An examination of pressure-pain thresholds at myofascial trigger points, following muscle energy technique or ischaemic compression treatment

Author: Jamie Dearing                                                    Superviser Fiona Hamilton 

Abstract:
Background and Objectives: Ischaemic compression and muscle energy techniques are commonly used by manual therapists to treat myofascial trigger points. The aim of this controlled study was to examine pressure-pain thresholds at myofascial trigger points in the upper trapezius of asymptomatic patients, following either ischaemic compression or muscle energy technique.

Methods: Subjects (n=50) were screened for myofascial trigger points in the upper trapezius and pain pressure threshold measurements were taken using a manual algometer before and after manual treatment. Subjects were allocated to one of three groups, receiving either a 90 second ischaemic compression technique, a muscle energy technique or listening to 3 minutes of relaxing music (control).

Analysis: Compared to pre-treatment levels, post-treatment myofascial trigger point sensitivity was significantly reduced in both the ischaemic compression group (P<0.001) and the muscle energy group (P<0.001), but not the control group (P>0.05), when analysed using within-group paired t-tests. A one-way analysis of variance and post hoc analysis revealed a significant difference between the muscle energy group and the control (P<0.05), and a very significant difference between the ischaemic compression group and the control (P<0.01). No significant difference was found between the two treatment groups (P>0.05). The within-group effect size was measured using Cohen’s d and found to be large for the ischaemic compression group (d=0.77), medium for the MET group (d=0.64), and less than small for the control group (d=0.12).

Conclusion: This study shows that both ischaemic compression and muscle energy technique produce a significant reduction in pain sensitivity at myofascial trigger points in the upper trapezius muscle. Ischaemic compression appeared to be more effective than muscle energy technique in reducing pain sensitivity at these trigger points in asymptomatic subjects.

Key Words: Myofascial trigger point, pressure-pain threshold, ischaemic compression, Muscle energy technique, trapezius, post-isometric stretch, algometry, osteopathy.