Effect of Reciprocal Inhibition with Ischemic Pressure on the Trigger Point of Quadratus Lumborum Muscle in Low Back Pain

Authors

  • Muhammad Sanaullah Senior Lecturer RCR&AHS Riphah International University Lahore HOD/Associate Professor Department of Rehabilitation Sciences
  • Abdul Ghafoor Sajjad HOD/Associate Professor Department of Rehabilitation Sciences Shifa Tameer e Millat University Islamabad https://orcid.org/0000-0002-4797-975X
  • Muhammad Atif Javed Senior Lecturer RCR & AHS Riphah International University LahoreCampus https://orcid.org/0000-0003-2549-6850
  • Muhammad Faheem Afzal Assistant professor Rehabilitation Department PSRD College of Rehabilitation Sciences. https://orcid.org/0000-0003-2099-632X

Keywords:

Reciprocal Inhibition, ischemic pressure, quadratus lumborum, Back Pain, Myofascial Trigger Point Pain, Articular Goniometry, range of motion

Abstract

BACKGROUND AND AIM

Quadratus lumborum trigger points developed in low back pain. The aim of this study was to compare Reciprocal Inhibition with Ischemic Pressure on the Trigger Point of Quadratus Lumborum muscle in Low Back Pain.

METHODOLOGY

A 6 month randomized controlled trial was conducted.  Non probability Convenience sampling was used to select a sample 50 participants having low back pain with Quadratus lamborum trigger points placed into group1 and group 2 by lottery method. Group 1 was treated with reciprocal inhibition and ischemic pressure along with conventional therapy and group 2 was treated with ischemic pressure along with conventional therapy. The data collection tools were Numeric pain rating scale and Goniometer. Data was analyzed by statistical package for social science 21. Independent t-test used for between comparison analysis and Paired t-test was used for within analysis.

RESULTS The numeric pain rating scale mean difference in group 1 and group 2 was 4.72±0.12, 5.13±0.13 respectively. The Quadratus lamborum muscle length mean difference in group 1 and group 2 was 8.95±1.67, 5.34±1.25 respectively.

CONCLUSION

The addition of reciprocal inhibition with ischemic pressure showed significant results.

References

Raja MP. A Comparative Study on Abdominal Strengthening Exercise with Interferential Therapy versus Back Strengthening Exercise with Interferential Therapy in Acute Low Back Pain.2020:19-4.

Hall H. Low Back Patterns of Pain: Classification Based on Clinical Presentation. Handbook of Spine Technology. 2021:3-25.

Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The lancet. 2012 Feb 4; 379(9814):482-91.

Mescouto K, Olson RE, Hodges PW, Setchell J. A critical review of the biopsychosocial model of low back pain care: time for a new approach? Disability and Rehabilitation. 2020 Nov 18:1-5.

Phillips S, Mercer S, Bogduk N. Anatomy and biomechanics of quadratus lumborum. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 2008 Feb 1; 222(2):151-9.

Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best practice & research Clinical rheumatology. 2011 Apr 1; 25(2):185-98.

Jiménez-Sánchez C, Gómez-Soriano J, Bravo-Esteban E, Mayoral-del Moral O, Herrero-Gállego P, Ortiz-Lucas M. The effect of dry needling of myofascial trigger points on muscle stiffness and motoneuron excitability in healthy subjects. Acupuncture in Medicine. 2021 Jul 20:09645284211027579.

Gerwin RD. Myofascial pain syndrome. InMuscle pain: diagnosis and treatment 2010 (pp. 15-83). Springer, Berlin, Heidelberg.

Nikam DP, Varadharajulu DG. Effect of Variants of Positional Release Technique vs. Ischemic Compression Technique on trigger point in Myofascial Pain Syndrome: A randomized controlled trial. (2021). Int. J. Life Sci. Pharma Res.; 11(2):L54-57.

