Myofascial Pain Syndrome (MPS)
Conditions
Keywords
Myofascial pain syndrome, Trigger point, Dry needling, Dry cupping therapy, Wet cupping therapy
Brief summary
This study aimed to compare the effectiveness of dry needling and cupping therapy in patients diagnosed with myofascial pain syndrome involving the trapezius, supraspinatus, infraspinatus, and levator scapulae muscles. Treatment efficacy was evaluated using the visual analog scale (VAS), the number of trigger points, the Likert satisfaction scale, and the multidimensional quality of life scale.
Detailed description
This study evaluated the effectiveness of dry needling (DN) and cupping therapy in 92 patients with chronic myofascial pain syndrome. Participants were randomly divided into two groups: one receiving a 10-session cupping regimen and the other undergoing a three-session dry needling protocol, with both groups performing home-based exercises. Results showed that both treatments significantly reduced pain and improved patient outcomes over three months. When compared directly, cupping therapy was more effective at reducing trigger points and improving overall quality of life. Conversely, dry needling resulted in higher levels of patient satisfaction. In conclusion, both methods are valuable tools for managing myofascial pain, and the choice of treatment may depend on whether the clinical priority is physical symptom relief or patient preference. Further research is recommended to better define the specific long-term applications of these therapies.
Interventions
PROCEDURECupping therapy
In the tenth session, wet cupping was performed directly over the patients' TNs. In addition to the TNs, wet cupping was also applied at the Dazhui DU-14 point in all patients. Before initiating the procedure, the treatment area was disinfected with alcohol. Sterile single-use cups numbered 5 and 6 were applied to the treatment area. After 3 to 5 minutes, the cups were removed one at a time. After the area was cleaned, a No. 15 scalpel blade was used to make shallow vertical cuts at the cupping site. Afterward, the cups were returned to the same places. The procedure was performed three times without making any new cuts. The blood was drained, and the cups were put back on. The entire procedure lasted approximately 20 min. The cups were removed at the end of the procedure, and the area that had been treated was cleaned and covered properly.
PROCEDUREDry needling
Needling was performed while the TNs in the levator scapulae, supraspinatus, and upper part of the trapezius muscles were sitting. Patients were placed in the prone position for the middle and lower parts of the trapezius and infraspinatus muscles. To increase the accuracy of localization and minimize the risk of injury to nearby structures, needling was performed under ultrasound guidance. We used the Esaote MyLab 60 ultrasound machine that we have in our clinic for this. Standard single-use sterile acupuncture needles (0.25 mm × 25 mm) were used.
Sponsors
Turkish League Against Rheumatism
Atatürk University Scientific Research Projects Coordination Unit
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Back pain lasting more than three months * At least one palpable myofascial TN in the trapezius, supraspinatus, infraspinatus, and/or levator scapulae muscles * Written informed consent
Exclusion criteria
* Prior dry needling treatment * Prior cupping therapy * Severe cognitive dysfunction * Spinal fracture * Infection * Malignancy * Ankylosing spondylitis * Central nervous system injury * Psychiatric disorder * Diseases causing tissue degeneration * Conditions associated with spasticity or cerebrovascular disease * Cervical radiculopathy due to structural abnormalities * Muscle or tendon injuries of the shoulder or neck * Fibromyalgia or other conditions presenting with symptoms similar to myofascial pain syndrome * Use of anticoagulant or antiplatelet therapy * Thrombocytopenia or hemorrhagic disorders * A history of surgery or blood donation within the previous three months * Pregnancy * Breastfeeding * Presence of renal, hepatic, or severe cardiovascular disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog scale | From enrollment to the end of the first month | The VAS score was used to measure pain intensity in each patient. Patients were told to rate their pain on a 10-cm horizontal line for the VAS test. A score of 0 indicated no pain, a score of 5 indicated moderate pain, and a score of 10 indicated the worst pain. |
| Trigger points count | From enrollment to the end of the first month | Trigger points were identified in the trapezius, levator scapulae, supraspinatus, and infraspinatus muscles by the presence of a hypersensitive spot within a palpable taut band, accompanied by a visible or palpable LTR and/or reproduction of referred pain upon palpation of the sensitive point. |
| Multidimensional quality of life score | From enrollment to the end of the first month | The multidimensional quality of life scale includes a total of 35 items and assesses nine subdomains, each with four items. The overall score is obtained by summing the responses to all the items. Each item is given a score from 1 to 7, with a total score of 35 to 245. Higher scores indicate better functional status. |
| Likert satisfaction scale | From enrollment to the end of the first month | Patient satisfaction was assessed using a Likert scale, where participants were asked to rate their experience by selecting one of the following options: none, mild, moderately good, good, or very good. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual analog scale | From enrollment to the end of the third month | The VAS score was used to measure pain intensity in each patient. Patients were told to rate their pain on a 10-cm horizontal line for the VAS test. A score of 0 indicated no pain, a score of 5 indicated moderate pain, and a score of 10 indicated the worst pain. |
| Trigger points count | From enrollment to the end of the third month | Trigger points were identified in the trapezius, levator scapulae, supraspinatus, and infraspinatus muscles by the presence of a hypersensitive spot within a palpable taut band, accompanied by a visible or palpable LTR and/or reproduction of referred pain upon palpation of the sensitive point. |
| Multidimensional quality of life score | From enrollment to the end of the third month | The multidimensional quality of life scale includes a total of 35 items and assesses nine subdomains, each with four items. The overall score is obtained by summing the responses to all the items. Each item is given a score from 1 to 7, with a total score of 35 to 245. Higher scores indicate better functional status. |
| Likert satisfaction scale | From enrollment to the end of the third month | Patient satisfaction was assessed using a Likert scale, where participants were asked to rate their experience by selecting one of the following options: none, mild, moderately good, good, or very good. |
Countries
Turkey (Türkiye)
Contacts
STUDY_DIRECTORFatih Baygutalp, Medical doctor
Department of Physical Medicine and Rehabilitation, Ataturk University Faculty of Medicine
Outcome results
None listed