Research Article

Application of Combined Laser and Compression Therapy on the Pain and Level of Disability on Trigger Points in Upper Trapezius Muscle


Introduction: Musculoskeletal disorders are among the main causes of disability in modern life. Myofascial trigger points are very common among musculoskeletal disorders and may occur through ordinary common activities. This study aimed to determine the combined effects of laser therapy and Ischemic Compression (IC) on the treatment of Myofascial Trigger Points (MTrPs) at the upper trapezius muscle.
Materials and Methods: Twenty men with at least one active trigger point at their upper trapezius muscle voluntarily participated in this study. Trigger points were under treatment of laser irradiation (6 Joules per point) and also ischemic compression. Treatment approaches were applied over the pain point every other day for 5 sessions in 10 days. Neck disability index, pain intensity by visual analog scale, pressure pain threshold by algometry, and cervical lateral flexion by goniometer were assessed and recorded before the intervention, and immediately after the last session.
Results: At the end of treatment, statistically significant improvements were seen in the neck disability index, VAS value, pressure pain threshold, and cervical lateral flexion. VAS values of the treatment and control groups were compared with the baseline (P<0.001).
Conclusion: Application of combined laser and compression therapy was effective on the pain and level of disability of patients with trigger points in the upper trapezius muscle.

1. Mense S, Simons DG, Jon Russell I. Muscle pain: Understanding its nature, diagnosis, and treatment. Philadelphia: Lippincott Williams & Wilkins; 2001.
2. Chao YW, Lin JJ, Yang JL, Wang WTJ. Kinesio taping and manual pressure release: Short-term effects in subjects with myofasical trigger point. Journal of Hand Therapy. 2016; 29(1):23-9. [DOI:10.1016/j.jht.2015.10.003] [PMID]
3. Simons DG, Travell JG, Simons LS. Travell & Simons’ myofascial pain and dysfunction: Upper half of body. Phila-delphia: Lippincott Williams & Wilkins; 1999.
4. Evan Rivers W, Garrigues D, Graciosa J, Norman Harden R. Signs and symptoms of myofascial pain: An interna-tional survey of pain management providers and proposed preliminary set of diagnostic criteria. Pain Medicine. 2015; 16(9):1794-805. [DOI:10.1111/pme.12780] [PMID]
5. Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Practice & Research Clinical Rheumatology. 2011; 25(2):185-98. [DOI:10.1016/j.berh.2011.01.002] [PMID]
6. Sciotti VM, Mittak VL, DiMarco L, Ford LM, Plezbert J, Santipadri E, et al. Clinical precision of myofascial trigger point location in the trapezius muscle. Pain. 2001; 93(3):259-66. [DOI:10.1016/S0304-3959(01)00325-6]
7. Dommerholt J, de las Penas CF, editors. Trigger point dry needling: An evidence and clinical-based approach. Edin-burgh: Elsevier; 2013.
8. Rickards LD. The effectiveness of non-invasive treatments for active myofascial trigger point pain: A systematic re-view of the literature. International Journal of Osteopathic Medicine. 2006; 9(4):120-36. [DOI:10.1016/j.ijosm.2006.07.007]
9. Beckerman H, de Bie RA, Bouter LM, De Cuyper HJ, Oostendorp RAB. The efficacy of laser therapy for musculo-skeletal and skin disorders: A criteria-based meta-analysis of randomized clinical trials. Physical Therapy. 1992; 72(7):483-91. [DOI:10.1093/ptj/72.7.483] [PMID]
10. Cardoso LM, Campos Kraychete D, Correia de Araújo RP. Effectiveness of laser therapy in the treatment of myofas-cial pain. American International Journal of Contemporary Research. 2016; 6(4):46-52. []
11. Simons DG. Understanding effective treatments of myofascial trigger points. Journal of Bodywork and Movement Therapies. 2002; 6(2):81-8. [DOI:10.1054/jbmt.2002.0271]
12. Gemmell H, Miller P, Nordstrom H. Immediate effect of ischaemic compression and trigger point pressure release on neck pain and upper trapezius trigger points: A randomised controlled trial. Clinical Chiropractic. 2008; 11(1):30-6. [DOI:10.1016/j.clch.2007.09.001]
13. Király M, Bender T, Hodosi K. Comparative study of shockwave therapy and low-level laser therapy effects in pa-tients with myofascial pain syndrome of the trapezius. Rheumatology International. 2018; 38(11):2045-52. [DOI:10.1007/s00296-018-4134-x] [PMID]
14. Tabatabaiee A, Ebrahimi-Takamjani I, Ahmadi A, Sarrafzadeh J, Emrani A. Comparison of pressure release, pho-nophoresis and dry needling in treatment of latent myofascial trigger point of upper trapezius muscle. Journal of Back and Musculoskeletal Rehabilitation. 2019; 32(4):587-94. [DOI:10.3233/BMR-181302] [PMID]
15. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain. 1987; 30(1):115-26. [DOI:10.1016/0304-3959(87)90089-3]
16. Ylinen J, Nykänen M, Kautiainen H, Häkkinen A. Evaluation of repeatability of pressure algometry on the neck mus-cles for clinical use. Manual Therapy. 2007; 12(2):192-7. [DOI:10.1016/j.math.2006.06.010] [PMID]
17. Fryer G, Hodgson L. The effect of manual pressure release on myofascial trigger points in the upper trapezius mus-cle. Journal of Bodywork and Movement Therapies. 2005; 9(4):248-55. [DOI:10.1016/j.jbmt.2005.02.002]
