Myofascial Trigger Points Improve with Regional Adjustments
Dear Patients & Friends:
Breakthrough research by a team of chiropractic scientists demonstrated significant regional improvement in muscle tenderness and trigger points after adjustments but not after control procedures in a randomized control group trial.
Since earlier studies by Andrew Fischer, MD, PhD in the 1980s and 1990s demonstrated that algometry is a reliable and valid way to detect tender and trigger points related to spasm in muscles, chiropractic scientists had not performed a single randomized trial of adjustments that also used this measure of muscle tenderness and trigger point.
All that changed with publication of research by John Z. Srbely, DC, PhD, Howard Vernon, DC, PhD, and co-workers, in the July 2013 issue of the Journal of Manipulative and Physiological Therapeutics.
The Canadian chiropractic scientists assigned subjects with identifiable myofascial trigger points in the right infraspinatous (shoulder) and gluteus medius (hip) muscles to receive either lower neck adjustments or placebo chiropractic procedures. Tender points were measured before and several times after the procedure.
Patients randomly assigned to chiropractic neck adjustments had significant and consistent improvement in pain thresholds in the shoulder muscles but not hip muscles, indicating regional improvement in tenderness and trigger points. Placebo treated patients had no improvement in either region.
If further studies confirm that these findings are accompanied by improvement in chronic pain, this could become an important measure of spinal lesions (i.e., so-called subluxation or segmental dysfunction) that chiropractors could use to monitor progress in their patients.
Kudos to these researchers for following up on Dr. Vernon’s prior studies, as patients may yet benefit when chiropractors—and other doctors and therapists—are able to better measure improvement in their patients’ spinal health.
Robert A. Leach, DC, MS, FICC(h), CHES
Chiropractic researchers have not often looked at possible “mediator” variables of subluxation or spinal lesions. To read more about this breakthrough research by Drs Srbely, Vernon and co-workers: http://www.ncbi.nlm.nih.gov/pubmed/23830709
In prior research published in Spine, Dr Howard Vernon published the first validity paper on use of a “sham manipulation” that did NOT result in an audible release or “cracking” sound but that patients felt was a real chiropractic procedure: http://www.ncbi.nlm.nih.gov/pubmed/23158966
Henry and co-workers (including Dr Vernon) publishing in Pain, Research and Treatment, have used algometry to measure hind paw sensitivity in the rat model as well: http://www.ncbi.nlm.nih.gov/pubmed/22966427
There is but scant chiropractic research directly testing subluxation as a lesion or as a theory, and little research of possible “mediator” variables of the lesion, as reported in this brief update by Vernon in 2010: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342797/