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THU0351 Efficacy of Pulsed and Continuous Therapeutic Ultrasound in Myofascial Pain Syndrome: A Randomised Controlled Study
  1. L. Ilter1,
  2. B. Dilek2,
  3. I. Batmaz1,
  4. M.A. Ulu3,
  5. M.A. Sarıyıldız1,
  6. K. Nas1,
  7. R. Çevik1
  1. 1Department of Physical Medicine and rehabilitation, Dicle University Faculty of Medicine, Diyarbakır
  2. 2Department of Physical Medicine and rehabilitation, Dokuz Eylul University Faculty of Medicine, İzmır
  3. 3Department of Physical Medicine and rehabilitation, Siirt Medlife Hospital, Siirt, Turkey

Abstract

Background Myofascial pain syndrome (MPS) is a common clinic problem caused by myofascial trigger point. Effective therapies include manuel therapies, physical therapy modalities, dry needling or injection. Therapeutic ultrasound therapy is often preferred in MPS, but its dose and frequency has not been studied sufficiently in the literature.

Objectives Our aim is to compare the effects of continuous and pulsed therapeutic ultrasound therapy with the sham ultrasound in terms of the pain, severity of the muscle spasm, neck function, depression and quality of life in MPS.

Methods Sixty patients with MPS participated in this prospective double-blind, randomized controlled trial. All patients were randomly divided into three groups: the continuous ultrasound group (3 MHZ, 1 W/cm2 ultrasound, hotpack and exercise, n=20), the pulsed ultrasound group (3 MHZ, 1 W/cm2, 1:1 ratio, hotpack and exercise, n=20) and the control group (sham ultrasound, hotpack and exercise, n=20). The primary outcome measure was the severity of the pain at rest and at activity assessed with visual analogue scale (0-10 cm). The secondary outcome measures were Neck Pain and Disability Scale used for functional evaluation; Beck Depression Scale used for depressive mood evaluation, and the quality of life assessed with the Nottingham Health Profile. Also, the patients' satisfaction and the severity of the muscle spasm were assessed using a Likert scale. All the evaluations were done at baseline, after treatment, and at the 6th and 12th weeks subsequent to the treatment.

Results The treatment results demonstrated significant improvement in all the pain scores, the severity of the muscle spasm, neck function assessment and certain sub-parameters of the quality of life scale in all three groups (p<0.05). When the changes in the groups after treatment were compared, improvement in the pain at rest was greater in the group that underwent continuous ultrasound therapy in comparison to the sham ultrasound and pulsed ultrasound groups (p<0.05). However, no statistically significant difference was observed in the other parameters (p>0.05).

Conclusions In MPS, continuous ultrasound therapy is more efficient in reducing the pain at rest in comparison to sham and pulsed ultrasound therapy.

References

  1. Han S.C, Harrison P. Myofascial pain syndrome and trigger point management, Reg Anest 22(1): 89-101,1997

  2. Srbely JZ, Dickey JP. Randomized controlled study of the antinociceptive effect of ultrasound on trigger point sensitivity: novel applications in myofascial therapy? Clinical Rehabilitation 2007;21:411-417

  3. Gam AN, Warming S, Larsen LH, Jensen B,Hiydalsmo O, Allon I, Andersen B, Gotzsche NE, Petersen M, Mathiesen B. Treatment of myofascial trigger points with ultrasound combined with massage and exercise: a randomized controlled Pain 1998;77:73-9.

  4. Esenyel M, Cağlar N, Aldemir T. Treatment of myofascial pain Am J Phys Med Rehabil 2000;79:48-52.

Acknowledgements We thank to all patients

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.3321

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