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The immediate effect of ischemic compression technique and transverse friction massage on tenderness of active and latent myofascial trigger points: A pilot study

PainSci » bibliography » Fernández-de-Las-Peñas et al 2006
Tags: treatment, self-treatment, massage, muscle pain, manual therapy, muscle, pain problems

PainSci commentary on Fernández-de-Las-Peñas 2006: ?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.

This pilot study compared the effects of two kinds of massage on trigger points in 40 people with neck pain. Pain and trigger point sensitivity were measured right before and after a single brief application of either ischemic pressure or transverse friction massage.

Treatment improved scores in both cases, but by unimpressive amounts, a classic damned-with-faint-praise result. The authors conclusion that these techniques were “equally effective in reducing tenderness in MTrPs” is not justified by the data.

Although the authors claim a “large” effect size, it’s based on an intra-group comparison that is meaningless. Without comparison to a control group, in principle we have no idea if the effects reported were actually caused by the treatments, or just by things like touch and medical attention. Using common sense instead of stats, for ischemic pressure they observed a drop on a 10-point pain scale of just .8, from 4.6 to 3.8. This is not nothing, but it’s in “take the edge off” territory, less than we’d expect from an aspirin for a headache.

~ 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.

The aim of this pilot study was to compare the effects of a single treatment of the ischemic compression technique with transverse friction massage for myofascial trigger point (MTrP) tenderness. Forty subjects, 17 men and 23 women, aged 19–38 years old, presenting with mechanical neck pain and diagnosed with MTrPs in the upper trapezius muscle, according to the diagnostic criteria described by Simons and by Gerwin, participated in this pilot study. Subjects were divided randomly into two groups: group A which was treated with the ischemic compression technique, and group B which was treated with a transverse friction massage. The outcome measures were the pressure pain threshold (PPT) in the MTrP, and a visual analogue scale assessing local pain evoked by a second application of 2.5 kg/cm2 of pressure on the MTrP. These outcomes were assessed pre-treatment and 2 min post-treatment by an assessor blinded to the treatment allocation of the subject. The results showed a significant improvement in the PPT (P=0.03), and a significant decrease in the visual analogue scores (P=0.04) within each group. No differences were found between the improvement in both groups (P=0.4). Ischemic compression technique and transverse friction massage were equally effective in reducing tenderness in MTrPs.

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