Effect of ischemic pressure using a Backnobber II device on discomfort associated with myofascial trigger points
Three pages on PainSci cite Gulick 2011: 1. The Complete Guide to Trigger Points & Myofascial Pain 2. Trigger Point Doubts 3. Trigger Points on Trial
PainSci commentary on Gulick 2011: ?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 wherever possible.
This experiment has the simple elegance of a good science-fair project. Dr. Dawn Gulick of the Widener University Physical Therapy Department simply compared the sensitivity of trigger points both with and without a simple treatment of pressure — squishing them, that is.
Dr. Gulick et al. tested a specific method of squishing: pressing a trigger point firmly and long enough to starve it of some oxygen (ischemic pressure), repeatedly, for several days. They measured trigger point sensitivity before and after treatment in 28 people with two trigger points in the upper back. Their conclusion: “There was a significant difference between the pre- and post-test sensitivities of the treated and non-treated trigger points … ischemic compression … was effective in reducing trigger point irritability.”
Excellent! This is small-scale science, but the results are encouraging and certainly consistent with my professional experience.
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 assess the effectiveness of ischemic pressure on myofascial trigger point (MTrP) sensitivity.
DESIGN: Randomized, controlled study with the researcher assessing MTrP sensitivity blinded to the intervention.
PARTICIPANTS: Twenty-eight people with two MTrPs in the upper back musculature.
INTERVENTION: The sensitivity of two MTrPs in the upper back was assessed with a JTECH algometer. One of the two MTrPs was randomly selected for treatment with a Backnobber II, while the other served as a control.Outcome measures: Pre- and post-test pressure–pain thresholds of the MTrPs.
RESULTS: There was a significant difference between the pre- and post-test sensitivities of the treated and non-treated MTrPs (p = 0.04).
CONCLUSIONS: The results of this study confirm that the protocol of six repetitions of 30-s ischemic compression with the Backnobber II rendered every other day for a week was effective in reducing MTrP irritability.
related content
- “The immediate effect of triceps surae myofascial trigger point therapy on restricted active ankle joint dorsiflexion in recreational runners: a crossover randomised controlled trial,” Grieve et al, Journal of Bodywork & Movement Therapies, 2013.
- “Myofascial techniques: What are their effects on joint range of motion and pain? A systematic review and meta-analysis of randomised controlled trials,” Webb et al, Journal of Bodywork & Movement Therapies, 2016.
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:
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.