EFFECTS OF ELECTROTHERAPY VS MYOFASCIAL RELEASE ON TRIGGER POINT.

1. EFFECTS OF
ELECTROTHERAPY
V/S
MYOFASCIAL
RELEASE
ON TRIGGER POINT
PRESENTED TO: DR SABA RIZWAN

2. 2
MARIA & HADISA
HOOR & RAMEEN
SAMEER
OUR TEAM

3. TABLE OF CONTENTS
3
04 07
08
05
06
Methodology
Result / Findings References
Conclusion
Discussion
01
02
03
Introduction
Rationale
Significance

4. What Are Trigger Points and What
Causes Them?
 A myofascial trigger point is an irritable spot within a
taught band of skeletal muscle, ligament or fascia (thin
connective tissue that surrounds muscles and organs).
 Trigger points often exhibit referred pain. This is pain that
is felt in a separate area from the site that is believed to
cause the pain.
 For example, a trigger point in your shoulder might refer
pain down into the rest of your arm.
4
INTRODUCTION

5. 5
What’s the difference between an active and latent trigger point?
Research has identified two different types of
trigger points:
1. ACTIVE
2. LATENT
 Active trigger points produce pain constantly or
during movement and can reduce the flexibility
of muscles.
 latent trigger points are only painful when
they’re compressed.

6. 6
What causes trigger points?
There are a few theories about what causes
trigger points:
 One theory suggests that active trigger points
develop through…
1. Overuse of the affected tissue.
2. Putting more athletic populations at risk.
&
 Latent trigger points
• Are suggested to develop in underused tissue,
making them more likely to occur in people who
are sedentary.

7. 7
MYO = Muscle
Fascia = a band or sheet of connective
tissue
Release = the relaxation and / or
stretching of tight structures
What is Myofascial Release ?

8. 8
What is Myofascial Release ?
 Myofascial Release is a specialised physical and
manual therapy used for the effective treatment and
rehabilitation of soft tissue and fascial tension and
restrictions.
 Safe and effective hands-on technique that works on
the fascia to release restrictions.
 Applied with prolonged pressure to restricted tissue.
 Aims to release tension and stretch out restricted
parts of the fascia .

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MECHANISM

10. 10
Electrotherapy a powerful tool used by
many physiotherapists, electrotherapy
treats chronic pain, musculoskeletal
injuries, muscle wasting, and nerve pain
by using targeted and controlled
electrical stimulation.
Electrotherapy

11. 11
MECHANISM

12. MYOFASCIAL
RELEASE
V/S ELECTROTHERAPY
12
Rationale EFFECTIVENESS
ON TRIGGER
POINT

13. • Myofascial Release can decrease
Pain : Endorphin release / increased
temperature / pain gate theory
• Myofascial Release promotes
healing Increased blood flow and
cell nutrition.
• Myofascial release can reduce
tension Stretching / elongation of
fascia / Increased heat in tissues.
vs
• Electrotherapy includes a range of
treatments using electricity to…
• reduce pain,
• improve circulation,
• repair tissues,
• strengthen muscles,
• And promote bone growth,
leading to improvements in
physical functioning.
13
SIGNIFICANCE
This study will give awareness to physiotherapy community on the
effectiveness of myofascial release vs electrotherapy on trigger points.

14. Research Design
14
Methodology
 The purpose of research design is to know about the
effectiveness of electrotherapy v/s myofascial release on
trigger point. Research design for this research was
quantitative. A 5-member group work on this study. Each
one must read at least 5 research article on their
respective topics, whole group total (25) articles to find
out which one is more effective.

15. Some studies showed that TENS was found to be one of the best
effective electro-modality in reducing pain among all
electrotherapies.
Some studies reported a significant effect of high power ultrasound
along with some analgesics to be effective in reducing pain.
15
 CROSS SECTIONAL STUDIES HAVE DONE FROM WHICH FOLLOWING
FINDINGS THROUGH SYSTEMATIC REVIEW CAME WHICH ARE AS FOLLOWS.
Result / Findings
An adequate amount of higher quality studies proposed that MFR is
one of the best therapy used to treat or resolve trigger points.
Hence, follow results would came if long term follow-up was
done under the supervision of physiotherapist.

16. 16
Result / Findings
There is significant evidence for the short-term effectiveness of laser therapy on pain
intensity and the immediate benefits of TENS. There are insufficient data to determine
the long-term effectiveness of TENS. The evidence for the effectiveness of frequency
modulated electrical muscle stimulation, electrical muscle stimulation, high voltage
galvanic stimulation and interferential current is limited. Preliminary evidence
indicates that magnet therapy may be effective. Ultrasound is no more effective than
placebo. The evidence for physical and manual therapies is high level.

