurs. The objective of this work is to design a massage chair that can mimic or perform massage activities similar to human masseurs as much as possible. Design and results : The work was performed in 3 phases; study phase, in which Thai massage was studied in some detail, massage chair design phase, and prototype and test phase. It was found that Thai massage could be characterized by 3 key actions; pull, press, pin or 3Ps for short. A massage chair was designed in such a way that it could perform back massage according to the 3P actions similar to human masseurs. A test of the prototype was carried out with 40 potential customers in Bangkok. The test results showed that the chair performed satisfactorily and the massage performed was more ‘human–like’ than those performed by existing roller-type massage chairs. A number of improvements were suggested by those participated in the test, however. Conclusions: This study indicates that design and development of more ‘human–like’ massage chairs is possible and, if successful, would improve access to massage for many. Such wider access to ‘human-like’ massage chairs would help improve health and quality of life both patients and general public.
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Background and Aim: Massage training and how the body is influenced by massage are common issues which are seriously under study and discussion in Iranian traditional medicine. Iranian physicians considered motion and massage as major principles of health maintenance. In this study, we examined the available literature of traditional medicine to evaluate location, purpose and use of massage therapy in Iranian medicine in comparison with other popular conventional styles. The aim of Iranian massage is to regulate the core body temperature and aid to eliminate the waste products from the body. This type of massage is divided into five categories including solid, soft, moderate, great and aggressive, based on the intensity, speed, duration and techniques of massage. Iranian physicians proposed general body massage or massage of a particular area based on subjective complaints. They recommended specific massages in particular groups including children, pregnant women, the elderly and athletes. In some cases, the effects of these recommendations have been studied in clinical trials. Conclusion: It seems that the major difference between Iranian massage and other styles of massage is special attention of Iranian massage to the individual circumstances, and the cause of the problem rather than technique of the massage. Key words: Massage, Iranian traditional medicine, Dalk and Ghamz
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The purpose of this study was to describe the characteristics of pain during labor with and without massage. Sixty primiparas in labor were randomly assigned to either a massage or control group and tested using the self-reported Short-Form McGill Pain Questionnaire (SF-MPQ) at 3 phases of cervical dilation: phase 1 dilation (3-4 cm), phase 2 dilation (5-7 cm), and phase 3 dilation (8-10 cm). The massage group received standard nursing care and massage intervention, whereas the control group received standard nursing care only. The results of this study showed: (1) In both groups, as cervical dilation increased, there were significant increases in pain intensity as measured by SF-MPQ; (2) massage lessened pain intensity at phase 1 and phase 2, but there were no significant differences between the groups at phase 3; (3) the most frequently selected five sensory words chosen by both groups were similar at phases 1 and 2-(a) sore, (b) sharp, (c) heavy, (d) throbbing, and (e) cramping, while of the 4 affective classes, "fearful" and "tiring-exhausting" were the most used by participants to describe the affective dimension. The results of this study indicate that, although massage cannot change the characteristics of pain experienced by women in labor, it can effectively decrease labor pain intensity at phase 1 and phase 2 of cervical dilation during labor. Nurses and caregivers could consider using massage to help laboring women through the labor pain.
Cervical dilation
McGill Pain Questionnaire
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Objective: To compare the effects of a neck-specific exercise programme with internet support and 4 physiotherapist sessions (NSEIT) and the same neck-specific exercises supervised by a physiotherapist (NSE) on neck muscle endurance and cervical range of motion. Design: Randomized controlled trial. Patients: A total of 140 participants with chronic whiplash-associated disorders grade II or grade III were randomly assigned to the NSEIT or NSE groups. Methods: Outcomes were changes in active cervical range of motion, cranio-cervical flexion test, neck muscle endurance, and neck pain, at 3- and 15-month follow-ups. Results: There were no significant differences between the NSEIT and NSE groups. There was a significant group-by-time inter-action effect in active cervical range of motion flexion/extension where the NSEIT group improved to 3-month follow-up, but the NSE group did not. Both groups were significantly improved over time in all other outcomes (p < 0.001) at 3- and 15-month follow-ups, with effect size between 0.64 and 1.35 in active cervical range of motion, cranio-cervical flexion test, dorsal neck muscle endurance, and neck pain, and effect size between 0.22 and 0.42 in ventral neck muscle endurance. Conclusion: Both NSE and NSEIT led to improved neck function. Depending on the patients’ needs, either NSE or NSEIT could be used as treatment for patients with chronic whiplash-associated disorders.
