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Treating Trigger Points with Ultrasound

In this study, ultrasound (US) was used and compared in two different ways to treat one-sided neck pain in 72 patients. US is a form of heat energy generated in the muscles and soft tissues. It's applied through the skin with a special machine.

All patients in the study had shoulder and neck trigger points and pain on one side. Trigger points are irritable spots in the muscle that cause pain and spasm.

The control group had standard US over the area of pain. The applicator was moved in small circles over the area. Each treatment lasted five minutes. In the study group, high-power pain threshold (HPPT) US was used. In this method the US was turned up to the point patients could feel pain. Then it was turned down to half the intensity. This cycle was repeated three times. The probe was held motionless over the trigger point.

The authors report the results of these two methods using pain and neck range of motion as measures. Patients were followed for one month. US done with HPPT reduced pain much faster than standard US. Range of motion was equal in both groups after treatment.

The researchers suggest that HPPT may save money since fewer treatments are needed. This method is painful, but the pain intensity can be controlled by the physical therapist applying the US.

References: Javid Majlesi, MD, and Halil Ünalan, MD. High-Power Pain Threshold Ultrasound Technique in the Treatment of Active Myofascial Trigger Points: A Randomized, Double-Blind, Case-Control Study. In Archives of Physical Medicine and Rehabilitation. May 2004. Vol. 85. No. 5. Pp. 833-836.

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