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Home Therapy Successful for Trigger Points

Myofascial trigger points (IPs) occur among patients with neck and upper back pain. Myofascial TPs can be effectively treated with a home program of ischemic pressure and stretching, according to a new study. Forty patients (17 men, 23 women, average age, 30.6 years) who had one or more TPs participated in the study. Patients with one or more active neck or upper back TP were included. Those selected for the study had to have a palpable tender spot in the upper back or neck, reproducible pain on palpation, and a "jump sign" (patient complaint or withdrawal). Excluded were those who had orthopedic back or neck surgery, had cardiovascular or neurologic conditions, or been treated for myofascial pain or TP at the time of the study. Subjects were randomly assigned into one of two groups. Group 1 received a 5-day home program of ischemic pressure twice a day followed by general sustained stretching of the neck and upper back muscles. These patients were taught how to use pressure to relieve pain by gradually increasing pressure on the trigger point. Group 2 (control) performed the same general stretching exercises but without ischemic pressure. A pressure algometer was used to assess the pressure/pain threshold, and ischemic pressure was ac-