Neck pain
Neck muscles
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To compare the efficacy difference between the mild moxibustion and acupuncture stimulation at trigger points in the treatment of shoulder and back myofascial pain syndrome (MPS), so as to provide a reference for clinical treatment of MPS.A total of 60 patients with shoulder and back MPS were equally and randomly divided into mild moxibustion group and acupuncture group. The myofascial trigger points in the shoulder and back regions were stimulated with mild moxibustion for 20-100 min every time or punctured with filiform needles by retaining the needles for 30 min after twirling for a while. The treatment was conducted once daily for 10 days. The short-form McGill pain questionnaire (SF-MPQ) including the pain rating index[PRI consisting of 15 descriptors (11 sensory, 4 affective) which are rated on an intensity scale as 0=none, 1=mild, 2=moderate and 3=severe], present pain intensity (PPI) index of the standard MPQ and a visual analogue scale (VAS) was used to assess the patient's pain severity before and after the treatment.Following the treatment, of the two 30 cases of MPS patients in the acupuncture and mild moxibustion groups, 1 and 7 were cured, 11 and 17 experienced marked improvement, 14 and 5 were effective, 4 and 1 was invalid, with the effective rates being 86.7% (26/30) and 96.7%(29/30), respectively. The cured plus markedly effective rate of the mild moxibustion group was significantly better than that of the acupuncture group(P<0.001). Self-comparison of the two groups showed that the scores of PRI, VAS and PPI after the treatment were apparently reduced in both groups compared with pre-treatment (P<0.001), but without significant differences between the two groups in the PRI, VAS and PPI scores after the treatment (P>0.05).Mild moxibustion stimulation of myofascial trigger point is effective in relieving shoulder-back MPS, being comparable to that of acupuncture therapy.
Moxibustion
McGill Pain Questionnaire
Myofascial pain syndrome
Therapeutic effect
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Background: Chronic pelvic pain (CPP) is a highly prevalent pain condition in which pelvic floor myofascial pain syndrome (MPPS) is also frequently found. Optimal treatments for CPP and MPPS are unknown. The aims of this pilot study were to investigate the effect of pelvic floor magnetic stimulation (MS) in women with MPPS. Treatment effects were compared between patients receiving MS alone, myofascial release therapy (MRT) alone, and MS + MRT. Methods: Patients were divided into three groups: MS, MRT, and MS + MRT. Questionnaires including Short-form McGill Pain Questionnaire (SF-MPQ), Pelvic Pain and Urgency/Frequency questionnaire (PUF), Female Sexual Function Index (FSFI), Hamilton Anxiety Scale (HAMA), and clinical global impression scale (CGI) were used to assess changes in subjective symptoms before and after treatment. Pelvic floor muscle function was assessed by the Modified Oxford Scale and Surface electromyography (sEMG). Pain mapping was used to locate trigger points (TPs) and to score the intensity of pain. A Visual Analog Scale (VAS) was used to measure the intensity of pain on a scale of 0 to 10. Changes in the above evaluation indexes within each group and between groups were evaluated after 5 treatment sessions and 10 treatment sessions. Results: Nineteen patients completed the treatment between November 2020 and August 2021. The SF-MPQ and PUF scores decreased significantly (p < 0.01) after treatment. The VAS score for pelvic floor tenderness also decreased significantly after 5 and 10 treatment sessions (p < 0.01). At the end of 10 sessions, the HAMA score was significantly lower than prior to treatment (p < 0.01). Conclusions: This preliminary study shows that MS is effective for the treatment of MPPS. Clinical Trial Registration: ChiCTR2000030881.
