Abstract
Background. Myofascial pain syndrome (MPS) is a common musculoskeletal dysfunction characterized by painful myofascial trigger points (MTrPs). Diagnosis of myofascial pain syndrome typically relies on manual examination, which depends heavily on the examiner’s skill and lacks objective criteria. Ultrasonography offers a non-invasive and objective method for diagnosing MTrPs and monitoring treatment outcomes. This study aimed to evaluate clinical and ultrasonographic changes before and after ischemic compression on the upper trapezius muscle and its contralateral side.
Methods. This quasi-experimental pre-post study was conducted on 12 patients suffering from bilateral shoulder pain due to MPS. Participants underwent 1 session of ischemic compression on the active trigger point of the upper trapezius. Clinical parameters assessed in this study included pain pressure threshold (PPT), pain intensity, and cervical range of motion, along with ultra-sonographic measurements of muscle stiffness at rest and during contraction, evaluated before and after treatment on both treated and untreated sides.
Results. On the treated side, pain intensity decreased from 8.41 ± 0.99 to 6.33 ± 1.77, pressure pain threshold increased from 8.60 ± 2.47 to 12.38 ± 3.75, and cervical lateral flexion range of motion improved from 36.25 ± 6.31 to 40.38 ± 5.22 (P<0.05). Muscle stiffness significantly decreased at rest (P = 0.02) but not during contraction (P = 0.138). On the untreated side, pain intensity decreased from 6.98 ± 1.69 to 5.14 ± 1.53, pressure pain threshold increased from 11.75 ± 1.64 to 14.31 ± 4.64, and lateral flexion range improved from 32.50 ± 3.42 to 38.16 ± 4.56 (P<0.05). Muscle stiffness showed no significant change. A moderate correlation was found between resting muscle stiffness and pain intensity (r = 0.496, P = 0.02).
Conclusion. Ischemic compression produced short-term improvements in pain and muscle function bilaterally, with minimal ultrasonographic changes in stiffness, supporting its effectiveness for upper trapezius MPS.
Practical Implications. Ischemic compression can be used as a practical and effective method to reduce pain and improve muscle function in patients with MPS, even on the contralateral side.