Shoulder Pain
Conditions
Keywords
Shoulder pain, Trigger points, Referred pain, Visual analogue scale
Brief summary
The first aim of the study will be to identify the most common ReP pattern and compare its coincidence with that described by Travell and Simons. Second, the study aim will be to verify whether there are any significant differences by sex and types of technique used in regard to the ReP pattern of TrP 2 of the infraspinatus muscle, an area described as more sensitive.Finally, the third aim of the study will be to determine whether deep dry needling will evoke the LTR and ReP more easily than manual palpation.
Detailed description
Patients will be recruited from a university's employee and student population by advertising at the university. Patients with shoulder complaints (described as pain felt in the shoulder or upper arm) will be randomly assigned to either an manual palpation or deep dry needling group. Participants will be randomly divided into 2 groups, a deep dry needling group and manual palpation group. Visual analogue scale (VAS), referred pain (ReP) pattern and features of referred pain of the infraspinatus muscle will be all assessed post-technique.
Interventions
OTHERManual palpation
The manual palpation level will kept constant by applying enough digital pressure to cause the finger nail bed to blanch. When the nail will be turn pale, the amount of pressure will be measured at approximately 3 4kg/cm2 and will be maintained for 5-10 seconds to evoke referred pain. A manual palpation referred pain will be present if the pain radiated far enough for the patient to feel more than just a local pain.
OTHERDeep dry needling
Intramuscular needling will be carried out via deep dry needling into myofascial trigger point (MTrP) area without the introduction any substances. The aim is to elicit a local twitch response upon inserting the needle into the MTrP area and perform a neurological stimulation (by rotating the needle 360 degrees) to more easily evoke referred pain, holding for 10 seconds and then extracting the needle gently. The procedure will be followed by one minute of haemostatic compression.
Sponsors
Universidad Miguel Hernandez de Elche
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Aged between 18 and 65 years. * To remain seated or in front of data visualization screens (tablets, computers or smartphones) for at least 4 hours a day. * Shoulder complaints in the last six weeks.
Exclusion criteria
* Patients with evidence of serious medical illness. * Cognitive impairment. * Psychosocial disorders. * Bilateral affectation of shoulder pain. * Pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mapping of Referred Pain Pattern | One month | The participants from both groups will ask to report whether ReP is evoked and to describe the ReP pattern using an anatomical map of the upper half of the human body divided into eighteen areas. Nine areas corresponded to the anterior part of the body and the other nine to the posterior part of the body. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence active trigger point | One month | Active trigger point is considered: Soreness taut band and familiar pain. |
| Evocation of Local Twitch Response | One month | These were assigned a numerical value of 0 (yes) or 1 (no) for better statistical handling of the data. |
| Subjective pain intensity: Visual Analogue Scale (VAS) | One month | The VAS for pain measures the amount of pain experienced by a subject on a continuum from 0 to 10, with 0 being no pain and 10 maximum pain. |
Outcome results
None listed