Comparison of the Effect of Radial Shock Wave and Acupuncture in the Treatment of Myofascial Pain Syndrome
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Myofascial Pain
- Sponsor
- Shin Kong Wu Ho-Su Memorial Hospital
- Enrollment
- 68
- Locations
- 1
- Primary Endpoint
- VAS for pain
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Myofascial pain syndrome is common in Rehabilitation clinic. The pain occurs asymmetrically in isolated or regional muscles, and is associated with acute muscle strain or chronic muscle overuse. Myofascial pain is characteristics with localized muscle tenderness, palpable intramuscular taut band, typical referred pain, and local twitch response.
Treatment of myofascial pain syndrome includes physical therapy, stretch exercise, dry needle insertion and trigger point injection. Acupuncture originated from ancient Chinese medicine which involves the insertion of fine needle to stimulate specific points of the body along the 12 meridians. The mechanism of pain relief may be initiated by activation of both spinal segmental and supraspinal centers. Acupuncture is commonly used for pain relief.
Recently, radial shock wave has been shown to be effective in the treatment of chronic musculoskeletal pain, including calcific tendinitis, epicondylitis, and plantar fasciitis. The energy and pressure produced by radial shock wave is focused on the treated musculoskeletal tissue. The mechanism of action has been hypothesized that the energy could result in analgesic effect and stimulation of angiogenesis and healing response and then relief of the symptoms. The effectiveness of radial shock wave on treatment of myofascial pain was reported by Jeon and colleagues in 2012.
The aim of this study is to compare the efficacy of acupuncture and radial shock wave therapy in patients with myofascial pain syndrome.
Detailed Description
80 participants diagnosed with myofascial pain syndrome in trapezius muscle will be enrolled from the outpatient clinic of Department of Physical Medicine and Rehabilitation in Shin Kong Wu Ho-Su Memorial Hospital . The patients will be randomized to either treatment groups: group 1, radial extracorporeal shock wave therapy (RSWT group) and group 2, acupuncture group (AC group). All treatments will be given in the Department of Physical Medicine and Rehabilitation, and will be handled by a physiatrist who is familiar with both kinds of therapy. The RSWT is delivered at 2 Hz with 2000 shock waves and the energy level of 0.056 mJ / mm2 in the trapezius muscle. Treatment point is the origin attachment of upper trapezius at the external occipital protuberance. RSWT will be performed once per week, and will be continued for 3 weeks. Acupuncture is performed at Fenfchi (GB20) point over upper back. This acupoint is a common local point for treating upper back pain. Acupuncture therapy will be provided by the same physiatrist to all patients. The primary outcome measures are VAS for pain and pain threshold. The secondary outcome measures are neck disability index, and patients' satisfaction. All subjects will be assessed by an independent, blinded investigator at baseline, post treatment and at 1-month after the treatments are completed. Demographic data, including age, sex, employment status, and sleep quality, history of head or neck surgery, or other psychiatric and medical disorders will be recorded at baseline. A history will be taken concerning the duration of complaints (months), previous treatments (injections, physical therapy), and current pain medications. Concomitant diseases and the use of medications will be registered.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Physical examination showed
- •unilateral upper back pain,
- •palpable intramuscular taut band,
- •normal neurological examination
- •presence of trigger points
Exclusion Criteria
- •bilateral neck pain
- •pregnancy
- •coagulopathy
- •patients with pacemaker
- •open wound at treatment area
- •cervical spine fracture or previous operation around neck
- •cervical myelopathy
- •rheumatoid arthritis
- •severe systemic disease
Outcomes
Primary Outcomes
VAS for pain
Time Frame: up to 1 week before treatment, on the day treatment is completed, 1 month after treatment completed
horizontal lines of 100 mm, with 0 indicating no pain on the left and 100 indicating very severe pain on the right
Pain threshold
Time Frame: up to 1 week before treatment, on the day treatment is completed, 1 month after treatment completed
A pressure algometer, the pressure threshold meter, was applied onto the affected and unaffected sides of upper trapezius, with the metal rod perpendicular to the surface of the skin. The pressure of compression was increased gradually until the subject began to feel pain or any discomfort. Three repetitive measurements at an interval of 20-60 s were performed. The average values of the three readings were used for data analysis of the pain threshold measurement.
Secondary Outcomes
- neck disability index(up to 1 week before treatment, on the day treatment is completed, 1 month after treatment completed)
- cervical active range of motion(up to 1 week before treatment, on the day treatment is completed, 1 month after treatment completed)