Dr. Deena Hakim, D.C.
The Healing Collaborative 
                                  Chiropractor

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Pacific Grove CA 93950

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What's New In Chiropractic Research!
 

 

 

 

 

Myofascial Trigger Points and Myofascial Pain Syndrome

Chiropractic Research

Numerous studies have shown that chiropractic treatment is both safe and effective.  The following are excerpts from a few of the more recent studies.  By examining the research supporting chiropractic care, you will find that chiropractic offers tremendous potential in meeting today's health care challenges.

 

(From ACA News)

Chiropractic care involves various therapies and physiologic therapeutic modalities for treating myofascial pain syndrome and trigger points.

Vernon H, Schneider, M. Chiropractic management of myofascial trigger points and myofascial pain syndrome: A systematic review of the literature. J Manipulative Physiol Ther 2009 Jan;32(1):14-24.

BACKGROUND
Since the 1950s, healthcare providers treating musculoskeletal conditions have been using the terms “myofascial pain” and “trigger points” to identify chronic and often severe pain that is associated with certain tender spots in the muscle. Nowadays, many patients suffering from chronic pain are diagnosed with myofascial pain syndrome by pain management specialists and general practitioners. Chiropractic and other complementary and alternative therapies have been commonly used in treating trigger points and myofascial pain.

THE OBJECTIVE of this literature synthesis was to review procedures most commonly used by doctors of chiropractic for treating myofascial trigger points and myofascial pain syndrome.

THIS STUDY conducted a search of literature through the following major healthcare databases: PubMed, Excerpta Medica Database, the Cumulative Index to Nursing and Allied Health Literature, and databases of systematic reviews and clinical guidelines. The results of the search were screened and rated for relevance, yielding 112 articles that were analyzed in detail.

RESULTS
• Manipulation and ischemic pressure for immediate pain relief at trigger points is supported by moderately strong evidence. Long-term pain relief is supported by limited evidence.
• The use of laser therapy for treating myofascial trigger points and myofascial pain syndrome has strong support in the literature.
• Moderate evidence supports the use of electrical nerve stimulation, acupuncture and magnet therapy for treating myofascial trigger points and myofascial pain syndrome.
• The use of electrical muscle stimulation, high-voltage galvanic stimulation, interferential current and frequency-modulated neural stimulation for treating myofascial trigger points and myofascial pain syndrome is supported by limited evidence.
• The use of ultrasound therapy for treating myofascial trigger points and myofascial pain syndrome is supported by weak evidence.

CAVEATS
The duration of pain relief varies among therapies.

LEARN MORE ABOUT chiropractic at www.acatoday.org. For more information on chiropractic research, go to www.fcer.org and www.ccgpp.org.

The research described in this column comes from credible, peer-reviewed journals. It is intended to serve as a resource for practitioners and patients to assist them in consideration of various healthcare options and does not replace clinical judgment.

 

For Acute and Chronic Pain

"Patients with chronic low-back pain btreated by chiropractors showed greater improvement and satisfaction at one month thanpaitnets treated by family physicians.  Satisfactition scores were higher for chiropractic patients.  A higher proportion of chiropractic patients (56 percentvs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse."

-Nyiendo et al (2000).  Juournal of Manipulative and Physiological Therapeutics

In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general pratitioner care (counseling, education and drugs) in a 52-week study.  The clinical outcomes meausres showed that manual therapy resulted in a faster recovery than physiotherapy and general practitioner care.  Moreover, total costs of the manual therapy treated patients were about one-third of the costs of physiotherapy or gernal practioner care.

-Korthals-de Bos et al (2003), British Medical Journal

 

In Comparison to Other Treatment Alternatives

"Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction; clinically impratant differences in pain and disability improvement were found for chronic patients."

-Haas et al (2005), Journal of Manipulative and Physiological Therapeutics

"In our randomized, controlled trial, we compared the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner in patients with nonspecific neck pain.  The success rate at seven weeks was twice as high for the manual therapy group (68.3 percent)  as for the continued care group (general practitioner).  Manual therapy scored better than physical therapy on all outcome measures.  Patients receiving manual therapy had fewer absences from work than patients receiving physical therapy or continued care, and manual therapy and physcial therapy each resulted in statistically significant less analgesic use than continued care."

-Hoving et al (2002), Annals of Internal Medicine

 

For Headaches

"Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache."

-Duke Evidence Report, McCrory, Penzlen, Hasselblad, Gray (2001)

 

Cost Effectiveness

"Chiropractic care appeared relatively cost-effective for the treatment of chronic low-back pain.  Chriorpactic and medical care performed comparably for acute patients.  Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and in some cases better than other therapies."

-Haas et al (2005), Journal of Manipualtive and Physiological Therapeutics

 

Patient Satisfaction

"Chiropractic patients were found to be more satisfied with their back care providers after four weeks of treatment than were medical patients.  Results from observational studies suggested that back pain patients are more satisfied with chiropractic care than with medical care.  Additionally, studies conclude that patients are more satisfied with chiropractic care than they were with physical therapy after six weeks."

-Hertzman-Miller et al (2002), American Journal of Public Health

 

Popularity of Chiropractic

"Chiropractic is the largest, most regulated, and best recognized of the complementary and alternative medicine (CAM) professions, CAM patient surveys show that chiropractors are used more often than any other alternative provider group and patient satisfaction with chiropractic care is very high.  There is steadily increasing patient use of chiropractic in the United States, which has tripled in the past two decades."

-Meeker, Haldeman (2002), Annals of Internal Medicine