Abstract
PURPOSE: Myofascial pain syndrome is a condition which is indicated by the presence of myofascial trigger points in the muscle and in its fascia. It is a common cause of discomfort and disability worldwide. These myofascial trigger points may refer pain to various areas in the body. One such muscle is the glute medius muscle which refers pain into the lower back and which may easily be misdiagnosed as non-specific low back pain. Various soft tissue therapies and modalities have been used to treat myofascial trigger points in order to relieve local muscle tightness and the associated referred pain. The aim of this comparative study was to compare activator trigger point therapy with shockwave therapy in the treatment of glute medius trigger points. The findings were compared in terms of changes in the intensity and characteristics of the pain as well as pain pressure threshold measurements in order to highlight the treatment protocol which was the most effective in treating the glute medius trigger points. METHOD: Thirty male and female participants between the ages of 18 and 50 presenting with an active glute medius trigger point were randomly and equally divided into two groups. Each participant met both the inclusion and exclusion criteria for the study. The two groups each comprised of 15 participants. Group 1 received activator trigger point therapy while group 2 received shockwave therapy to the glute medius trigger point identified. PROCEDURE: Each participant who had met the criteria received six treatments over a three-week period with a seventh visit for the purpose of measurements only. Subjective and objective data was collected on visits 1, 4 and 7. The subjective data measurements included the numerical pain rating scale and the McGill pain questionnaire, while the objective data measurements were recorded by means of a pressure pain algometer. RESULTS: Statistical analyses was performed using non-parametric testing that included the Shapiro-Wilk test to test for normality. For the intra-group analysis, the Friedman and Wilcoxon signed rank test was conducted in order to check statistically significant changes between the two time periods while, for the inter-group analysis, the Mann-Whitney tests was performed in order to check statistically significant changes between the two groups. vi The analyses conducted showed that the numerical pain rating scale and the McGill Pain Questionnaire data produced statistically and clinically significant results for both groups. The pressure algometer data showed statistically and/or clinically significant results in terms of decreasing the pain pressure threshold. The intergroup analysis of both groups showed no statistically significant results in respect of either the subjective or the objective data collection. CONCLUSION: The statistical findings showed neither one of the two treatment protocols used in this study to treat glute medius trigger points were superior to the other protocol. The intragroup and intergroup analyses both showed that neither of the treatments administered to either group 1 or group 2 were more effective than the other. It was, therefore, concluded that both treatment protocols may be used to effectively treat both glute medius trigger points and the associated non-specific low back pain.
M.Tech. (Chiropractic)