Myofacial Pain Syndromes Clinical Trial
Official title:
Is Low-level Laser on Traditional Acupoint as Effective as That on Trigger Point in the Management of Cervical Myofascial Pain Syndrome?
Objective: To compare the effectiveness of application of low-level laser therapy (LLLT) to
trigger points and traditional acupoints for patients with cervical myofascial pain syndrome
(MPS).
Design: A single-blinded, randomized, placebo-controlled trial Setting: University
rehabilitation hospital Participants: One hundred and twenty one patients with cervical MPS
Intervention: The investigators performed this experiment using low level 810-nm gallium
aluminum arsenide (Ga-Al-As) laser. One hundred participants were randomly assigned to four
treatment groups, including (1) acupoint therapy (2) acupoint control (3) trigger point
therapy and (4) trigger point control groups.
Main Outcome measures: The investigators evaluated the patient's visual analogue scale (VAS)
pain scores, pressure pain threshold and cervical range of motion (ROM) before and after the
therapy.
Low level laser therapy (LLLT) has been promoted since 1960s. It was clinically applied on
neurological, musculoskeletal and soft tissue disorders, with the effects such as
acceleration of wound healing, edema reduction in human flexor tendon injuries, improvement
of morning stiffness, and pain relief in rheumatoid arthritis and lateral epicondylitis. As
for relief of musculoskeletal pain, however, the effect of LLLT is controversial. Some
studies reported that LLLT was a safe and effective treatment for relief of musculoskeletal
pain, while others considered LLLT as ineffective in treating certain musculoskeletal
diseases.
LLLT has been used to stimulate traditional acupoints, which is denoted as laser
acupuncture. In addition to pain relief, laser acupuncture has been reported to be effective
in a variety of disorders such as intractable hiccups,enuresis, as well as weight reduction.
Nevertheless, the underlying mechanisms and modes of application of laser acupuncture remain
unclear.
There has been evidence that needle acupuncture on traditional acupoints or trigger points
may ease neck pain. However, needle acupuncture has some limitations because it is an
invasive procedure with risk of infection or pneumothorax. Besides, some patients were not
able to tolerate the discomfort from needle manipulation during acupuncture therapy.
LLLT is a type of non-invasive painless therapy and hence a good alternative to needle
acupuncture. LLLT has been used to treat neck pain since 1981 and demonstrated significant
reduction of pain intensity and improvement of cervical range of motion (ROM) in patients
with cervical myofascial pain syndrome (MPS). In most of the studies on LLLT and cervical
MPS, trigger points were chosen as the application area domain for LLLT. However, there is
no report yet to compare the effectiveness of LLLT on trigger points and traditional
acupoints.
In the present single-blinded, randomized, controlled study, the investigators aimed to
investigate the effectiveness of application of LLLT to the trigger points and traditional
acupoints in patients with cervical MPS. The outcome measurement was pain relief and the
improvement of cervical ROM, on which the findings could provide in-depth understanding of
the therapeutic mechanism of LLLT and further allow more flexible options of clinical
application.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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