Petrofsky Jerrold, Laymon Michael, Lee Haneul
School of Physical Therapy, Touro University Nevada, Henderson, Nevada, USA.
Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea.
J Back Musculoskelet Rehabil. 2020;33(1):21-28. doi: 10.3233/BMR-181222.
Heating the skin and muscles is a commonly accepted method of pain relief and a modality to increase relaxation in muscles and increase tissue blood flow.
The purpose of the present study was to examine the effect of local heat applied to trigger points and to determine if there was pain relief in the neck and plantar fascia.
Forty adults were divided into 2 different groups according to their pain; twenty subjects had plantar foot pain and the other 20 had nonspecific neck pain. The 20 subjects in each group were randomly subdivided into a heat and a sham group. Sensitivity to pressure was measured with an algometer. A stopwatch was given to the subject and started when either the heat patch or placebo was applied. Heat cells were applied at trigger points on the pain area.
Subjective pain significantly decreased in both sham and heat group patients with neck pain (p< 0.05), however, the change was greater in the heat group and there was a significant difference between the heat and sham groups (p= 0.002, d= 0.81). For the plantar pain group, a significant decrease in subjective pain was found in the heat group but not in the sham group. Pressure pain threshold significantly decreased in the heat group patients both with neck and plantar pain but for the sham group there was an increase in the pressure after sham treatment. Pain relief during the intervention was also significantly different between the heat and sham group in both patients with neck and plantar pain.
The effect of local heat on trigger points of the body on pain relief was significantly better in the heat groups than in the sham groups. This finding is significant because using heat on trigger points could be an alternative to dry needling performed by healthcare professionals. This modality can be alternative for home use and avoids opioids.
加热皮肤和肌肉是一种公认的缓解疼痛的方法,也是一种增加肌肉放松和促进组织血流的方式。
本研究旨在探讨对触发点施加局部热疗的效果,并确定其是否能缓解颈部和足底筋膜的疼痛。
40名成年人根据疼痛情况分为2组;20名受试者有足底疼痛,另外20名有非特异性颈部疼痛。每组的20名受试者再随机分为热疗组和假治疗组。使用痛觉计测量压力敏感性。给受试者一个秒表,在贴上热贴或安慰剂时开始计时。在疼痛区域的触发点处应用热疗单元。
颈部疼痛的假治疗组和热疗组患者的主观疼痛均显著降低(p<0.05),然而,热疗组的变化更大,且热疗组与假治疗组之间存在显著差异(p=0.002,d=0.81)。对于足底疼痛组,热疗组的主观疼痛显著降低,而假治疗组则未降低。颈部和足底疼痛的热疗组患者的压力疼痛阈值均显著降低,但假治疗组在假治疗后压力有所增加。颈部和足底疼痛患者的热疗组和假治疗组在干预期间的疼痛缓解情况也存在显著差异。
热疗组中局部热疗对身体触发点疼痛缓解的效果明显优于假治疗组。这一发现具有重要意义,因为对触发点使用热疗可能是医疗专业人员进行干针疗法的替代方法。这种方式可供家庭使用,且避免使用阿片类药物。