Myofascial pain syndrome
McGill Pain Questionnaire
Pelvic Floor Muscle
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Введение. Миофасциальный болевой синдром (МФБС) является следствием «цепной реакции» включения психологических и механических компенсаторных механизмов, запущенных болевым синдромом различной локализации. Данная патология характеризуется формированием в мышцах триггерных точек (ТТ), из которых формируются болезненные мышечные тяжи. Их пальпация вызывает усиление болей в пораженной мышце, а также в зоне иррадиации.Цель. Изучение эффективности аппаратно-пунктурной противоболевой терапии (АПП-терапии) в лечении пациентов с МФБС.Материалы и методы. 19 пациентов с МФБС различной локализации (15% мужчин, 85% женщин, средний возраст 45 лет) были разделены на группы: 1) МФБС шейно-плечевой локализации (n=10), 2) МФБС грудо-поясничной локализации (n=6), 3) МФБС поясничного отдела позвоночника (ПОП) с иррадиацией в ногу (n=3). Анализировались данные неврологического осмотра, мануального мышечного тестирования, тестирования по ВАШ, ранговый индекс боли (РИБ) по опроснику боли MPQ, индекс качества жизни Освестри, эстезиометрии, термографии. Для лечения применялась АПП-терапия.Результаты. До начала лечения получены следующие результаты: средняя интенсивность боли по ВАШ 7,5 балла, средний ранговый индекс боли по MPQ 30, средний индекс Освестри 69, выявлена локальная гипертермия в зонах боли (+1 град. С в сравнении с окружающими тканями) и достаточно большая разница между показателями болевой и тактильной чувствительности. Каждому пациенту проводились микроинъекции раствора толперизона с лидокаином с периодичностью раз в 2 дня. Курс составлял 3–5 сеансов. Нивелирование болевого синдрома и восстановление объема движений в пораженных мышцах после первого сеанса наблюдалось у 17 пациентов (89%). Проведение повторных сеансов привело к полномукупированию болевого синдрома и увеличению объема движений в пораженных мышцах у всей обследованной группы пациентов. По результатам контрольных осмотров в 100% случаев наблюдается улучшение состояния пациентов, что подтверждается результатами опросников и дообследований: средняя интенсивность боли по ВАШ 1 балл, средний ранговый индекс боли по MPQ 0–2, средний индекс Освестри 12 баллов, выравнивание температурной картины по данным термографии, уменьшение разницы показателей болевой и тактильной чувствительности. В процессе лечения развития побочных реакций не наблюдалось. Расход препарата на 1 микроинъекцию 0,002 мл.Выводы. Положительная клиническая картина течения заболевания и анализ полученных данных обследований у пациентов с МФБС различной локализации доказывают эффективность применения АПП-терапии как метода лечения МФБС. Introduction. Myofascial pain syndrome (MFPS) is a consequence of the "chain reaction" of psychological and mechanical compensatory mechanisms triggered by pain syndrome of various localizations. This pathology is characterized by the formation of trigger points (TP) in the muscles, from which painful muscle cords are formed. Palpation of them causes increased pain in the affected muscle, as well as in the area of irradiation.Purpose. To study the effectiveness of instrumental-puncture pain therapy (APP-therapy) in the treatment of patients with MFРS.Materials and methods. 19 patients with MFPS of various localizations (15% of men, 85% of women, average age – 45 years) were divided into groups: 1) MFPS of cervicobrachial localization (n=10),2) MFPS of thoracolumbar localization (n=6), 3) MFPS of the lumbar spine (LSP) with irradiation to the leg (n=3). The following data were analyzed: neurological examination, manual muscle testing, VAS testing, pain rank index (PRI) according to the MPQ pain questionnaire, Oswestry quality of life index, esthesiometry, thermography. APP therapy was used for treatment.Results. Before the start of treatment, the following results were obtained: average pain intensity according to VAS – 7.5 points, average rank pain index according to MPQ – 30, average Oswestry index – 69, local hyperthermia was detected in pain zones (+1 deg. C in comparison with surrounding tissues), and significantly big difference between the indicators of pain and tactile sensitivity. Each patient received microinjections of the solution of tolperisone with lidocaine every 2 days. The course consisted of 3–5 sessions. Leveling of pain and restoration of the range of motion in