The effect of manual pressure release on myofascial trigger points in the upper trapezius muscle

Introduction

Sustained manual pressure has been advocated as an effective treatment for myofascial trigger points (MTrPs). This study aimed to investigate the effect of manual pressure release (MPR) on the pressure sensitivity of latent MTrPs in the upper trapezius muscle, using a novel pressure algometer.

Design

Randomised blinded clinical trial.

Methods

Participants: Thirty-seven subjects (mean age 23.1 years±3.2; M=12, F=23) were screened for the presence of latent MTrPs in the upper trapezius muscle (tender band that produced referred pain to the neck and/or head on manual pressure).

Intervention: Subjects were randomly allocated into either treatment (MPR pressure sustained for 60s) or control (sham myofascial release) group.

Outcome Measures: The pressure pain threshold (PPT) was recorded pre- and post-intervention using a digital algometer, consisting of a capacitance sensor attached to the tip of the palpating thumb. Changes in pressure sensitivity were also measured during the application of MPR via a verbal analogue pain scale (0–10, 0=no pain, 10=severe pain).

Results

There was a significant increase in mean PPT following MPR (P<0.001), but not following the sham treatment. Pressure was monitored and maintained during the application of MPR, and a reduction in perceived pain and significant increase in tolerance to treatment pressure (P<0.001) appeared to be caused by a change in tissue sensitivity, rather than an unintentional reduction of pressure by the examiner.

Conclusions

The results suggest that MPR may be an effective therapy for MTrPs in the upper trapezius muscle.

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