Musculoskeletal Diseases
Conditions
Interventions
Spinal manipulation and Ischaemic compression
Muscle energy technique
Sponsors
National Research Fund
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: • Participants must be between the ages of 20 and 50 years. With respect to age, individuals in their mature years (31-50) are more likely to suffer from MPS (Simons, Travell and Simons 1999). However, the condition does occur in younger individuals. These statistics would support the current age group limits set for this study. This will be applied during the telephonic screening. • Signed consent (available in English and isiZulu) for involvement in the study will be required for inclusion. • Non-specific neck pain (=12 weeks duration) of at least 4 and a maximum of 6 on an 11-point Numerical Pain Rating Scale 101 (NRS 101) (to maintain sample homogeneity) (Gemmell, Miller and Nordstrom 2008) with associated myofascial pain syndrome of the upper trapezius. • Participants diagnosed with active trigger points one and/or two in the trapezius muscle that shows the characteristics as outlined by Travell, Simons and Simons, (1999), including: ? Taut band of muscle fibers palpated by snapping or rolling the muscle under the finger. ? Tender nodule palpated within this taut band of muscle fibers. ? Local twitch response of the taut band fibers to snapping palpation. ? Pain reference to the reference zone specific to the muscle involved. This will be applied during the initial consultation.
Exclusion criteria
Exclusion criteria: Any participant for whom spinal manipulation is contraindicated as described by (Gatterman 1990) will be excluded from the study. These include: Vertebral artery insufficiency syndrome, History of positional vertigo, transient ischaemic attack, or severe arteriosclerosis, Uncontrolled hyper or hypotension , Severe cardiovascular disease and diabetes, Patients on medications such as anticoagulants that could predispose to vascular insult, Rheumatoid Arthritis or other arthritides, Vertebral malignancy, spondylolisthesis or recent traumatic injuries (whiplash), Presence of neurological symptoms such as chronic headaches, visual disturbances, drop attacks, transient weakness in the legs and family history of stroke, Participants can be excluded from the study even after case history, physical and regional examinations should contra-indications only then be found or noted. Participants who displayed any of the following contra-indications to myofascial manipulation therapy as recommended by Nook (1998): Vascular compromise; Use of anticoagulants and haemophiliacs; Severe diabetes with associated peripheral neuropathy; Sensory deficit; and Infection which can either be local or systemic. Participants who display any contra-indications of MET (including but not limited to): tissue fragility, hypermobility, myositis, tumours (Chaitow and Crenshaw 2006; Ferna´ndez-de-las-Pen~as, Cleland and Huijbregts 2011). Participants who are any oral non-steroidal anti-inflammatory drug would be required to participate in a three day wash out period prior to entering the study (Poul et al. 1993). Participants who exhibit signs of fibromyalgia syndrome (Schneider 1996). Participants refusing to sign the informed consent form (Appendix F). This will be applied prior to the initial consultation. Participants suffering from neck or shoulder pain caused by trigger points other those included in the study. This will be applied during the initial consultation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain rating according to the Numerical pain rating scale.;Pressure pain threshold via the Algometer measurements.;Cervical range of motion via the Goniometer instrument. | — |
Secondary
| Measure | Time frame |
|---|---|
| Neck disability via the CMCC Neck disability index | — |
Countries
South Africa
Contacts
Public ContactLavisha Deonarian
Lecturer
Outcome results
None listed