18. Reese NB, Bandy WD. Joint range of motion and muscle length testing. Amsterdam: Elsevier Health Sciences; 2016.
19. Rezaei S, Shadmehr A, Bashardoust Tajali S, Attarbashi Moghadam B, Jalaei S. The effect of laser therapy and is-chemic compression on active trigger points in upper trapezius muscle. Journal of Modern Rehabilitation. 2019; 13(4):221-6. [DOI:10.32598/JMR.13.4.221]
20. Kannan P. Management of myofascial pain of upper trapezius: A three group comparison study. Global Journal of Health Science. 2012; 4(5):46-52. [DOI:10.5539/gjhs.v4n5p46] [PMID] [PMCID]
21. Hakgüder A, Birtane M, Gürcan S, Kokino S, Nesrin Turan F. Efficacy of low level laser therapy in myofascial pain syndrome: An algometric and thermographic evaluation. Lasers in Surgery and Medicine. 2003; 33(5):339-43. [DOI:10.1002/lsm.10241] [PMID]
22. Gemmell H, Allen A. Relative immediate effect of ischaemic compression and activator trigger point therapy on ac-tive upper trapezius trigger points: A randomised trial. Clinical Chiropractic. 2008; 11(4):175-81. [DOI:10.1016/j.clch.2009.01.007]
23. Hanten WP, Olson SL, Butts NL, Nowicki AL. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Physical Therapy. 2000; 80(10):997-1003. [DOI:10.1093/ptj/80.10.997] [PMID]
24. Young BA, Walker MJ, Strunce JB, Boyles RE, Whitman JM, Childs JD. Responsiveness of the Neck Disability Index in patients with mechanical neck disorders. The Spine Journal. 2009; 9(10):802-8. [DOI:10.1016/j.spinee.2009.06.002] [PMID]
25. Uemoto L, Garcia MAC, Gouvêa CVD, Vilella OV, Alfaya TA. Laser therapy and needling in myofascial trigger point deactivation. Journal of Oral Science. 2013; 55(2):175-81. [DOI:10.2334/josnusd.55.175] [PMID]
26. Ceylan Y, Hizmetli S, Siliğ Y. The effects of infrared laser and medical treatments on pain and serotonin degradation products in patients with myofascial pain syndrome. A controlled trial. Rheumatology International. 2004; 24(5):260-3. [DOI:10.1007/s00296-003-0348-6] [PMID]
27. Gur A, Sarac AJ, Cevik R, Altindag O, Sarac S. Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: A double‐blind and randomize‐controlled trial. Lasers in Sur-gery and Medicine. 2004; 35(3):229-35. [DOI:10.1002/lsm.20082] [PMID]
28. Cagnie B, Dewitte V, Coppieters I, Van Oosterwijck J, Cools A, Danneels L. Effect of ischemic compression on trig-ger points in the neck and shoulder muscles in office workers: A cohort study. Journal of Manipulative and Physio-logical Therapeutics. 2013; 36(8):482-9. [DOI:10.1016/j.jmpt.2013.07.001] [PMID]
29. Capuano-Pucci D, Rheault W, Aukai J, Bracke M, Day R, Pastrick M. Intratester and intertester reliability of the cer-vical range of motion device. Archives of Physical Medicine and Rehabilitation. 1991; 72(5):338-40. [PMID]
30. Gulick DT, Palombaro K, Lattanzi JB. Effect of ischemic pressure using a Backnobber II device on discomfort asso-ciated with myofascial trigger points. Journal of Bodywork and Movement Therapies. 2011; 15(3):319-25. [DOI:10.1016/j.jbmt.2010.06.007] [PMID]
31. Uemoto L, de Azevedo RN, Alfaya TA, Reis RNJ, de Gouvêa CVD, Garcia MAC. Myofascial trigger point therapy: Laser therapy and dry needling. Current Pain and Headache Reports. 2013; 17(9):357. [DOI:10.1007/s11916-013-0357-4] [PMID]
32. Simunovic Z. Low level laser therapy with trigger points technique: A clinical study on 243 patients. Journal of Clini-cal Laser Medicine & Surgery. 1996; 14(4):163-7. [DOI:10.1089/clm.1996.14.163] [PMID]
33. Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy. 2009; 14(5):531-8. [DOI:10.1016/j.math.2008.09.001] [PMID] [PMCID]
34. Wilke J, Vogt L, Banzer W. Immediate effects of self-myofascial release on latent trigger point sensitivity: A random-ized, placebo-controlled trial. Biology of Sport. 2018; 35(4):349-54. [DOI:10.5114/biolsport.2018.78055] [PMID] [PMCID]
35. Hou CR, Tsai LC, Cheng KF, Chung KC, Hong CZ. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Archives of Physical Medicine and Rehabilitation. 2002; 83(10):1406-14. [DOI:10.1053/apmr.2002.34834] [PMID]
36. Salvo SG. Massage therapy: Principles and practice. Amsterdam: Elsevier Health Sciences; 2015.
37. Tengrungsun T, Mitriattanakul S, Buranaprasertsuk P, Suddhasthir T. Is low level laser effective for the treatment of orofacial pain? A systematic review. Cranio. 2012; 30(4):280-5. [DOI:10.1179/crn.2012.042] [PMID]
38. López-Ramírez M, Vílchez-Pérez MÁ, Gargallo-Albiol J, Arnabat-Domínguez J, Gay-Escoda C. Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extrac-tion: A preliminary study. Lasers in Medical Science. 2012; 27(3):559-66. [DOI:10.1007/s10103-011-0936-8] [PMID]
IssueVol 14 No 2 (2020) QRcode
SectionResearch Article(s)
Myofascial pain syndrome Pain Trigger points Laser therapy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Rezaei S, Shadmehr A, Bashardoust Tajali S, Attarbashi Moghadam B, Jalaei S. Application of Combined Laser and Compression Therapy on the Pain and Level of Disability on Trigger Points in Upper Trapezius Muscle. jmr. 14(2):97-104.