Lendraitienė et al., Orthop Muscular Syst 2017, 6:4
DOI: 10.4172/2161-0533.1000246
Open Access Research Article
Volume 6 • Issue 4 • 1000246
Orthop Muscular Syst, an open access journal
ISSN: 2161-0533
Orthopedic & Muscular System:
Current Research
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ISSN: 2161-0533
The Effectiveness of Different Physical Therapy Techniques for Relieving
Pain and Increasing Neck Range of Motion in Patients with Diagnosed
Latent Myofascial Trigger Points
Eglė Lendraitienė
1
, Dovilė Bagdonaitė
1
, Daiva Petruševičienė
1
*, Vilma Dudonienė
2
and Vitas Lendraitis
3
1
Clinical Department of Rehabilitation, Lithuanian University of Health Sciences, Lithuania
2
Department of Applied Biology and Rehabilitation, Lithuanian Sports University, Lithuania
3
Institute of Sport Science and Innovations, Lithuanian Sports University, Lithuania
Abstract
Aim:Researchers are demonstrating increasing interest in latent myofascial trigger points (LMTP) because of
their signifcantly higher prevalence, compared to active myofascial trigger points (AMTP). Even though LMTP are
quite prevalent and are important for muscle function, their effect is essentially under-researched due the lack of
studies in the area. The aim is to compare the effectiveness of different physical therapy techniques for relieving pain
and increasing neck range of motion in patients with diagnosed latent myofascial trigger points.
Population: The study included 27 volunteers (group I – 15 subjects, and group II – 12 subjects) with at least
one LMTP in the upper part of the trapezius muscle and without any health problems that could affect the results of
the study.
Methods: Prior to the physical therapy, immediately after it, and one week after its completion, algometric
measurements were performed in order to determine which pressure force provoked pain. Also, a 10-point visual
analogue pain scale (VAS) was applied in order to determine the severity of pain that could be caused by 4 kg/cm
2
pressure. Goniometric measurements were performed to evaluate changes in the range of motion when performing
neck fexion, extension, and lateral fexion.
Results: In subjects who underwent ischemic compression procedures (group I), the pain threshold increased
signifcantly from 2.27 ± 0.28 kg/cm
2
at baseline to 3.01 ± 0.33 kg/cm
2
immediately after physical therapy, and to
2.63 ± 0.3 kg/cm
2
at one week after physical therapy (p<0.05). Meanwhile, pain intensity statistically signifcantly
decreased from 5.20 ± 0.56 points at baseline to 3.20 ± 0.78 points immediately after physical therapy, and to 4.53
± 0.74 points at one week after physical therapy (p<0.05). The range of fexion in the neck statistically signifcantly
increased both immediately and at one week after physical therapy, whereas no changes in the range of motion
were observed during extension or lateral fexion. In subjects who underwent taping procedures (group II), the pain
threshold increased signifcantly from 2.13 ± 0.43 kg/cm
2
at baseline to 2.30 ± 0.36 kg/cm
2
immediately after physical
therapy, and to 2.33 ± 0.46 kg/cm
2
at one week after physical therapy (p<0.05). Meanwhile, pain intensity statistically
signifcantly decreased only immediately after physical therapy - from 5.33 ± 0.78 points to 5 ± 0.74 points (p<0.05).
No changes in the range of motion during neck fexion, extension, or lateral fexion were observed. The comparison
of the groups showed that pain intensity in group I subjects (i.e., in those who underwent ischemic compression
procedures) was statistically signifcantly lower immediately after physical therapy and at one-week follow-up. There
were no statistically signifcant differences in the range of motion during neck fexion, extension, or lateral fexion
between the groups.
Conclusion: Ischemic compression proved to be a more effective physical therapy technique than taping in
reducing pain in latent myofascial trigger points.
*Corresponding author: Daiva Petruševičienė, Clinical Department of
Rehabilitation, Lithuanian University of Health Sciences, Lithuania, Tel: +370
68027117; E-mail: daiva.petruseviciene@gmail.com
Received September 01, 2017; Accepted September 09, 2017; Published
September 20, 2017
Citation: Lendraitienė E, Bagdonaitė D, Petruševičienė D, Dudonienė V, Lendraitis
V (2017) The Effectiveness of Different Physical Therapy Techniques for Relieving
Pain and Increasing Neck Range of Motion in Patients with Diagnosed Latent
Myofascial Trigger Points. Orthop Muscular Syst 6: 246. doi:10.4172/2161-
0533.1000246
Copyright:t © 2017 Lendraitienė E, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Keywords: Latent myofascial trigger point; Pain; Physical therapy
Introduction
Myofascial pain syndrome (MPS) is a well-known condition of
regional pain caused by myofascial trigger points and tense fbers [1-4].
Myofascial trigger points are the most extensively discussed cause of
myofascial pain because this pain may signifcantly afect patients’ daily
life and even psychological condition [5].
Myofascial trigger points (MTP) are classifed into active and
latent ones [6]. Te active form of MTP manifests itself either through
spontaneous pain or pain provoked by certain movements [7] as well as
by reduced muscle elasticity, muscle weakness, and pain related to direct
pressure. Pain intensity and radiation depend on MTP stimulation [8].
Latent MTP (LMTP) have the same – albeit not as severe – clinical
characteristics as active MTP (AMTP) do [9]. However, the pain is
not persistent – instead, it is provoked only by direct pressure on the
latent MTP [10]. For this reason, people frequently do not realize
that they have latent MTP [11,12]. Even though attention is mostly
focused on active MTP, latent MTP are starting to attract increasing
attention of researchers because even though these MTP do not cause
spontaneous pain, they can cause such musculoskeletal problems as
local hypersensitivity, pain on mechanical stimulation, reduced range
of motion, muscle weakness, fatigue, and cramps [13,14]. In addition,
the prevalence of LMTP is signifcantly higher than that of AMTP [1].
LMTP cause the myofascial pain syndrome when they are activated