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

Guo, Yaorui; Lv, Xiuying; Zhou, Yu; Li, Zhijun; She, Huiping; Bai, Li; Bao, Jing

doi:10.1177/02692155221136108

Cited by 8 publications

(20 citation statements)

References 42 publications

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“…The findings of this study are consistent with previous research, [ 36 , 37 ] which also reported significant improvements in similar variables following similar interventions. The study conducted by Hashim et al (2020) revealed that both Post-Isometric Relaxation and Laser Therapy interventions demonstrated efficacy in decreasing pain pressure threshold and pain intensity among patients with muscle trigger point discomfort.…”

Section: Discussionsupporting

confidence: 92%

Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, ROM, and functional limitations associated with myofascial trigger points

Ghulam,

Alqhtani,

Alshahrani

et al. 2023

Medicine

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Background: Sedentary lifestyle, age-related degenerative changes or traumatic injuries leads to cervical spine structural mal-alignment, which results in neck pain and other symptoms. Various therapeutic exercises and manual techniques have been proven to be beneficial in terms of managing these symptoms. This study aimed to determine the combined effects of cervical mobilization and post-isometric relaxation (PIR) technique on managing neck pain, cervical side flexion range of motion, and functional limitation in participants with mechanical neck pain linked with myofascial trigger points. Methods: This study followed a 2-arm, parallel-group, pretest-posttest randomized comparative design. Thirty participants with mechanical neck pain associated with myofascial trigger points aged 30.87 ± 4.45 years were randomly allocated to Groups 1 and 2. Group 1 received conventional intervention, PIR, and cervical mobilization techniques while Group 2 received conventional intervention and PIR technique only. Neck pain, muscle tenderness, cervical range of motion, and functional limitations were assessed using a visual analog scale, pressure pain threshold (PPT), goniometer, and neck disability index (NDI) questionnaire, respectively at baseline on day 1 and post-intervention on day 7, 14, and 21. Wilcoxon signed-rank test and the Mann–Whitney U test evaluated within-group and between-group analyses, respectively. Statistical significance was established at a 95% confidence interval, indicated by P < .05. Results: Significant differences (95% confidence interval [CI], P < .05) were observed within each group for all the outcomes scores when compared to the baselines across multiple time points. Significant variations were observed between the groups when comparing visual analog scale and NDI scores at weeks 1, 2, and 3 post-interventions. In contrast, insignificant differences (95% CI, P > .05) were observed for side flexion range of motion and PPT compared at weeks 1, 2, and 3 post-interventions except for PPT at week 3 post-intervention (95% CI, P < .05). Additionally, Cohen d test revealed the superiority of group 1 over group 2 in reducing pain and functional limitations and improving cervical side flexion range of motion and PPT. Conclusion: The combination of cervical mobilization and Post-isometric relaxation techniques was discovered to effectively alleviate neck pain and enhance functional abilities when contrasted with the application of post-isometric relaxation alone in patients with mechanical neck pain linked with myofascial trigger points.

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Section: Discussionsupporting

confidence: 92%

Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, ROM, and functional limitations associated with myofascial trigger points

Ghulam,

Alqhtani,

Alshahrani

et al. 2023

Medicine

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“…In recent years, there have been increasing meta-analyses of the efectiveness of MFR intervention in various types of diseases, and the results from these meta-analyses are similar to our fndings [34][35][36][37][38]. Te studies indicate a positive role of myofascial release in alleviating symptoms related to low back pain [34,35], fbromyalgia [36], neck pain [37], and orthopedic conditions [38], such as pain relief, improvement in sleep quality, and disability levels. Headaches may have multiple triggering factors, such as medication overuse [11], alcohol [39,40], obstructive sleep apnea [41], and sleep disorders [42], but at the same time, myofascial mechanisms are likely closely linked to headaches.…”

Section: Discussionsupporting

confidence: 54%

“…In recent years, there have been increasing meta-analyses of the effectiveness of MFR intervention in various types of diseases, and the results from these meta-analyses are similar to our findings [ 34 – 38 ]. The studies indicate a positive role of myofascial release in alleviating symptoms related to low back pain [ 34 , 35 ], fibromyalgia [ 36 ], neck pain [ 37 ], and orthopedic conditions [ 38 ], such as pain relief, improvement in sleep quality, and disability levels.…”

Section: Discussionmentioning

confidence: 99%

Myofascial Release for the Treatment of Tension-Type, Cervicogenic Headache or Migraine: A Systematic Review and Meta-Analysis

