Effectiveness of a home program of ischemic pressure followed by sustainedstretch for treatment of myofascial trigger points

Background and Purpose. Myofascial trigger points (TPs) are found among pat ients who have neck and upper back pain. The purpose of this study was to d etermine the effectiveness of a home program of ischemic pressure followed by sustained stretching for the treatment of myofascial TPs. Subjects. Fort y adults (17 male, 23 female), aged 23 to 58 years ((X) over bar =30.6, SD =9.3), with one or more TPs in the neck or upper back participated in this study. Methods. Subjects were randomly divided into 2 groups receiving a 5- day home program of either ischemic pressure followed by general sustained stretching of the neck and upper back musculature or a control treatment of active range of motion. Measurements were obtained before the subjects rec eived the home program instruction and on the third day after they disconti nued treatment. Trigger point sensitivity was measured with a pressure algo meter as pressure pain threshold (PPT). Average pain intensity for a 24-hou r period was scored on a visual analog scale (VAS). Subjects also reported the percentage of time in pain over a 24-hour period. A multivariate analys is of covariance, with the pretests as the covariates, was performed and fo llowed by 3 analyses of covariance, 1 for each variable. Results. Differenc es were found between the treatment and control groups for VAS scores and P PT. No difference was found between the groups for percentage of time in pa in. Conclusion and Discussion. A home program, consisting of ischemic press ure and sustained stretching, was shown to be effective in reducing Tr sens itivity and pain intensity in individuals with neck and upper back pain. Th e results of this study indicate that clinicians can treat myofascial TPs t hrough monitoring of a home program of ischemic pressure and stretching.