the affected muscles after the first session was observed in 17 patients (89%). Repeated sessions led to complete relief of pain syndrome and increase of the range of motion in the affected muscles in the entire examined group of patients. According to the results of control examinations in 100% of cases, there is an improvement in the patient's condition, which is confirmed by the results of questionnaires and follow-up examinations: the average pain intensity according to the VAS is 1 point, the average rank pain index according to MPQ is 0–2, the average Oswestry index is 12 points, the temperature picture is aligned according to thermography data, decrease of the difference in the indicators of pain and tactile sensitivity. In the course of treatment, the development of adverse reactions was not observed. The consumption of the drug per 1 microinjection is 0.002 ml.Conclusions. The positive clinical picture of the course of disease and the analysis of the survey data obtained in patients with MFPS of various localizations prove the effectiveness of the use of APP therapy as the method of treatment of MFPS.
Palpation
Myofascial pain syndrome
McGill Pain Questionnaire
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Reflexology
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Massage is the manipulation of the body's soft tissues. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. A person professionally trained to give massages is traditionally known as a masseur (male) or a masseuse (female) in European countries.
In the United States, these individuals are often referred to as massage therapists because they must be certified and licensed as Licensed Massage Therapists.In professional settings, clients are treated while lying on a massage table, sitting in a massage chair, or lying on a mat on the floor.
There are many different modalities in the massage industry including but not limited to: Swedish, deep tissue, structural integration, trigger point, manual lymphatic drainage, sports massage, Thai massage, and medical massage.
Sitting
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Massage therapy has grown in popularity, yet little is known globally or in New Zealand about massage therapists and their practices.The aims of this study were to describe the practice patterns of trained Massage New Zealand massage therapists in New Zealand private practice, with regard to therapist characteristics; practice modes and settings, and therapy characteristics; referral patterns; and massage therapy as an occupation.A survey questionnaire was mailed to 66 trained massage therapist members of Massage New Zealand who were recruiting massage clients for a concurrent study of massage therapy culture.Most massage therapists were women (83%), NZ European (76%), and holders of a massage diploma qualification (89%). Massage therapy was both a full- (58%) and part-time (42%) occupation, with the practice of massage therapy being the only source of employment for 70% of therapists. Nearly all therapists (94%) practiced massage for more than 40 weeks in the year, providing a median of 16 - 20 hours of direct client care per week. Most massage therapists worked in a "solo practice" (58%) and used a wide and active referral network. Almost all therapists treated musculoskeletal symptoms: the most common client issues or conditions treated were back pain/problem (99%), neck/shoulder pain/problem (99%), headache or migraine (99%), relaxation and stress reduction (96%), and regular recovery or maintenance massage (89%). The most frequent client fee per treatment was NZ$60 per hour in a clinic and NZ$1 per minute at a sports event or in the workplace. Therapeutic massage, relaxation massage, sports massage, and trigger-point therapy were the most common styles of massage therapy offered. Nearly all massage therapists (99%) undertook client assessment; 95% typically provided self-care recommendations; and 32% combined other complementary and alternative medicine therapies with their massage consultations.This study provides new information about the practice of massage therapy by trained massage therapists. It will help to inform the massage industry and other health care providers, potential funders, and policymakers about the provision of massage therapy in the NZ health care system.
Demographics
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