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Effect of ischemic compression on trigger points in the neck and shoulder muscles in office workers: a cohort study

PainSci » bibliography » Cagnie et al 2013
Tags: treatment, self-treatment, massage, muscle pain, neck, manual therapy, muscle, pain problems, head/neck, spine

Two articles on PainSci cite Cagnie 2013: 1. The Complete Guide to Trigger Points & Myofascial Pain2. Trigger Point Doubts

PainSci commentary on Cagnie 2013: ?This page is one of thousands in the 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 wherever possible.

Yet another deeply flawed trial of ischemic pressure for TrPs: tiny (just 19 subjects), and uncontrolled. They tried to control the experiment by comparing to a no-treatment period before the treatment, but that’s really no different than a simple before-and-after comparison, and it just doesn’t cut it: no matter what the results are, they can’t be taken seriously.

For whatever it's worth — almost nothing — they treated the subjects with eight sessions of massage each, “in which deep pressure was given on the 4 most painful TPs identified during examination.” They measured several things — pain, pressure tolerance, disability, strength — and only clinically change was pain... which they claim without publishing numerical data. Based on a graph, it looks like the change just barely reached the level of clinical significant. In a tiny uncontrolled trial.

Completely unpersuasive! But they conclude: “This study has demonstrated that a 4-week treatment of TPs for IC resulted in a significant improvement in general neck and shoulder complaint.”

~ Paul Ingraham

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.

OBJECTIVE: The purpose of this study was to determine the short-term effect of ischemic compression (IC) for trigger points (TPs) on muscle strength, mobility, pain sensitivity, and disability in office workers and the effect on disability and general pain at 6-month follow-up.

METHODS: Nineteen office workers with mild neck and shoulder complaints received 8 sessions of IC in which deep pressure was given on the 4 most painful TPs identified during examination. Outcome measures were general neck and shoulder complaints on a Numeric Rating Scale, Neck Disability Index (NDI), neck mobility (inclinometer), muscle strength (dynamometer), and pain sensitivity (Numeric Rating Scale and algometry). Subjects were tested at baseline (precontrol), after a control period of no treatment of 4 weeks (postcontrol), and after a 4-week intervention training (posttreatment). At 6-month follow-up, pain and disability were inquired.

RESULTS: The results showed a statistically significant decrease in general neck/shoulder pain at posttreatment (P = .001) and at 6-month follow-up (P = .003) compared with precontrol and postcontrol. There was no significant main effect for NDI scores. Pressure pain threshold increased at posttreatment in all 4 treated TPs (P < .001). There was a significant increase in mobility and strength from precontrol/postcontrol to posttreatment (P < .05).

CONCLUSION: This study has demonstrated that a 4-week treatment of TPs for IC resulted in a significant improvement in general neck and shoulder complaints, pressure pain sensitivity, mobility, and muscle strength in the short term in a small sample of office workers with mildly severe chronic pain. At 6-month follow-up, there was a further decrease in general pain, but no change in NDI scores.

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