Clinical Research Directory

rESWT vs LLLT for Cervical Myofascial Pain

Background and Aim: Myofascial pain syndrome (MPS) in the cervical region is one of the most common musculoskeletal disorders associated with myofascial trigger points that cause muscle pain, stiffness, and reduced range of motion, precipitated by forward head posture. Many non-invasive modalities, including low-level laser therapy (LLLT) and extracorporeal shockwave therapy (ESWT), have been reported to reduce symptoms. However, comparative effectiveness of these interventions remains unclear. This study aimed to compare the effectiveness of radial ESWT and LLLT in reducing pain and improving functional outcomes in patients with cervical MPS among the working-age adults. Methods: A randomized controlled study was conducted in a working-age adults with MPS. Fifty subjects, divided in two groups received either ESWT or LLLT. Numeric rating scale (NRS), cervical range of motion (ROM), and craniovertebral angle (CVA) were assessed before and throughout three weeks post intervention. Results: Both LLLT and ESWT showed significant (p \< 0.001) changes in NRS, cervical ROM, and CVA. LLLT showed a difference in pain reduction at week three (p \< 0.001) and flexion and extension ROM at week two and three (p \< 0.05). Conclusion: LLLT demonstrated superior results in pain reduction at the three-week mark and produced greater increases in cervical flexion and extension ROM during the two- and three-week periods when compared with ESWT.

Effectiveness of Positional Release Techniques and Graston Technique In Trigger Point

The purpose of the study is to evaluate comparative effectiveness of positional release techniques and graston technique In trapezius trigger point

Accuracy of Rib Palpation for Dry Needling of Deep Periscapular Musculature, Measured With Ultrasound

Ultrasound was used to identify the location of a rib. This was compared to a practitioner's ability to palpate the area.

Evaluation of a Novel Class of Objective Myofascial Pain Assessments

This is an observational study that is intended to determine the capacity of three technologies to serve as diagnostic biomarkers for myofascial pain syndrome. Investigators will seek patients with myofasical pain syndrome as well as healthy subjects for this study. Electrical impedance myography (EIM), myofiber threshold tracking (TT) excitability testing, and ultrasound with shear wave elastography (SWE) measurements will be obtained from the trapezius muscle (the muscle that extends over the back of the neck and shoulders). These measurements will be repeated within 2-5 days to assess repeatability of these methods.

Effect of MET vs Neck Calliet Exercises on Neck Pain and Disability in Nurses

This study compares the effectiveness of Muscle Energy Techniques (MET) and Neck Calliet Exercises in managing mechanical neck pain and associated disability due to trapezius trigger points among nurses. A total of 38 female nurses were randomly assigned to two intervention groups, each receiving therapy for four weeks. Pain, cervical range of motion, and disability outcomes were assessed.

Efficacy of Adding Greater Occipital Nerve Block to Trigger Point Injection in Patients With Neck Pain