Lu,

Zou,

Zhao

et al. 2024

Pain Research and Management

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Objective. To assess the effectiveness of myofascial release (MFR) techniques on the intensity of headache pain and associated disability in patients with tension-type headache (TTH), cervicogenic headache (CGH), or migraine. Design. A systematic review and meta-analysis. Methods. Eight databases were searched on September 15, 2023, including PubMed, Scopus, Web of Science, CINAHL, Cochrane Library, Embase, CNKI, and Wanfang Database. The risk of bias was evaluated utilizing the Cochrane Risk of Bias 2 (RoB 2) tool. Results. Pooled results showed that MFR intervention significantly reduces pain intensity [SMD = −2.01, 95% CI (−2.98, −1.03), I2 = 90%, P<0.001] and improves disability [SMD = −1.3, 95% CI (−1.82, −0.79), I2 = 74%, P<0.001]. Subgroup analysis based on the type of headache revealed significant reductions in pain intensity for CGH [SMD = −2.01, 95% CI (−2.73, −1.29), I2 = 63%, P<0.001], TTH [SMD = −0.86, 95% CI (−1.52, −0.20), I2 = 50%, P=0.01] and migraine [SMD = −6.52, 95% CI (−8.15, −4.89), P<0.001] and in disability for CGH [SMD = −1.45, 95% CI (−2.07, −0.83), I2 = 0%, P<0.001]; TTH [SMD = −0.98, 95% CI (−1.32, −0.65), I2 = 0%, P<0.001] but not migraine [SMD = −2.44, 95% CI (−6.04, 1.16), I2 = 97%, P=0.18]. Conclusion. The meta-analysis results indicate that MFR intervention can significantly alleviate pain and disability in TTH and CGH. For migraine, however, the results were inconsistent, and there was only moderate quality evidence of disability improvement for TTH and CGH. In contrast, the quality of other evidence was low or very low.

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“…We included 17 publications in this map covering 13 health conditions. 4 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 The literature flowchart ( Figure 1 ) summarizes results of the study selection process, and eAppendix 2 in Supplement 1 presents citations for all excluded reviews at full-text screening.…”

Section: Resultsmentioning

confidence: 99%

“…The total number of primary studies about massage therapy for pain in the included reviews ranged from 2 studies to 23 studies. There were 12 reviews that included fewer than 10 primary studies 4 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 20 , 21 , 22 , 23 and 5 reviews that included 10 to 25 studies about massage therapy for pain. 10 , 18 , 19 , 24 , 25 Of included reviews, 3 reviews were completed by the Cochrane Collaboration 4 , 19 , 23 and 2 reviews were completed by the AHRQ EPC program.…”

Section: Resultsmentioning

confidence: 99%

Use of Massage Therapy for Pain, 2018-2023

Mak,

Allen,

Begashaw

et al. 2024

JAMA Netw Open

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ImportanceMassage therapy is a popular treatment that has been advocated for dozens of painful adult health conditions and has a large evidence base.ObjectiveTo map systematic reviews, conclusions, and certainty or quality of evidence for outcomes of massage therapy for painful adult health conditions.Evidence ReviewIn this systematic review, a computerized search was conducted of PubMed, the Allied and Complementary Medicine Database, the Cumulated Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews, and Web of Science from 2018 to 2023. Included studies were systematic reviews of massage therapy for pain in adult health conditions that formally rated the certainty, quality, or strength of evidence for conclusions. Studies of sports massage therapy, osteopathy, dry cupping or dry needling, and internal massage therapy (eg, for pelvic floor pain) were ineligible, as were self-administered massage therapy techniques, such as foam rolling. Reviews were categorized as those with at least 1 conclusion rated as high-certainty evidence, at least 1 conclusion rated as moderate-certainty evidence, and all conclusions rated as low- or very low–certainty evidence; a full list of conclusions and certainty of evidence was collected.FindingsA total of 129 systematic reviews of massage therapy for painful adult health conditions were found; of these, 41 reviews used a formal method to rate certainty or quality of evidence of their conclusions and 17 reviews were mapped, covering 13 health conditions. Across these reviews, no conclusions were rated as high certainty of evidence. There were 7 conclusions that were rated as moderate-certainty evidence; all remaining conclusions were rated as low- or very low–certainty evidence. All conclusions rated as moderate certainty were that massage therapy had a beneficial associations with pain.Conclusions and RelevanceThis study found that despite a large number of randomized clinical trials, systematic reviews of massage therapy for painful adult health conditions rated a minority of conclusions as moderate-certainty evidence and that conclusions with moderate- or high-certainty evidence that massage therapy was superior to other active therapies were rare.

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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

Cited by 8 publications

References 42 publications

Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, ROM, and functional limitations associated with myofascial trigger points

Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, ROM, and functional limitations associated with myofascial trigger points

Myofascial Release for the Treatment of Tension-Type, Cervicogenic Headache or Migraine: A Systematic Review and Meta-Analysis

Use of Massage Therapy for Pain, 2018-2023

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