Reduction of Spontaneous Electrical Activity and Pain Perception of Trigger Points in the Upper Trapezius Muscle Through Trigger Point Compression and Passive Stretching

Dimitrios Kostopoulos, PT, PhD, DSc
Arthur J. Nelson, Jr., PT, PhD
Reuben S. Ingber, MD
Ralph W. Larkin, PhD


Objectives: Investigate the effects of ischemic compression [IC] technique and
passive stretching [PS] in isolation and in combination on the reduction of spontaneous electrical
activity [SEA] and perceived pain in trigger points [TrPs] located in the upper trapezius muscle.

Methods: Ninety participants with TrPs in the upper trapezius muscle were randomly assigned
to three treatment groups: IC, PS, and IC + PS. TrP compression was applied on the TrP for three
applications of 60 seconds each, followed by a 30-second rest period. PS was applied for three
45-second applications, with 30-second rest intervals. All patients received the same amount of

Results: Significant decreases were found in pain perception and on SEA for all study participants.
The IC + PS group evidenced greater declines in pain perception and SEA when compared
to the IC and PS groups.

Conclusion: Because of ethical considerations, a control group design was not possible, thereby
limiting the robustness of the findings. Although each technique significantly reduced pain perception
and SEA, the combination of IC and PS was superior, apparently because of the complementary
nature of the therapeutic interventions.

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