17. 17
“
“
Guys what about
both on trigger
points..?
SAMEER
HOOR & RAMEEN
HADISA & MARIA
DISCUSSION
Myofascial release is
best on trigger
points?
No!!!
Electrotherapy is the
paracetamol in
physiotherapy.

18. DISCUSSION
• Myofascial trigger points (MTrps) are present in most of the musculoskeletal
conditions due to sustained activity in incorrect posture . This study is
intended to compare the effectiveness of ELECTROTHERAPY V/S
MYOFASCIAL RELEASE in MTrps in different muscles.
• Hong CZ (2002) said that the pathogenesis of myofascial trigger points
appears to be related to the integration in the spinal cord in response to the
disturbance of the nerve endings and abnormal contractile mechanism at
multiple dysfunctional endplates. Methods usually applied to treat
myofascial trigger point include stretch, massage, thermotherapy,
electrotherapy, laser therapy, Myofascial trigger point injection, dry needling,
and acupuncture.
• Aguilera MJ et al., (2009) did a study to determine immediate effect of
ischemic compression and ultrasound on MTrps of upper trapezius muscle.
This study was a randomized control trial in which 66 volunteers diagnosed
with latent MTrps of upper trapezius muscle participated. The study
concluded that both treatments were shown to have immediate effect of
pain reduction on latent MTrps.

19. DISCUSSION
• Rickards LD (2006) in a systemic review of 23 randomized control trials on
effectiveness of non- invasive treatment for myofascial trigger point,
concluded that there is significant evidence for short term effectiveness of
laser therapy on pain intensity and immediate benefits of Transcutaneous
Electrical Nerve Stimulation (TENS). But the evidence for effectiveness of
frequency modulated electrical muscle stimulation, high voltage galvanic
stimulation and interferential current is limited. Evidence for physical and
manual therapies is high.
• Rachlin ES (1994) suggested that the most effective technique for electrical
stimulation of myofascial trigger points is to increase the electrical stimulus
to the point of gentle muscular contraction in cyclic mode which is a
passive form of contract relax and recommended duration is 10- 15 minutes
of intermittent current which can be surged type of current.
• Hou et al., (2002) investigated the immediate effects of manual pressure
release on pain reduction, MTrp sensitivity and improvement in cervical
range of motion in 48 women with upper trapezius MTrps. They concluded
that significant change was seen in groups using low pressure for 90 sec,
and high pressure for 30 sec and 60 sec.

20. DISCUSSION
SUMMARY
• The obtained results remain in line with those of a study by Mukkannavar
[15] compared between combination therapy (transcutaneous electric nerve
stimulation and US) and ischemic compression in the treatment of active
myofascial trigger points and showed that combination therapy resolved
acute active trigger points pain and increased ROM more rapidly than the
ischemic compression treatment technique.
• Also, the results of this study agree with those obtained by Namvar et al. [16],
who concluded that myofascial release was one of the effective manual
therapy techniques in reducing pain and disability, as well as improving the
isometric extension strength of neck in patients with non-specific chronic
neck pain.
• In summary, the study demonstrated that a comparison between
multimodal approach of electrotherapy and myofascial release for their
effect on pain, CROM, and functional restriction in the treatment of patients
with chronic mechanical neck pain revealed no significant differences
between them & When treatment efficacy were taken into consideration
for significance, there was no significant difference between both the
groups.

21. This study can be concluded by stating that
both groups have got beneficial effect in
reducing the pain intensity and increasing
the range of motion in patients with
myofascial trigger point in muscles. When
treatment efficacy were taken into
consideration for significance, there was no
significant difference between both the
groups.
21
CONCLUSIONS

