Myofascial Treatment for Microcirculation in Patients with Postural Neck and Shoulder Pain

Abstract

Vascular impairment is a crucial factor associated with chronic muscle pain, but relevant research from the microcirculatory aspect is lacking. Here, we investigated the differences in neck muscle microcirculation detected through laser-doppler flowmetry (LDF) and cervical biomechanics by a videofluoroscopic image in asymptomatic participants and patients with postural neck and shoulder pain. To understand the mechanism behind the effect of myofascial treatment, transverse friction massage (TFM) was applied and the immediate effects of muscular intervention on microcirculation were monitored. In total, 16 asymptomatic participants and 22 patients (mean age = 26.3 ± 2.4 and 25.4 ± 3.2 years, respectively) were recruited. Their neck muscle microcirculation and spinal image sequence were assessed. The differences in the baseline blood flow between the asymptomatic and patient groups were nonsignificant. However, the standard deviations in the measurements of the upper trapezius muscle in the patients were significantly larger (p < 0.05). Regarding the TFM-induced responses of skin microcirculation, the blood flow ratio was significantly higher in the patients than in the asymptomatic participants (p < 0.05). In conclusion, postintervention hyperemia determined through noninvasive LDF may be an indicator for the understanding of the mechanism underlying massage therapies and the design of interventions for postural pain.

Evaluation of Shoulder Microcirculation Abnormality Using Laser Doppler Flowmetry

“…The other limitation is no diagnostic result of the patient group regarding the anatomical location of the pain. According to our recent research [ 37 ], we also found that the variability of MMBF among the patients with higher Neck Disability Index and limited cervical range of motion was significantly high, even though the difference of MMBF between the asymptomatic subjects and the patients was nonsignificant. Therefore, future study of myofascial pain needs to combine biochemical tests, physical examinations, and blood flow measurements to provide physicians a better understanding of the pathogenesis and mechanism of neck/shoulder pain.…”

Modulation of Heart Rate Variability following PAP Ion Magnetic Induction Intervention in Subjects with Chronic Musculoskeletal Pain: A Pilot Randomized Controlled Study

“…A possible hypothesis that could explain such effect is related to the influence PEMFs have on the membrane potential of body cells [40,62,63]. In this regard, an impaired blood-flow regulation in the affected tissue in patients with chronic pain was reported [64,65]. This degradation in microcirculation is speculated to reduce the level of oxygen and alter natural membrane potential (approximately −73 mV), which is crucial for transport regulation and signal transmission in healthy cells [66,67].…”

Advances in Diagnosis and Pathophysiology of Microvascular Dysfunction

“…The microvascular dynamics assessed by LDF provides a novel way to diagnose the underlying mechanisms of microvascular dysfunction caused by the endothelial, neurogenic, and myogenic controls [8]. Bau et al [9] used this method to examine whether a vascular impairment is associated with chronic muscle pain and how an intervention (transverse friction massage) could improve the vascular impairment. Their results show that the differences in the baseline blood flow between the asymptomatic and patient groups were non-significant; however, the standard deviations in the measurements of the upper trapezius muscle in the patients were significantly larger.…”