Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.
Albert F Moraska, Sarah J Schmiege, John D Mann and 2 others
PMID 28248690WHAT IT FOUND
In people with tension-type headache, a 45-minute massage protocol increased pain threshold at neck and shoulder trigger points after a single session and after multiple sessions.
Sham ultrasound and waiting did not change pain threshold.
Key findings
01In the massage group, pain threshold at suboccipital and upper trapezius trigger points increased after the first session and remained elevated before the final session.
02Pain threshold did not change in the sham ultrasound or wait-list groups, and the untreated tibia reference site did not change.
03The massage intervention included multiple techniques, so the result cannot be attributed to trigger point release alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Participants and therapists knew treatment group, and pressure-pain threshold is subjective, so expectations or assessor knowledge could influence results. The massage group received several techniques together, so trigger point release cannot be isolated as the cause. The results reported here are for pain threshold at trigger points, not headache frequency. Seven subjects were removed before randomization, five for headache screening failure and two for scheduling. Sternocleidomastoid trigger points were not assessed in all subjects because of reported sensitivity. No assessments between the first and final sessions were conducted, so the time course between sessions is not fully known. The study used an untreated tibia reference site rather than a healthy muscle comparison site. Massage therapists performed pressure-pain threshold assessments and may have been aware of group assignment after the initial assessment.
Declared interests
The study was supported by NIH/NCCAM Grant number R21 AT00469. No author disclosures are provided beyond the heading.
The easy way to misread this
Do not conclude that trigger point release alone caused the change. The massage group received myofascial release, trigger point release, post-isomeric relaxation, circular or cross-fiber friction on the masseter, temporalis, and occipitofrontalis muscles, gentle effleurage, and petrissage together, and the study did not separate their effects.