Restricted accessResearch articleFirst published online 2024-7
Effects of transcutaneous radiofrequency diathermy versus ultrasound on latent myofascial trigger points in the upper trapezius: A randomized crossover trial
Currently, the use of radiofrequency diathermy for the treatment of neck pain is booming.
OBJECTIVE:
This study aimed to evaluate the clinical efficacy of Digital Capacitive Diathermy (DCD®) on stiffness, pain, cervical range of motion, and cervical disability and to compare it with ultrasound (US) in patients with latent myofascial trigger point (MTrP) in the upper trapezius.
METHODS:
Nineteen participants with latent MTrPs in the upper trapezius were included in the assessor-masked, randomized, clinical crossover trial. Subjects were exposed to both interventions: US and DCD® and treatment effectiveness was measured by myotonometric variables, pressure pain threshold (PPT), visual analog scale (VAS), cervical side-bending flexion ranges, and the neck disability index scale (NDI).
RESULTS:
There were no significant differences between US and DCD® interventions regarding changes in outcome measures. The US group achieved a statistically significant difference of 2.16 to 1.13 points ( 0.005; 0.646) for the VAS. The DCD® intervention showed a statistically significant improvement of 1.11 points for the NDI at 1-week following intervention (95% CI 0.14–2.07; 0.27; 0.217).
CONCLUSION:
Our findings suggest that DCD® and US can both be considered effective modalities for the treatment of latent MTrPs, having a longer duration of action with DCD® therapy.
SimonsDG. Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction. J Electromyogr Kinesiol. 2004; 14: 95-107.
2.
LluchENijsJDe KooningM, et al. Prevalence, incidence, localization, and pathophysiology of myofascial trigger points in patients with spinal pain: a systematic literature review. J Manipulative Physiol Ther. 2015; 38: 587-600.
3.
Martín-SacristánLCalvo-LoboCPecos-MartínD, et al. Dry needling in active or latent trigger point in patients with neck pain: a randomized clinical trial. Sci Rep. 2022; 12: 3188.
4.
LiuLHuangQ-MLiuQ-G, et al. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2015; 96: 944-955.
5.
van der WindtDAWMvan der HeijdenGJMGvan den BergSGM, et al. Ultrasound therapy for musculoskeletal disorders: a systematic review. Pain. 1999; 81: 257-271.
6.
EbadiSAnsariNNNaghdiS, et al. The effect of continuous ultrasound on chronic non-specific low back pain: a single blind placebo-controlled randomized trial. BMC Musculoskelet Disord. 2012; 13: 192.
7.
AliHAElzohieryAKArafaMM, et al. Dry needling versus ultrasonic in treating cervical myofascial pain syndrome. QJM Int J Med. 2020; 113: hcaa064005.
8.
QingWShiXZhangQ, et al. Effect of Therapeutic Ultrasound for Neck Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2021; 102: 2219-2230.
9.
DraperDOMahaffeyCKaiserD, et al. Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles. Physiother Theory Pract. 2010; 26: 167-172.
10.
EbadiSHenschkeNNakhostin AnsariN, et al. Therapeutic ultrasound for chronic low-back pain. Cochrane Database Syst Rev. 2014; CD009169.
11.
BeltrameRRonconiGFerraraPE, et al. Capacitive and resistive electric transfer therapy in rehabilitation: a systematic review. Int J Rehabil Res Int Z Rehabil Rev Int Rech Readaptation. 2020; 43: 291-298.
12.
AdairERBlackDR. Thermoregulatory responses to RF energy absorption. Bioelectromagnetics. 2003; Suppl 6: S17-38.
13.
KumaranBWatsonT. Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part I: acute conditions. Phys Ther Rev. 2015; 20: 241-254.
14.
Carralero-MartínezAMuñoz PérezMAPané-AlemanyR, et al. Efficacy of capacitive resistive monopolar radiofrequency in the physiotherapeutic treatment of chronic pelvic pain syndrome: study protocol for a randomized controlled trial. Trials. 2021; 22: 356.
15.
KumaranBWatsonT. Thermal build-up, decay and retention responses to local therapeutic application of 448 kHz capacitive resistive monopolar radiofrequency: A prospective randomised crossover study in healthy adults. Int J Hyperth Off J Eur Soc Hyperthermic Oncol North Am Hyperth Group. 2015; 31: 883-895.
16.
RickardsLD. The effectiveness of non-invasive treatments for active myofascial trigger point pain: A systematic review of the literature. Int J Osteopath Med. 2006; 9: 120-136.
17.
KimYYangH-RLeeJ-W, et al. Effects of the high-power pain threshold ultrasound technique in the elderly with latent myofascial trigger points: a double-blind randomized study. J Back Musculoskelet Rehabil. 2014; 27: 17-23.
18.
Montañez-AguileraFJValtueña-GimenoNPecos-MartínD, et al. Changes in a patient with neck pain after application of ischemic compression as a trigger point therapy. J Back Musculoskelet Rehabil. 2010; 23: 101-104.
19.
RusuLCosmaGCalinaML, et al. Evaluation of two muscle training programs by assessment of the muscle tone. Sci Sports. 2015; 30: e65-e72.
20.
BaileyL. Parameters Representing Muscle Tone, Elasticity and Stiffness of Biceps Brachii in Healthy Older Males: Symmetry and Within-Session Reliability Using the MyotonPRO. J Neurol Disord; 01. Epub ahead of print 2013. doi: 10.4172/2329-6895.1000116.
