PainSci summary of Müller 2015?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
These reseachers tested trigger point treatment in 24 women who’d had shoulder pain for at least six months, presumed to be caused by trigger points in the trapezius muscles. They compared acupuncture and electroacupuncture to a sham treatment, and measured the size of the trigger points with ultrasonography and ultrasound elastography before and after.
(Acupuncture disclaimer: acupuncture does not work, and the use of acupuncture and electroacupuncture casts some doubt on the whole experiment. However, whether the authors saw it this way or not, it’s also just a test of the effect of inserting fine needles in or near trigger points — which happens to be a popular non-acupuncture treatment, “dry needling,” used by many physical therapists and doctors. In this study, the authors noted that some of the points they picked corresponded with suspected trigger points — ashi points, the acupuncture term for a tender point or trigger point. In other words, even though acupuncture doesn’t work, this was still a test of a popular form of trigger point therapy, at least partially.)
A standard set of acupuncture points was treated, plus up to two relevant ashi points in both trapezius muscles. For the sham, needles were inserted one centimetre from the real point.
Pain was reduced, and the trigger points decreased in size in all groups, but significantly more so in the treatment groups. The size of the effect on pain was clinically significant: pain dropped by about 2-3 points (on a 10-scale). Trigger points got about 30 to 50% smaller.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Chronic pain has been often associated with myofascial pain syndrome (MPS), which is determined by myofascial trigger points (MTrP). New features have been tested for MTrP diagnosis. The aim of this study was to evaluate two-dimensional ultrasonography (2D US) and ultrasound elastography (UE) images and elastograms of upper trapezius MTrP during electroacupuncture (EA) and acupuncture (AC) treatment. 24 women participated, aged between 20 and 40 years (M ± SD = 27.33 ± 5.05) with a body mass index ranging from 18.03 to 27.59 kg/m2 (22.59 ± 3.11), a regular menstrual cycle, at least one active MTrP at both right (RTPz) and left trapezius (LTPz) and local or referred pain for up to six months. Subjects were randomized into EA and AC treatment groups and the control sham AC (SHAM) group. Intensity of pain was assessed by visual analogue scale; MTrP mean area and strain ratio (SR) by 2D US and UE. A significant decrease of intensity in general, RTPz, and LTPz pain was observed in the EA group (p = 0.027; p < 0.001; p = 0.005, respectively) and in general pain in the AC group (p < 0.001). Decreased MTrP area in RTPz and LTPz were observed in AC (p < 0.001) and EA groups (RTPz, p = 0.003; LTPz, p = 0.005). Post-treatment SR in RTPz and LTPz was lower than pre-treatment in both treatment groups. 2D US and UE effectively characterized MTrP and surrounding tissue, pointing to the possibility of objective confirmation of subjective EA and AC treatment effects.
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- “Endplate potentials are common to midfiber myofacial trigger points,” David G Simons, Chang-Zern Hong, and Lois Statham Simons, Am J Phys Med Rehabil, 2002.
- “Accelerated muscle fatigability of latent myofascial trigger points in humans,” Hong-You Ge, Lars Arendt-Nielsen, and Pascal Madeleine, Pain Med, 2012.
- “Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points,” Hong-You Ge, Yang Zhang, Shellie Boudreau, Shou-Wei Yue, and Lars Arendt-Nielsen, Exp Brain Res, 2008.
- “Assessment of myofascial trigger points (MTrPs): a new application of ultrasound imaging and vibration sonoelastography,” Siddhartha Sikdar, Jay P Shah, Elizabeth Gilliams, Tadesse Gebreab, and Lynn H Gerber, Conf Proc IEEE Eng Med Biol Soc, 2008.
- “Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome,” Jay P Shah and Elizabeth A Gilliams, Journal of Bodywork & Movement Therapies, 2008.
- “Ability of magnetic resonance elastography to assess taut bands,” Qingshan Chen, Jeffrey Basford, and Kai-Nan An, Clin Biomech (Bristol, Avon), 2008.
- “Identification and quantification of myofascial taut bands with magnetic resonance elastography,” Qingshan Chen, Sabine Bensamoun, Jeffrey R Basford, Jeffrey M Thompson, and Kai-Nan An, Archives of Physical Medicine & Rehabilitation, 2007.
These two articles on PainScience.com cite Müller 2015 as a source:
- Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option
- Save Yourself from Neck Pain! — A complete guide to chronic neck pain and the disturbing sensation of a “crick”
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.