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.