In a recent study, women with chronic neck pain experienced a significant decrease in subjective pain following four 30-second compressions of myofascial trigger points in their trapezius muscles.
The research found that applying pressure to these trigger points resulted in a significant increase in parasympathetic nervous system activity, a significant decrease in sympathetic nervous system activity and a corresponding significant decrease in prefrontal cortex hemodynamic activity.
The study, “Compression at myofascial trigger point on chronic neck pain provides pain relief through the prefrontal cortex and autonomic nervous system: a pilot study,” involved 21 women with chronic neck pain.
Potential participants were assessed by a clinical practitioner and included in the study if they had been experiencing neck pain for three or more months and presented with “a palpable band or hardened nodules in the upper trapezius muscle and myofascial pain emanating from a well-localized area in the palpable band.”
The subjects were randomly assigned to either a myofascial trigger point compression group or a non-myofascial trigger point compression group.
For the intervention, 30 seconds of ischemic compression was applied to either the myofascial or non-myofascial trigger points in the trapezius muscles four times in a row, with a two-minute break between each compression.
According to the study’s authors, the compression consisted of “constant deep pressure by the thumb” with an intensity halfway between each subject’s pressure pain threshold and maximally tolerable pain level.
The main outcome measures in this study were subjective pain; prefrontal hemodynamic activity, which was measured using near infrared spectroscopy; and autonomic nervous system activity, based on heart-rate variability and measured using electrocardiography.
Results of the research revealed a significant reduction in subjective pain among subjects in the myofascial trigger point compression group as compared to the non-myosfascial trigger point compression group.
The study also showed a significant decrease in prefrontal hemodynamic activity during the myofascial trigger point compressions as compared to the non-myofascial trigger point compressions.
In addition, there was a significant increase in the heart-rate variability parameters associated with parasympathetic activity and a significant decrease in the heart-rate variability parameters associated with sympathetic activity during the myofascial trigger point compressions as compared to the non-myofascial trigger point compressions.
“Along with previous studies indicating a role for sympathetic activity in the exacerbation of chronic pain, the present results suggest that [myofascial trigger point] compression in the neck region alters the activity of the autonomic nervous system via the prefrontal cortex to reduce subjective pain,” the study’s authors conclude.
Authors: Yoshiki Morikawa, Kouich Takamoto, Hiroshi Nishimaru, Toru Taguchi, Susumu Urakawa, Shigekazu Sakai, Taketoshi Ono and Hisao Nishijo.
Sources: System Emotional Science and Department of Judo Neurophysiotherapy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan. Originally published online in April 2017 in Frontiers in Neuroscience.
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