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titleChronic shoulder pain of myofascial origin: a randomized clinical trial using ischemic compression therapy
typearticle in a journal
pubmedhttp://www.ncbi.nlm.nih.gov/pubmed/20605555
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noteIn this clinical trial, researchers evaluated the effect of 15 treatments of ischemic compression — pressing and holding trigger points (muscle knots) — for patients with shoulder pain. Trigger points in the supraspinatus, infraspinatus, deltoid and biceps muscles were treated in 41 patients, and the results compared to 18 who received the same treatment but in other muscles (the cervical and upper thoracic areas). A score measuring shoulder discomfort went down a whopping 75% in those treated, compared to a mere 30% reduction in people who received treatment in a nearby location.

The authors concluded: “The results of this study suggest that myofascial therapy using ischemic compression on shoulder trigger points may reduce the symptoms of patients experiencing chronic shoulder pain.”

This study may show only that poking people’s trigger points gives great placebo. An obvious problem with this experiment is that it compared treatment in the right place to treatment in the wrong place. Patients in the control group would have been well aware that pressure was being applied in muscles mostly irrelevant to their shoulder pain, probably decreasing their satisfaction and expectation of benefit. Meanwhile, people getting treatment in the “right” place will likely feel much better about the treatment and have a much higher hopes: rich soil for a placebo effect.

authorsGuy Hains, Martin Descarreaux, and François Hains
keywordsmyofascial pain syndrome, massage therapy
journalJournal of Manipulative & Physiological Therapeutics
year2010
monthJun
volume33
number5
pages362-9
abstract
OBJECTIVE: The aim of this clinical trial was to evaluate the effect of 15 myofascial therapy treatments using ischemic compression on shoulder trigger points in patients with chronic shoulder pain.
METHODS: Forty-one patients received 15 experimental treatments, which consisted of ischemic compressions on trigger points located in the supraspinatus muscle, the infraspinatus muscle, the deltoid muscle, and the biceps tendon. Eighteen patients received the control treatment involving 15 ischemic compression treatments of trigger points located in cervical and upper thoracic areas. Of the 18 patients forming the control group, 16 went on to receive 15 experimental treatments after having received their initial control treatments. Outcome measures included a validated 13-question questionnaire measuring shoulder pain and functional impairment. A second questionnaire was used to assess patients' perceived amelioration, using a scale from 0% to 100%. Outcome measure evaluation was completed for both groups at baseline after 15 treatments, 30 days after the last treatment, and finally for the experimental group only, 6 months later.
RESULTS: A significant group x time interval interaction was observed after the first 15 treatments, indicating that the experimental group had a significant reduction in their Shoulder Pain and Disability Index (SPADI) score compared with the control group (62% vs 18% amelioration). Moreover, the patients perceived percentages of amelioration were higher in the experimental group after 15 treatments (75% vs 29%). Finally, the control group subjects significantly reduced their SPADI scores after crossover (55%).
CONCLUSION: The results of this study suggest that myofascial therapy using ischemic compression on shoulder trigger points may reduce the symptoms of patients experiencing chronic shoulder pain.