Effects of the release technique by pressing on the latent myofascial trigger point of the upper trapezius muscle: random controlled clinical trial

Abstract

Introduction. Latent myofascial trigger points (LMTPs) are responsible for intense and spontaneous pain. Non-traumatic mechanical neck pain is characterized by the presence of pressure hyperalgesia in the cervical spine, which equally affects the cervical muscles, such as upper trapezius, since these muscles receive their innervation from the CII–IV levels.The goal of research — to find out how the release technique by pressing on the LMTP of the upper trapezius immediately affects the pressure pain threshold (PPT) of this muscle, of the elevator muscle of scapula, the greater occipital nerve (GON), the supra-orbital nerve (V1) and articular processes of CIII–IV bilaterally, as well as on the range of active neck movements (RANM).Materials and methods. Sixty subjects diagnosed with LMTP in the antero-superior fibers of the upper trapezius muscle were included in the study. PPT values were measured bilaterally in the upper trapezius, elevator muscle of scapula, GON, V1, and CIII–IV articular processes using a digital algometer. RANM in flexion, extension, homolateral lateral flexion, contralateral lateral flexion, homolateral rotation, and contralateral rotation were measured with a bubble inclinometer. The intervention group received the MTP release technique, and the control group received a placebo technique with ultrasound without intensity.Results. The results obtained show that the release technique by pressing on the LMTP of the upper trapezius is effective in increasing the PPT in this muscle immediately after its application (p<0,01). It was also verified that the increase in the PPT in the upper trapezius, after the release of the LMTP, was accompanied by a simultaneous increase in the PPT in the contralateral upper trapezius, as well as in the elevator muscle of scapula bilaterally, GON bilaterally, CIII–IV articular processes bilaterally and V1 homolaterally. In both groups there was a significant increase in RANM (p<0,01). However, in the intervention group this increase was significantly higher, which may be quite relevant from a clinical point of view.Conclusions. The release technique by pressing on the LMTP of the upper trapezius muscle is a useful technique in osteopathy, since it contributes to the increase in PPT and RANM immediately after its application.