21.
Jiménez-SánchezCOrtiz-LucasMBravo-EstebanE, et al. Myotonometry as a measure to detect myofascial trigger points: an inter-rater reliability study. Physiol Meas. 2018; 39: 115004.
22.
Abu TalebWRehan YoussefASalehA. The effectiveness of manual versus algometer pressure release techniques for treating active myofascial trigger points of the upper trapezius. J Bodyw Mov Ther. 2016; 20: 863-869.
23.
WaltonDMMacdermidJCNielsonW, et al. Reliability, standard error, and minimum detectable change of clinical pressure pain threshold testing in people with and without acute neck pain. J Orthop Sports Phys Ther. 2011; 41: 644-650.
24.
Cerezo-TéllezETorres-LacombaMFuentes-GallardoI, et al. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016; 157: 1905-1917.
25.
KovacsFMAbrairaVRoyuelaA, et al. Minimum detectable and minimal clinically important changes for pain in patients with nonspecific neck pain. BMC Musculoskelet Disord. 2008; 9: 43.
26.
YoungBAWalkerMJStrunceJB, et al. Responsiveness of the Neck Disability Index in patients with mechanical neck disorders. Spine J Off J North Am Spine Soc. 2009; 9: 802-808.
27.
Andrade OrtegaJADelgado MartínezADAlmécija RuizR. [Validation of a Spanish version of the Neck Disability Index]. Med Clin (Barc). 2008; 130: 85-89.
28.
FritzCOMorrisPERichlerJJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen. 2012; 141: 2-18.
29.
LeeJHDoJGParkHJ, et al. A Comparison of the Effect of a 44-MHz. Radiofrequency Deep Heating Therapy and Ultrasound on Low Back Pain: A Randomized, Double-Blind, Multicenter Trial. J Clin Med. 2022; 11: 5011.
30.
SrbelyJZDickeyJP. Randomized controlled study of the antinociceptive effect of ultrasound on trigger point sensitivity: novel applications in myofascial therapy? Clin Rehabil. 2007; 21: 411-417.
31.
BenjaboonyanupapDPaungmaliAPirunsanU. Effect of therapeutic sequence of hot pack and ultrasound on physiological response over trigger point of upper trapezius. Asian J Sports Med. 2015; 6: e23806.
32.
EbadiSHenschkeNForoghB, et al. Therapeutic ultrasound for chronic low back pain. Cochrane Database Syst Rev. 2020; 7: CD009169.
33.
DiegoIMAFernández-CarneroJValSL, et al. Analgesic effects of a capacitive-resistive monopolar radiofrequency in patients with myofascial chronic neck pain: a pilot randomized controlled trial. Rev Assoc Medica Bras 1992. 2019; 65: 156-164.
34.
SarrafzadehJAhmadiAYassinM. The effects of pressure release, phonophoresis of hydrocortisone, and ultrasound on upper trapezius latent myofascial trigger point. Arch Phys Med Rehabil. 2012; 93: 72-77.
35.
KisilewiczAJanusiakMSzafraniecR, et al. Changes in muscle stiffness of the trapezius muscle after application of ischemic compression into myofascial trigger points in professional basketball players. J Hum Kinet. 2018; 64: 35-45.
36.
Jiménez-SánchezCGómez-SorianoJBravo-EstebanE, et al. Effects of dry needling on biomechanical properties of the myofascial trigger points measured by myotonometry: a randomized controlled trial. J Manipulative Physiol Ther. 2021; 44: 467-474.
37.
KavadarGÇağlarNÖzenŞ, et al. Efficacy of conventional ultrasound therapy on myofascial pain syndrome: a placebo controlled study. Agri Agri Algoloji Derneginin Yayin Organidir J Turk Soc Algol. 2015; 27: 190-196.
38.
Fortún-RabadánRSierra-ArtalBJiménez-SánchezC. Effectiveness of intracavitary monopolar dielectric radiofrequency in women with endometriosis-associated pain: A case series. Complement Ther Clin Pract. 2022; 46: 101517.
39.
Albornoz-CabelloMIbáñez-VeraAJAguilar-FerrándizME, et al. Monopolar dielectric diathermy by emission of radiofrequency in Patellofemoral pain. A single-blind-randomized clinical trial. Electromagn Biol Med. 2020; 39: 282-289.
40.
Albornoz-CabelloMBarrios-QuintaCJEscobio-PrietoI, et al. Treatment of patellofemoral pain syndrome with dielectric radiofrequency diathermy: a preliminary single-group study with six-month follow-up. Med Kaunas Lith. 2021; 57: 429.
41.
KimG-WWonYHParkS-H, et al. Effects of a newly developed therapeutic deep heating device using high frequency in patients with shoulder pain and disability: a pilot study. Pain Res Manag. 2019; 2019: 8215371.
42.
TashiroYHasegawaSYokotaY, et al. Effect of capacitive and resistive electric transfer on haemoglobin saturation and tissue temperature. Int J Hyperth Off J Eur Soc Hyperthermic Oncol North Am Hyperth Group. 2017; 33: 696-702.
43.
DaleckiD. Mechanical bioeffects of ultrasound. Annu Rev Biomed Eng. 2004; 6: 229-248.
44.
UstunNArslanFMansurogluA, et al. Efficacy of EMLA cream phonophoresis comparison with ultrasound therapy on myofascial pain syndrome of the trapezius: a single-blind, randomized clinical study. Rheumatol Int. 2014; 34: 453-457.
