Effectiveness of Manual Therapy on Pain, Range of Motion and Functional Performance among Patients with Myofascial Trigger Point Pain of Upper Trapezius Muscle: A Systematic Review

1. Consultant Physiotherapist, Department of Physiotherapy, Anodyne Spine Fit Life Clinic, Delhi, India. 2. Assistant Professor, Department of Physiotherapy, Graphic Era College of Paramedical Sciences, Graphic Era (Deemed to be University), Dehradun, Uttarakhand, India. 3. Assistant Professor, Department of Health Science, Uttaranchal University, Dehradun, Uttarakhand, India. 4. Associate Professor, Department of Galgotias Multi-Disciplinary Research and Development Cell (G-MRDC), Galgotias University, Greater Noida, Uttar Pradesh, India. 5. Professor, Depertment of School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India. 6. Associate Professor, Depertment of School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India. 7. Professor, Department of Galgotias Multi-Disciplinary Research and Development Cell (G-MRDC), Galgotias University, Greater Noida, Uttar Pradesh, India.

Abstract

Introduction: A prominent cause of pain that manifests in the Musculoskeletal System is Myo-fascial Trigger Points (MTrPs). MTrPs Points provide a clear basis for evaluation, often resulting in neck pain that can lead to occupational disability. In recent years, effective manual therapeutic strat-egies have been implemented to manage MTrPs. These strategies include myofascial release, positional release, muscle energy techniques, Ischaemic Compression (IC) therapy, transverse friction massage, man-ual pressure release, trigger point therapy, and exercise therapy.

Aim: The present review aimed to determine the effect of various Manual Therapy (MT) techniques on pain, Range Of Motion (ROM), and functional performance among patients with Myofascial trigger point pain of the upper trapezius muscle and extract promising techniques from evidence-based practice in man-aging them.

Materials and Methods: The present review has been registered under International Prospective Register of Systematic Reviews (PROSPERO) with a unique no. CRD42023427359. Databases of PubMed, Google Scholar, and Cochrane were searched. The search was conducted between March 2023 and October 2023. Meth-odological quality was assessed independently by two authors using the Physiotherapy Evidence Database (PEDro) scale. Four main outcome parameters were evaluated in the short and medium term: pain, pressure threshold, cervical ROM, and disability, including muscle stiffness.

Results: After fulfilling the inclusion and exclusion criteria, 15 articles were incorporated in the systematic review. Two independent authors verified and screened data and the third author dou-ble-checked and searched for additional articles. The findings reveal that MT influences the clinical presentation in patients with upper trapezius trigger points by reducing pain intensity and duration, while also accelerating cervical ROM and decreasing the incidence of neck disability, indicating a sig-nificant role of MT in enhancing the health-related quality of life for those with upper trapezius MTrPs.

Conclusion: The current study comes to the conclusion that giving patients with upper trapezius trigger points an efficient protocol based on MT therapy and exercise reduces the incidence of adhesion formation, improving neck pain and thereby, greatly enhancing the overall quality of life.

Disability, Massage, Movement, Posture, Spasm