A Combination of Therapies Relieve Neck Pain Best

Injured or overstressed muscles can lead to a condition called myofascial pain syndrome (MPS). Neck pain is often due to cervical MPS and is very common. This condition can limit daily activities and be accompanied by stiffness, frequent headaches, dizziness, nausea/vomiting, and insomnia. However, what works best to treat MPS has not always been clear. A random controlled trial published in 2002 evaluated various methods used by physical therapists to treat this condition, concluding that a combination of therapies was the most effective.

Diagnostic tools used to pinpoint the muscle knots within muscle spasm (myofascial trigger points or MTrPs) were meters that actually measured at what point pressure caused pain, how much pressure could be tolerated, and how mobile the involved area was. Types of treatment used included hot packs, active range of motion (exercises), applying direct pressure to the MTrP (ischemic compression), TENS units that apply electrical stimulation, stretching of the affected muscle followed by spraying a chemical coolant on the area ("stretch and spray"), interferential current that also uses electrical stimulation but in a different pattern, and myofascial release, which uses massage-type techniques to release all of the "spasmed" or adherent tissues surrounding the MTrPs.

Participants were divided into six different treatment groups with different combinations of therapies used in each of the groups. The authors of this study concluded that ischemic compression therapy provides immediate pain relief and suppression of the MTrP sensitivity. Results suggested that therapeutic combinations are most effective. The most effective combinations of treatment included hot pack plus active ROM plus stretch with spray, or those three modalities plus TENS, or hot pack plus active ROM plus interferential current plus myofascial release. They indicated that further study is required to determine long-term effect and cumulative effect of using these physical therapy treatment methods.

For further information, refer to: "Immediate Effects of Various Physical Therapeutic Modalities on Cervical Myofascial Pain and Trigger-Point Sensitivity," Hou, C PhD; Tsai, L MS; Cheng, K MS; Chung K PhD; Hong C MD, Archives of Physical Medicine and Rehabilitation, Volume 83, Issue 10, October 2002.