Study Title: Evaluation of the Effectiveness of Adding Greater Occipital Nerve Block to Trigger Point Injection in Patients with Neck Pain Due to Upper Trapezius Trigger Points: A Single-Blind Randomized Controlled Trial Purpose of the Study: This study aims to evaluate whether adding a Greater Occipital Nerve (GON) block to the standard trigger point injection treatment provides better pain relief and improves daily function in patients with neck pain caused by trigger points in the upper trapezius muscle. Trigger points are small, sensitive spots in muscles that can cause significant pain and discomfort. While both trigger point injections and GON blocks are common treatments for neck and head pain, it is not yet clear if combining these two methods offers better results. Why is this study important? Neck pain related to trigger points in the upper trapezius muscle is a frequent problem, but there is limited research on the effectiveness of combining trigger point injections with GON blocks. This study will provide important information on whether the combination therapy can reduce pain more effectively and improve patients' quality of life and ability to perform daily activities. Who can participate? Adults aged 18 to 65 years old Diagnosed with myofascial pain syndrome (MAS) based on specific clinical criteria, including the presence of trigger points in the upper trapezius muscle Experiencing neck pain lasting longer than 3 months Pain intensity rated 5 or higher on a scale of 0 to 10 Who cannot participate? Pregnant or breastfeeding women, children, elderly people, unconscious or critically ill patients Patients with allergies to local anesthetics or steroids Individuals with bleeding disorders or infections near the injection site Patients with serious psychiatric or neurological diseases, or other medical conditions that may affect study results Those who have recently received similar treatments or surgery for neck or shoulder problems Study Design and Procedures: The study will include 60 patients meeting the criteria, randomly assigned to two groups using a balanced randomization method. Group A will receive only trigger point injections into the upper trapezius muscle using a mixture of lidocaine and saline solution. Group B will receive both trigger point injections and an ultrasound-guided GON block, which involves injecting a combination of local anesthetics and steroid near the greater occipital nerve to reduce pain signals. Both groups will receive the same home exercise program focusing on stretching and strengthening neck muscles to support recovery. Patients will be encouraged to perform these exercises regularly and will be followed up weekly by phone to check their progress. The doctor assessing patients' progress will not know which treatment the patient received, to ensure unbiased results. Assessments: Patients will be evaluated at three different times: before treatment, 1 week after treatment, and 4 weeks after treatment. Assessments include: Pain intensity and quality (using Visual Analog Scale and McGill Pain Questionnaire) Neck disability and ability to perform daily activities (Neck Disability Index) Quality of life (Nottingham Health Profile) Neck joint movement and position sense (using clinical tests with special equipment) Posture evaluation (measuring head position using photography) Expected Outcomes: The main goal is to determine if the combined treatment of trigger point injection plus GON block is more effective than trigger point injection alone in reducing pain, improving neck function, and enhancing quality of life. Duration and Follow-Up: The study is planned to last 12 months. Patients will be closely monitored during and after treatment to ensure safety and to collect necessary data. Potential Benefits and Risks: Participants may experience pain relief and improved function if the combined treatment is effective. Risks include mild discomfort or side effects related to injections, which will be minimized by experienced medical staff.

Strain Counterstrain Technique and Graston Technqiue on Quadratus Lumborum Trigger Points

Poor body mechanics and posture affects body positioning and stresses quadratus lumborum muscle which ultimately leads to myofascial trigger points in muscle. This study aims to compare the effects of Strain counterstrain technique and Graston technique on trigger points of quadratus lumborum in nonspecific low back patients. This study will be a randomized controlled trial and will be conducted in Riphah Rehabilitation Clinic Lahore and SPARC Physiotherapy Clinic Lahore. Non-probability convenient sampling will be used to collect the data. Sample size of 34 subjects with age group between 20-45 years will be taken. baseline and after 4 weeks. Data analysis will be done by SPSS version 25.

Clinical Study on Dry Needling for Primary Dysmenorrhea and Its Preliminary Correlation With Acupoints

Primary dysmenorrhea refers to menstrual pain not caused by pelvic organic lesions, commonly seen in young women, significantly affecting patients' quality of life. Dry needling therapy targeting myofascial trigger points for primary dysmenorrhea has been preliminarily applied in clinical settings. However, related research is limited with questionable quality, hindering its widespread clinical application. Furthermore, is there a connection between myofascial trigger points in dry needling and acupuncture acupoints in terms of selection and mechanism of action? Could this be a new interpretation of acupuncture theory? These are important questions that have garnered widespread attention. This study employs a randomized patient-blinded controlled design, enrolling primary dysmenorrhea patients aged 18 to 30 years. They are randomly divided into three groups: the trigger point dry needling group, traditional acupuncture treatment group, and trigger point sham needle (placebo) group. Changes in pain levels, quality of life scores, inflammatory factor levels, and local blood flow before and after treatment among the three groups are observed. The aim is to assess the therapeutic effects of dry needling trigger points and acupuncture treatments on primary dysmenorrhea and explore their potential mechanisms of action. By comparing the differences and similarities between dry needling trigger points and acupuncture treatments in terms of acupoint selection, treatment effects, and potential mechanisms of action, this study seeks to preliminarily explore the feasibility of integrating trigger point theory into the meridian 'acupoint' theory, laying the foundation for a modern interpretation of acupuncture

Safe Zone in Trigger Point Injection

The goal of this observational study is to define the safe distance that will reduce the risk of pneumothorax through ultrasonographic imaging measurements in both sitting and prone positions to ensure patient safety during these procedures. The main question\[s\] it aims to answer \[is/are\]: The mean distance between the skin and pleura in sitting position during the inhalation and exhalation The mean distance between the skin and pleura in prone position during the inhalation and exhalation

Subthreshold Stimulation Versus Suprathreshold Stimulation in People With Chronic Low Neck Pain

this trial will involve three groups. Group 1 will receive subthreshold stimulation. Group 2 will receive suprathreshold stimulation. Group 3 will receive shame treatment.