Myofascial Pain Clinical Trial
Official title:
Comparison of the Effect of Radial Shock Wave and Acupuncture in the Treatment of Myofascial Pain Syndrome
Myofascial pain syndrome is common in Rehabilitation clinic. The pain occurs asymmetrically
in isolated or regional muscles, and is associated with acute muscle strain or chronic
muscle overuse. Myofascial pain is characteristics with localized muscle tenderness,
palpable intramuscular taut band, typical referred pain, and local twitch response.
Treatment of myofascial pain syndrome includes physical therapy, stretch exercise, dry
needle insertion and trigger point injection. Acupuncture originated from ancient Chinese
medicine which involves the insertion of fine needle to stimulate specific points of the
body along the 12 meridians. The mechanism of pain relief may be initiated by activation of
both spinal segmental and supraspinal centers. Acupuncture is commonly used for pain relief.
Recently, radial shock wave has been shown to be effective in the treatment of chronic
musculoskeletal pain, including calcific tendinitis, epicondylitis, and plantar fasciitis.
The energy and pressure produced by radial shock wave is focused on the treated
musculoskeletal tissue. The mechanism of action has been hypothesized that the energy could
result in analgesic effect and stimulation of angiogenesis and healing response and then
relief of the symptoms. The effectiveness of radial shock wave on treatment of myofascial
pain was reported by Jeon and colleagues in 2012.
The aim of this study is to compare the efficacy of acupuncture and radial shock wave
therapy in patients with myofascial pain syndrome.
80 participants diagnosed with myofascial pain syndrome in trapezius muscle will be enrolled
from the outpatient clinic of Department of Physical Medicine and Rehabilitation in Shin
Kong Wu Ho-Su Memorial Hospital .
The patients will be randomized to either treatment groups: group 1, radial extracorporeal
shock wave therapy (RSWT group) and group 2, acupuncture group (AC group).
All treatments will be given in the Department of Physical Medicine and Rehabilitation, and
will be handled by a physiatrist who is familiar with both kinds of therapy.
The RSWT is delivered at 2 Hz with 2000 shock waves and the energy level of 0.056 mJ / mm2
in the trapezius muscle. Treatment point is the origin attachment of upper trapezius at the
external occipital protuberance. RSWT will be performed once per week, and will be continued
for 3 weeks.
Acupuncture is performed at Fenfchi (GB20) point over upper back. This acupoint is a common
local point for treating upper back pain. Acupuncture therapy will be provided by the same
physiatrist to all patients.
The primary outcome measures are VAS for pain and pain threshold. The secondary outcome
measures are neck disability index, and patients' satisfaction. All subjects will be
assessed by an independent, blinded investigator at baseline, post treatment and at 1-month
after the treatments are completed.
Demographic data, including age, sex, employment status, and sleep quality, history of head
or neck surgery, or other psychiatric and medical disorders will be recorded at baseline. A
history will be taken concerning the duration of complaints (months), previous treatments
(injections, physical therapy), and current pain medications. Concomitant diseases and the
use of medications will be registered.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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