Transdermal Iontophoresis Versus High Power Pain Threshold Ultrasound in Mechanical Neck Pain: a Randomized Controlled Trial

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2024 Oct 15

PMID 39407315

Authors

Nouran A Ibrahim

Hend A Hamdy

Rana Hesham Mohamed Elbanna

Dina M A Mohamed

Ebtesam A Ali

Affiliations

Soon will be listed here.

Abstract

Background: The investigation aimed to assess the impacts of magnesium sulphate (MgSO4) iontophoresis and high-power pain-threshold ultrasound (HPPT-US) on pain, range of motion (ROM), and functional activity in physical therapy students suffering from mechanical cervical pain.

Methods: Typically, 75 males aged 19 to 30 years suffering from mechanical neck pain were enrolled in this investigation. Participants were divided at random into three groups. Group A received iontophoresis plus conventional physical therapy program, Group B received HPPTUS along with conventional therapy, and Group C received conventional therapy only. The outcomes were pain evaluated by visual analog scale (VAS) and Digital Electronic Pressure Algometer, cervical range of motion measured by Myrin gravity reference goniometer, and Arabic Neck disability index (ANDI) evaluate neck function.

Results: The differences within and between groups were detected utilizing a mixed-design multivariate analysis of variance (MANOVA). The within- and between-group analysis of all outcome measures revealed that there were statistically significant differences at post-intervention between high-power ultrasound and conventional group at all variables and also between iontophoresis and conventional group, but there was no statistically significant variation between high-power ultrasound and iontophoresis.

Conclusion: MgSO4 iontophoresis and HPPT-US are effective in decreasing pain, improving neck function, and improving neck ROM in subjects with mechanical neck pain who have active myofascial trigger points (MTrPs) on the upper fibers of the trapezius with no superiority of one over the other.

Trail Registration: The study was registered in the Clinical Trials Registry (registration no: NCT05474898) 26/7/2022.

References

Borg-Stein J, Simons D . Focused review: myofascial pain. Arch Phys Med Rehabil. 2002; 83(3 Suppl 1):S40-7, S48-9. DOI: 10.1053/apmr.2002.32155. View

Antonaci F, Sand T, Lucas G . Pressure algometry in healthy subjects: inter-examiner variability. Scand J Rehabil Med. 1998; 30(1):3-8. DOI: 10.1080/003655098444255. View

Hanten W, Olson S, Butts N, Nowicki A . Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Phys Ther. 2000; 80(10):997-1003. View

Ibrahim N, Abdel Raoof N, Mosaad D, Abu El Kasem S . Effect of magnesium sulfate iontophoresis on myofascial trigger points in the upper fibres of the trapezius. J Taibah Univ Med Sci. 2021; 16(3):369-378. PMC: 8178646. DOI: 10.1016/j.jtumed.2020.12.015. View

Cagnie B, Castelein B, Pollie F, Steelant L, Verhoeyen H, Cools A . Evidence for the Use of Ischemic Compression and Dry Needling in the Management of Trigger Points of the Upper Trapezius in Patients with Neck Pain: A Systematic Review. Am J Phys Med Rehabil. 2015; 94(7):573-83. DOI: 10.1097/PHM.0000000000000266. View

Vazquez-Delgado E, Cascos-Romero J, Gay-Escoda C . Myofascial pain syndrome associated with trigger points: a literature review. (I): Epidemiology, clinical treatment and etiopathogeny. Med Oral Patol Oral Cir Bucal. 2009; 14(10):e494-8. DOI: 10.4317/medoral.14.e494. View

Vernon H, Mior S . The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991; 14(7):409-15. View

Hamdy H, Grase M, El-Hafez H, Abd-Elazim A . Instrument Assisted Soft Tissue Mobilization versus Integrated Neuromuscular Inhibition Technique in Nonspecific Chronic Neck Pain: Single-blinding Randomized Trial. J Chiropr Med. 2024; 22(4):247-256. PMC: 10774614. DOI: 10.1016/j.jcm.2023.07.004. View

Unalan H, Majlesi J, Aydin F, Palamar D . Comparison of high-power pain threshold ultrasound therapy with local injection in the treatment of active myofascial trigger points of the upper trapezius muscle. Arch Phys Med Rehabil. 2011; 92(4):657-62. DOI: 10.1016/j.apmr.2010.11.030. View

10.

Kavadar G, Caglar N, Ozen S, Tutun S, Demircioglu D . Efficacy of conventional ultrasound therapy on myofascial pain syndrome: a placebo controlled study. Agri. 2016; 27(4):190-6. DOI: 10.5505/agri.2015.48569. View

11.

Guo Y, Lv X, Zhou Y, Li Z, She H, Bai L . Myofascial release for the treatment of pain and dysfunction in patients with chronic mechanical neck pain: Systematic review and meta-analysis of randomised controlled trials. Clin Rehabil. 2022; 37(4):478-493. DOI: 10.1177/02692155221136108. View

12.

Pan H, Zhou Y, Izadnegahdar O, Cui J, Deng C . Study of sonoporation dynamics affected by ultrasound duty cycle. Ultrasound Med Biol. 2005; 31(6):849-56. DOI: 10.1016/j.ultrasmedbio.2005.03.014. View

13.

Fejer R, Hartvigsen J . Neck pain and disability due to neck pain: what is the relation?. Eur Spine J. 2007; 17(1):80-8. PMC: 2365525. DOI: 10.1007/s00586-007-0521-9. View

14.

Majlesi J, Unalan H . High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: a randomized, double-blind, case-control study. Arch Phys Med Rehabil. 2004; 85(5):833-6. DOI: 10.1016/j.apmr.2003.07.023. View

15.

Tsui P, Wang S, Huang C . In vitro effects of ultrasound with different energies on the conduction properties of neural tissue. Ultrasonics. 2005; 43(7):560-5. DOI: 10.1016/j.ultras.2004.12.003. View

16.

Hakkinen A, Salo P, Tarvainen U, Wiren K, Ylinen J . Effect of manual therapy and stretching on neck muscle strength and mobility in chronic neck pain. J Rehabil Med. 2007; 39(7):575-9. DOI: 10.2340/16501977-0094. View

17.

Koca I, Tutoglu A, Boyaci A, Ucar M, Yagiz E, Isik M . A comparison of the effectiveness of low-, moderate- and high-dose ultrasound therapy applied in the treatment of myofascial pain syndrome. Mod Rheumatol. 2013; 24(4):662-6. DOI: 10.3109/14397595.2013.860001. View

18.

Schulz K, Altman D, Moher D . CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 340:c332. PMC: 2844940. DOI: 10.1136/bmj.c332. View

19.

Graven-Nielsen T, Vaegter H, Finocchietti S, Handberg G, Arendt-Nielsen L . Assessment of musculoskeletal pain sensitivity and temporal summation by cuff pressure algometry: a reliability study. Pain. 2015; 156(11):2193-2202. DOI: 10.1097/j.pain.0000000000000294. View

20.

Munoz-Munoz S, Munoz-Garcia M, Alburquerque-Sendin F, Arroyo-Morales M, Fernandez-de-Las-Penas C . Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. J Manipulative Physiol Ther. 2012; 35(8):608-13. DOI: 10.1016/j.jmpt.2012.09.003. View