Invasive Techniques in Trigger Points
- Conditions
- Trigger Point Pain, Myofascial
- Interventions
- Other: Dynamic dry needlingDevice: Algorithm-based dose static MEPDevice: Fixed dose dynamic MEPOther: Static Dry needlingDevice: Fixed dose static MEPOther: Placebo
- Registration Number
- NCT05478928
- Lead Sponsor
- Maimonides University
- Brief Summary
Myofascial pain syndrome (MPS) is present in up to 87% of the patients that present pain. MPS usually presents painful myofascial trigger points (MTrPs).
One methodology used to quantify the pain in MPS is the algometry, which measures the pressure pain threshold (PPT).
Invasive techniques in physiotherapy have become popular in the last years due to their clinical efficacy and evidence. Percutaneous Microelectrolysis (MEP®) and dry needling are techniques that are already in use for this syndrome.
MEP® is a technique that employs a galvanic current up to 990 microAmperes, which is applied percutaneously with an acupuncture needle connected to the cathode. It is also known as low intensity percutaneous electrolysis.
The aim of this study is to compare the effects in pain and muscle tone (measured with algometry and surface electromyography) of invasive techniques. Healthy subjects between 18 to 48 years old, both sex, presenting MTrPs in upper trapezius will be recruited.
The secondary objectives are to determine the discomfort degree of each technique and if it is better to use MEP® with a fixed dose or with an algorithm in which the dose varies.
The hypothesis, according to our previous studies, is that MEP® generates higher changes in PPT.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 60
- Neck pain during the last 6 months
- Presence of a palpable taut band in the upper trapezius
- Presence of a hypersensitive tender spot in the taut band, with local or referred pain elicitation in response to compression
- PPT less than 3 Kg/cm2
- Previous cervical and/or shoulder surgical intervention.
- Phobia to needles.
- Temporomandibular disorders.
- Medicated with anticoagulants
- Still receiving a treatment for the myofascial trigger points (Physical therapy, NSAIDs, etc.)
- Diagnosis of fibromyalgia.
- Radiculopathies and/or radicular pain
- Whiplash related neck pain
- Migraines
- Dizziness
- Endocrinal diseases
- Being pregnant
- Cancer
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Dynamic dry needling Dynamic dry needling Dynamic dry needling will be done in the upper trapezius trigger point. Algorithm-based dose static MEP Algorithm-based dose static MEP Low intensity percutaneous electrolysis will be applied in the upper trapezius trigger point with an algorithm-based dose. Fixed dose dynamic MEP Fixed dose dynamic MEP Dynamic low intensity percutaneous electrolysis will be applied in the upper trapezius trigger point with a fixed dose. Static dry needling: Static Dry needling Static dry needling will be done in the upper trapezius trigger point. Fixed dose static MEP Fixed dose static MEP Static low intensity percutaneous electrolysis will be applied in the upper trapezius trigger point with a fixed dose. Placebo Placebo An acupuncture needle will be slightly introduced into the upper trapezius trigger point.
- Primary Outcome Measures
Name Time Method Pressure Pain Threshold (PPT) - 10 minutes 10 minutes Algometry is used to measure the Pressure Pain Threshold (PPT). PPT is defined as the minimum force applied which induces pain. It will be applied in the Myofascial Trigger points.
Surface electromyography at rest - 24 hours 24 hours Electromyography (EMG) is used to measure muscular electrical activity at rest to determine the basal tone. Peak voltage and root mean square (RMS) voltage will be informed.
Surface electromyography at maximum voluntary contraction - 48 hours 48 hours Electromyography (EMG) is used to measure muscular electrical activity at maximum voluntary contraction to determine the recruitment. Peak voltage and RMS voltage will be informed.
Pressure Pain Threshold (PPT) - 48 hours 48 hours Algometry is used to measure the Pressure Pain Threshold (PPT). PPT is defined as the minimum force applied which induces pain. It will be applied in the Myofascial Trigger points.
Surface electromyography at rest - Baseline Baseline Electromyography (EMG) is used to measure muscular electrical activity at rest to determine the basal tone. Peak voltage and root mean square (RMS) voltage will be informed.
Surface electromyography at rest - 48 hours 48 hours Electromyography (EMG) is used to measure muscular electrical activity at rest to determine the basal tone. Peak voltage and root mean square (RMS) voltage will be informed.
Surface electromyography at rest - Day 7 Day 7 Electromyography (EMG) is used to measure muscular electrical activity at rest to determine the basal tone. Peak voltage and root mean square (RMS) voltage will be informed.
Surface electromyography at maximum voluntary contraction - Baseline Baseline Electromyography (EMG) is used to measure muscular electrical activity at maximum voluntary contraction to determine the recruitment. Peak voltage and RMS voltage will be informed.
Surface electromyography at maximum voluntary contraction - 24 hours 24 hours Electromyography (EMG) is used to measure muscular electrical activity at maximum voluntary contraction to determine the recruitment. Peak voltage and RMS voltage will be informed.
Surface electromyography at maximum voluntary contraction - Day 7 Day 7 Electromyography (EMG) is used to measure muscular electrical activity at maximum voluntary contraction to determine the recruitment. Peak voltage and RMS voltage will be informed.
Pressure Pain Threshold (PPT) - Baseline Baseline Algometry is used to measure the Pressure Pain Threshold (PPT). PPT is defined as the minimum force applied which induces pain. It will be applied in the Myofascial Trigger points.
Pressure Pain Threshold (PPT) - 24 hours 24 hours Algometry is used to measure the Pressure Pain Threshold (PPT). PPT is defined as the minimum force applied which induces pain. It will be applied in the Myofascial Trigger points.
Pressure Pain Threshold (PPT) - Day 7 Day 7 Algometry is used to measure the Pressure Pain Threshold (PPT). PPT is defined as the minimum force applied which induces pain. It will be applied in the Myofascial Trigger points.
Surface electromyography at rest - 10 minutes 10 minutes Electromyography (EMG) is used to measure muscular electrical activity at rest to determine the basal tone. Peak voltage and root mean square (RMS) voltage will be informed.
Surface electromyography at maximum voluntary contraction - 10 minutes 10 minutes Electromyography (EMG) is used to measure muscular electrical activity at maximum voluntary contraction to determine the recruitment. Peak voltage and RMS voltage will be informed.
- Secondary Outcome Measures
Name Time Method Visual Analogue Scale of the procedure Immediately after the intervention To determine how unpleasant the procedure is, the visual analog scale (VAS) will be used.
Expresed in centimeters.
Minimum value: 0 Maximum value: 10 A higher score implicates a worse outcome.Post-needling soreness Four times per day (in the morning, before lunch, in the afternoon, and in the evening) during the seven days following intervention. To determine how unpleasant the post-needling soreness is, a pain diary with the visual analog scale (VAS) will be used. The patient will register the pain intensity in the needle area.
Expresed in centimeters.
Minimum value: 0 Maximum value: 10 A higher score implicates a worse outcome.Dose Immediately after the intervention To determine the amount of electric charge applied, the millicoulombs (mC) informed in the MEP device will be recorded.
Trial Locations
- Locations (1)
Universidad Maimónides
🇦🇷Ciudad Autonoma de Buenos Aires, Caba, Argentina