THE EFFECTIVENESS OF SIMULTANEOUS THERMOTHERAPY WITH ULTRASOUND AND ELECTROTHERAPY WITH COMBINED AC AND DC CURRENT ON THE IMMEDIATE PAIN RELIEF OF MYOFASCIAL TRIGGER POINTS

Objectives: This study is designed to investigate the immediate effect iveness of combining ultrasound [deep heat] therapy and modified elect rotherapy for the treatment of myofascial trigger points [TrPs] of upp er trapezius [UT] muscle. Methods: Twenty-six patients [12 males and 1 4 females, average age 42.1 +/- 16.4 years] were studied. All patients had myofascial TrPs in one or two sides of the UT muscles. Fifty skel etal muscles were studied. The involved UT muscles were treated with d ifferent methods according to random assignment: Group A muscles were given placebo treatment [Control group]; Group B muscles were treated with only ultrasound [USD]; Group C muscles were given only electrothe rapy [ET]; and Group D muscles were given a combination of ultrasound therapy and electrotherapy [USD + ET]. The effectiveness of treatment was assessed by conducting three measurements on each patient before a nd immediately after treatment: subjective pain intensity [PI], pain t hreshold [PT], and range of motion [ROM] of UT muscle [lateral bending of cervical spine to the opposite side]. Results: When the effectiven ess of treatment was compared with that of the placebo group [Group A] , there was no significant improvement [P < 0.05] for Group B muscles. There was significant improvement [P < 0.05] in PI [but not in PT or ROM] in Group C immediately after therapy. In Group D, the improvement in ROM [but not in PI or PT] immediately after therapy was significan tly greater [P < 0.05] than Group A, B, or C muscles. Conclusions: The results of this study suggest that, when treating myofascial trigger points of the upper trapezius [UT] muscles, the combination of ultraso und therapy [USD] and electrotherapy [ET] offers a greater immediate i ncrease in the range of motion [ROM] of the muscle than placebo therap y, ultrasound therapy alone, or electrotherapy [ET] alone. In clinical management of myofascial TrPs, one may expect that combining USD and ET helps to reduce the muscle tightness caused by TrPs. Therefore, the use of this combination therapeutic modality to treat myofascial TrPs should be seriously considered.