Effect of ischemic compression on myofascial pain syndrome: a systematic review and meta-analysis

Wei Lu; Jiong Li; Ye Tian; Xingang Lu

doi:10.1186/s12998-022-00441-5

Effect of ischemic compression on myofascial pain syndrome: a systematic review and meta-analysis

Chiropr Man Therap. 2022 Sep 1;30(1):34. doi: 10.1186/s12998-022-00441-5.

Authors

Wei Lu¹, Jiong Li², Ye Tian³, Xingang Lu⁴

Affiliations

¹ Department of Nursing, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, People's Republic of China.
² Department of Hepatobiliary Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, People's Republic of China.
³ Department of Rehabilitation, Baoshan Branch, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200436, People's Republic of China.
⁴ Department of Traditional Chinese Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People's Republic of China. 11231280003@fudan.edu.cn.

Abstract

Background: Myofascial pain syndrome (MPS) is a condition with local and referred pain characterized by trigger points (taut bands within the muscle). Ischemic compression is a noninvasive manual therapy technique that has been employed for the treatment of MPS in past decades. However, little attention has been devoted to this topic.

Objectives: The present review was designed to explore the efficacy of ischemic compression for myofascial pain syndrome by performing a descriptive systematic review and a meta-analysis to estimate the effect of ischemic compression on MPS.

Methods: A systematic review and meta-analysis concerning randomized controlled trials (RCTs) with myofascial pain subjects who received ischemic compression versus placebo, sham, or usual interventions. Five databases (PubMed, The Cochrane Library, Embase, Web of Science, Ovid) were searched from the earliest data available to 2022.1.2. The standardized mean difference (SMD) and the 95% confidence interval (CI) were used for statistics. Version 2 of the Cochrane risk of tool 2 (RoB 2) was used to assess the quality of the included RCTs.

Results: Seventeen studies were included in the systematic review, and 15 studies were included in the meta-analysis. For the pressure pain threshold (PPT) index, 11 studies and 427 subjects demonstrated statistically significant differences compared with the control at posttreatment (SMD = 0.67, 95% CI [0.35, 0.98], P < 0.0001, I² = 59%). For visual analog scale (VAS) or numeric rating scale (NRS) indices, 7 studies and 251 subjects demonstrated that there was no significant difference between ischemic compression and controls posttreatment (SMD = - 0.22, 95% CI [- 0.53, 0.09], P = 0.16, I² = 33%).

Conclusion: Ischemic compression, as a conservative and noninvasive therapy, only enhanced tolerance to pain in MPS subjects compared with inactive control. Furthermore, there was no evidence of benefit for self-reported pain. The number of currently included subjects was relatively small, so the conclusion may be changed by future studies. Big scale RCTs with more subjects will be critical in future.

Keywords: Ischemic compression; Manual therapy; Massage; Myofascial pain; Trigger point.

Publication types

Meta-Analysis
Review
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Myofascial Pain Syndromes* / drug therapy
Pain
Pain Measurement / methods
Pain Threshold