Lucas KR. The effects of latent myofascial trigger points on muscle activation patterns during scapular plane elevation. Melbourne. RMIT University, School of Health Sciences (Dissertation). 2007 Mar.

Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best practice & research Clinical rheumatology. 2011 Apr 1; 25(2):185-98.

Gross JM, Fetto J, Rosen E. Musculoskeletal examination. John Wiley & Sons; 2015 Jun 29.

Nasb M, Qun X, Ruckmal Withanage C, Lingfeng X, Hong C. Dry cupping, ischemic compression, or their combination for the treatment of trigger points: a pilot randomized trial. The Journal of Alternative and Complementary Medicine. 2020 Jan 1; 26(1):44-50.

Li L, Stoop R, Clijsen R, Hohenauer E, Fernández-de-Las-Peñas C, Huang Q, Barbero M. Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review. The Clinical Journal of Pain. 2020 Dec 22; 36(12):955-67.

Chaitow L, Crenshaw K. Muscle energy techniques. Elsevier Health Sciences; 2006.

Young IA, Dunning J, Butts R, Mourad F, Cleland JA. Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiotherapy theory and practice. 2019 Dec 2; 35(12):1328-35.

Dias LV, Cordeiro MA, de Sales RS, dos Santos MM, Korelo RI, Vojciechowski AS. Immediate analgesic effect of transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) on chronic low back pain: Randomised placebo-controlled trial. Journal of Bodywork and Movement Therapies. 2021 Jul 1; 27:181-90.

Metgud SC, Monteiro SS, Heggannavar A, D'Silva PV. Effect of integrated neuromuscular inhibition technique on trigger points in patients with nonspecific low back pain: Randomized controlled trial. Indian Journal of Physical Therapy and Research. 2020 Jul 1; 2(2):99.

Togha M, Bahrpeyma F, Jafari M, Nasiri A. A sonographic comparison of the effect of dry needling and ischemic compression on the active trigger point of the sternocleidomastoid muscle associated with cervicogenic headache: A randomized trial. Journal of back and musculoskeletal rehabilitation. 2020 Jan 1; 33(5):749-59.

Kumar GY, Sneha P, Sivajyothi N. Effectiveness of Muscle energy technique, Ischaemic compression and Strain counterstrain on Upper Trapezius Trigger Points: A comparative study. International journal of physical education, sports and Health. 2015; 1(3):22-6.

Nagrale AV, Glynn P, Joshi A, Ramteke G. The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial. Journal of Manual & Manipulative Therapy. 2010 Mar 1; 18(1):37-43.

Manzoor A, Anwar N, Haider R, Saghir M, Javed MA. Comparison of effectiveness of muscle energy technique with Mulligan mobilization in patients with non-specific neck pain. JPMA. The Journal of the Pakistan Medical Association. 2021 Mar 5; 71(6):1532-24.

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 Mar 1; 11(1):30-6.

Kostopoulos D, Nelson Jr AJ, Ingber RS, Larkin RW. Reduction of spontaneous electrical activity and pain perception of trigger points in the upper trapezius muscle through trigger point compression and passive stretching. Journal of musculoskeletal pain. 2008 Jan 1; 16(4):266-78.

De las Peñas CF, Campo MS, Carnero JF, Page JC. Manual therapies in myofascial trigger point treatment: a systematic review. Journal of bodywork and movement therapies. 2005 Jan 1; 9(1):27-34.

Rickards LD. The effectiveness of non-invasive treatments for active myofascial trigger point pain: a systematic review of the literature. International journal of osteopathic medicine. 2006 Dec 1; 9(4):120-36.

Downloads

Published

2022-01-14

How to Cite

Effect of Reciprocal Inhibition with Ischemic Pressure on the Trigger Point of Quadratus Lumborum Muscle in Low Back Pain. (2022). Pakistan Journal of Rehabilitation, 11(1), 95-102. https://ojs.zu.edu.pk/pjr/article/view/1369