Combined Effects of Shock Wave Therapy and Muscle Energy Technique on Active Trigger Points of the Upper Trapezius Muscle

Objective: We investigated the combined effect of Radial Shockwave Therapy (RSWT) and muscle energy technique (MET) on pain, range of motion (ROM), and neck function in people with active trigger points (ATrPs) of the upper trapezius muscle. Materials & Methods: Fifty-four participants with ATrPs of the upper trapezius muscle were randomly divided into three groups. Group A (n=18) received only MET, group B (n=18) received only RSWT, and group C (n=18) received both RSWT and RSWT. Pain intensity using the Visual Analog Scale (VAS), pressure pain threshold (PPT), neck function using the Neck Disability Index (NDI) questionnaire, and lateral-flexion range of movement (LF ROM) were measured before and after the intervention. The participants were treated for three sessions in one week with at least two days of rest between sessions. Results: All three intervention groups showed pain reduction (p<0.001), an increase in PPT (p<0.001), counter-lateral flexion (CLF) (p<0.001), and also improvement in neck function (p<0.001). The combined group showed a more obvious improvement than the other two groups in PPT (p<0.001). There was no difference between the three groups in terms of VAS and NDI scores and CLF (p>0.05). Conclusion: The results of this study showed that all three interventions used in the upper trapezius trigger points therapy were effective; however, the combined group showed a significant difference in PPT. Therefore, combined therapy is superior to MET and RSWT alone in improving pressure pain relief in individuals with upper trapezius trigger points.