22.  Kshama. S. Shetty, A. Joseph Oliver Raj (2015). Effect of Surged Faradic Current on Myofascial Trigger Point of Upper
Trapezius Muscle as compared with Manual Pressure Release. International Journal of Science and Research. 2319-
7064 https://www.ijsr.net/archive/v6i3/ART20172020.pdf
 Rickards LD (2006). The effectiveness of non-invasive treatments for active myofascial trigger point pain. A systematic
review of the literature. Database of Abstracts of Reviews of Effects (DARE):
https://www.ncbi.nlm.nih.gov/books/NBK72610/
 Jibi Paul, Selvabharathi. C. Effect of Myofascial Release and Trigger Point Release among Osteoarthritis Knee Patients.
Research J. Pharm. and Tech. 2019. https://rjptonline.org/HTMLPaper.aspx
 Mohammed H. El-Gendy, Yasser R. Lasheen, Wafaa K.S. Rezkalla(2019). Multimodal approach of electrotherapy versus
myofascial release in patients with chronic mechanical neck pain: a randomized controlled trial. Physiotherapy
Quarterly. https://www.researchgate.net/publication/337760966.
 Zeng.C, H. Li, T .Zeng (2015). Electrical stimulation for pain relief in knee osteoarthritis: systematic review and network
meta-analysis. Osteoarthritis and Cartilages Volume 92. Science Direct Journal and Books.
https://www.sciencedirect.com/science/article/pii/S1063458414013375
 Carol Grace T. Vance, Barbara A. Rakel, Nicole P. Blodgett, Josimari Melo DeSantana, Annunziato Amendola, Miriam
Bridget Zimmerman, Deirdre M. Walsh, Kathleen A. Sluka, Effects of Transcutaneous Electrical Nerve Stimulation on
Pain, Pain Sensitivity, and Function in People With Knee Osteoarthritis: A Randomized Controlled Trial, Physical
Therapy, Volume 92, Issue 7, 1 July 2012, Pages 898–910, https://doi.org/10.2522/ptj.20110183
 P. Gurudut, A. Welling, G. Kudchadkar (2019). Combined Effect of Gross and Focused Myofascial Release Technique on
Trigger Points and Mobility in Subjects with Frozen Shoulder. International Journal of Health Sciences & Research.
2249-9571. https://www.ijhsr.org/IJHSR_Vol.9_Issue.4_April2019/10.pdf
 Ge, hy., fernández-de-las-peñas, c. & yue, sw. Myofascial trigger points: spontaneous electrical activity and its
consequences for pain induction and propagation. Chin med 6, 13(2011). Https://doi.org/10.1186/1749-8546-6-13.
 Sara ahmed, md, christopher haddad, msc, shoba subramaniam, mph, shereen khattab, msc, dinesh kumbhare, md,
msc, frcpc, faapmr, the effect of electric stimulation techniques on pain and tenderness at the myofascial trigger point:
a systematic review, pain medicine volume 20, issue 9, september 2019, pages 1774–1788,
https://doi.org/10.1093/pm/pny278
 Donelly J (2018) Myofacial pain and dysfunction. Wolters Kluwer Health 654-800.
https://books.google.com.pk/books/download/Travell_Simons_Simons_Myofascial_Pain_an.bibtex?id=qYxjDwAAQBAJ
&output=bibtex
 Micheal. H (2013) Myofacial release for trigger points using shockwave. Medical Wave 1- 25
https://medicalwaveus.com/2021/09/22/
 Blennerhasset DG (2021) Trigger point release explanation. Dr Greame Health Products 1-20
https://www.drgraeme.com/articles/author/dr-graeme-blennerhassett
 Alvarez DJ, Rockwell PG (2002) Trigger points: diagnosis and management. Am Fam Physician 65: 653-660
http://www.ncbi.nlm.nih.gov/pubmed/11871683
 Majlesi J, Unalan H (2010) Effect of treatment on trigger points. Curr Pain Headache Rep 14: 353-360.
http://www.ncbi.nlm.nih.gov/pubmed/20652653
 Han SC, Harrison P (1997) Myofascial pain syndrome and trigger-point management. Reg Anesth 22: 89-101.
http://www.ncbi.nlm.nih.gov/pubmed/9010953
 Han SC, Harrison P (1997) Myofascial pain syndrome and trigger-point management. Reg Anesth 22: 89-101.
http://www.ncbi.nlm.nih.gov/pubmed/9010953
 Arne N Gam, Susan Warming, Lone Hørdum Larsen, Bente Jensen, Ola Høydalsmo, Ingelise Allon, Bente Andersen, Niels
E Gøtzsche, Marelis Petersen, Birgitte Mathiesen,
 Treatment of myofascial trigger-points with ultrasound combined with massage and exercise – a randomised controlled
trial,Pain. Volume 77, Issue 1,1998,Pages 73-79, https://www.scimedjournal.org/index.php/SMJ/article/view/336/pdf
 David O Draper, Chad Mahaffey, David Kaiser, Dennis Eggett, Jake Jarmin. (2010) Thermal ultrasound decreases tissue
stiffness of trigger points in upper trapezius muscles. Physiotherapy Theory and Practice 26:3, pages 167-172.
https://doi.org/10.1300/J094v01n02_04.
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REFERENCES

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● ANY QUESTION ?