The effectiveness of trigger point treatment in rotator cuff pathology: A randomized controlled double-blind study

Article type: Research Article

Authors: Akbaba, Yildiz Analay^a | Mutlu, Ebru Kaya^{a; *} | Altun, Suleyman^b | Turkmen, Ezgi^c | Birinci, Tansu^d | Celik, Derya^a

Affiliations: [a] Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey | [b] Clinics of Orthopedics and Traumatology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey | [c] Department of Physiotherapy and Rehabilitation, Institute of Graduate Education, Istanbul University-Cerrahpasa, Istanbul, Turkey | [d] Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey

Correspondence: [*] Corresponding author: Ebru Kaya Mutlu, Saglık Bilimleri Fakultesi, Fizyoterapi ve Rehabilitasyon, Istanbul Universitesi-Cerrahpasa, 34740, Bakirkoy, Istanbul, Turkey. Tel.: +90 212 414 1500 40168; Fax: +90 212 414 1515; E-mail: fztebrukaya@hotmail.com.

Abstract: BACKGROUND:Studies have emphasized the importance of the presence of myofascial trigger points (MTrPs) in patients with rotator cuff pathologies and the high frequency of MTrPs in rotator cuff muscles. OBJECTIVE: Evaluate the effectiveness of the treatment of active MTrPs in patients with rotator cuff pathologies. METHODS: Fifty-three patients with rotator cuff tear were randomized into two groups. All patients received the same standard conservative treatment twice a week for 6 weeks. Patients in Group 1 additionally received ischemic compression (IC) of MTrPs. Pain, range of motion (ROM), function, and anxiety and depression were assessed. MTrPs in rotator cuff muscles were assessed manually, and the number of MTrPs on the shoulder complex was counted. RESULTS: There were no significant differences between the groups in terms of changes in resting/activity/night pain, ROM, function, or anxiety and depression (p> 0.05). Pain scores improved only in Group 1. However, the total number of MTrPs was significantly decreased in Group 1 (p= 0.001). CONCLUSION: A six-week course of IC helps treat active MTrPs. A standard conservative treatment program reduced pain and increased function; the addition of MTrP treatment did not improve clinical outcomes in patients with rotator cuff pathologies.

Keywords: Shoulder pain, trigger points, range of motion, rehabilitation

DOI: 10.3233/BMR-181306

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 519-527, 2019