Comparison the efficacy of phonophoresis and ultrasound therapy in myofascial pain syndrome

Abstract

The aim of this study is to compare the effect of phonophoresis, ultrasound and placebo ultrasound therapies in the treatment of myofascial pain syndrome (MPS). This is a randomized, double-blind placebo controlled study. Sixty patients (48 women, 12 men, mean age 37.9 ± 12.2 years) with MPS were included in this study. Patients were allocated into three groups. Group 1(n = 20) was received diclofenac phonophoresis, group 2(n = 20) was received ultrasound and group 3(n = 20) was received placebo ultrasound therapies over trigger points, 10 min a day for 15 session during 3 weeks (1 MHz-1,5 watt/cm²). Additionally, all patients were given neck exercise program including isotonic, isometric and stretching. Patients were assessed by means of pain, range of motion (ROM) of neck, number of trigger points (NTP), algometric measurement and disability. Pain severity was measured by visual analog scale (VAS) and Likert scale. The neck pain disability index (NPDI) was used for assessing disability. Measurements were taken before and after treatment. After treatment, there were statistically significant improvements in pain severity, NTP, pressure pain threshold (PPT), ROM and NPDI scores both in phonophoresis and in ultrasound therapy groups (P < 0.05). Statistically significant increase in cervical lateral flexion and rotation was observed in the placebo US group. While there was no statistically significant improvement in the cervical flexion-extension joint movement, pain levels, number of trigger points and NPDI score, pressure pain threshold (P > 0.05), also there were no significant differences in all parameters between group 1 and 2 (P = 0.05). Both diclofenac phonophoresis and ultrasound therapy were effective in the treatment of patients with MPS. Phonophoresis was not found to be superior over ultrasound therapy.

Myofascial Pain Syndrome: A Treatment Review

“…Another RCT evaluating MTrP of the infraspinatus demonstrated a statistically significant increase in pain pressure threshold ( P  < 0.002) [64]. Another RCT compared ultrasound to diclofenac phonophoresis and placebo, which demonstrated a statically significant improvement in pain, ROM, number of trigger points, and neck pain disability index amongst the two former modalities ( P  < 0.05) [65]. There was no significant difference between the two treatment groups in those outcome measurements [65].…”

“…Another RCT compared ultrasound to diclofenac phonophoresis and placebo, which demonstrated a statically significant improvement in pain, ROM, number of trigger points, and neck pain disability index amongst the two former modalities ( P  < 0.05) [65]. There was no significant difference between the two treatment groups in those outcome measurements [65]. A similar study undertaken in 2012 examined the use of pressure release, hydrocortisone phonophoresis, ultrasound therapy, and placebo for the treatment of upper trapezius MTrPs.…”

Evaluating the Effectiveness of Phonophoresis by Piroxicam and Dimethyl Sulfoxide for Women’s With Osteoarthritis Knee Joint

“…questionable concepts such as the preparation of ibuprofen cream, duration of treatment per session, and recruitment of participants with a severe grading of OA (Kellgren-Lawrence Grade IV), which inspired to generate the hypothesis of this study [14][15][16][17][18]. Identifying the superiority of the phonophoresis technique to conventional US in OA was conducted using the piroxicam gel, 10 min of treatment per session and mild to moderate degree of knee OA.…”

Síndrome de dolor miofascial cervical: revisión narrativa del tratamiento fisioterápico

“…La técnica de US fue la que obtuvo menor mejoría y la sonoforesis resultó ser la más eficaz. Sin embargo, en otro estudio de Ay y col 60 con una muestra de 60 sujetos con SDM en los que comparó la sonoforesis con diclofenaco y el US convencional, se obtuvieron resultados similares en el rango de movilidad cervical y disminución álgica en ambas téc-nicas. Recientemente, un estudio de Koca y col 61 analizó en 61 pacientes con SDM la aplicación de distintas intensidades de US, demostrando que la aplicación de dosis altas puede ser considerada como método de terapia alternativa más económico y eficaz.…”