Immediate effects of three different upper trapezius trigger point techniques on pain intensity and pressure threshold in students with cervical pain: a randomized clinical trial

Abstract

Objective: To compare the effectiveness of three manual therapy protocols (Jones, Lewit, and Chaitow) with a sham group in terms of pain pressure threshold and intensity. Participants: Fifty-two physiotherapy bachelor students with neck pain lasting more than 3 days were recruited. Outcomes: Pain was assessed with Numerical Rating Scale and Pressure Algometer, while cervical range of motion was evaluated with the Baiobit Inertial sensor. Intervention: An investigator, independent of the assessment and randomization, conducted all the interventions and sham procedures. Specifically, the Jones group received pincer palpation with a 1-min duration of ischemic compression, followed by 90 s of the no-pain Strain-Counterstrain technique. The Lewit group underwent flat palpation for 1 min, accompanied by 40 s of intermittent compression and post-isometric relaxation. The Chaitow group received deep palpation for 1 min, followed by the pressure release position lasting 20 s to 1 min, concluding with the muscle energy technique. The Sham group received only flat palpation and a 3-min homolateral muscle shortening position. Results: Effects for all three techniques (Chaitow/Lewit/Jones) when comparing them to sham were not significant on pain intensity . No adverse events or undesirable effects were observed during the study. Conclusion: Immediate effects on pain intensity and pressure threshold are not directly attributable to any of the three tested trigger techniques.