LIPUS and CPPS

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Interesting study showing that LIPUS (low intensity pulsed ultrasound) can improve CPPS symptoms. Some very complex reasons are proposed.

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But what the above study does not consider is that ultrasound itself has an effect on trigger points (abstract). Canadian researchers treated trigger points in 50 patients with either ultrasound or a sham, and the amount of pressure on the trigger point required to induce pain was measured before and after. Trigger points treated with ultrasound were significantly more tolerant of pressure than those that were not treated, at 1, 3 and 5 minutes after treatment. The improvement was no longer significant just 10 and 15 minutes after treatment, however — so the effect in this case was brief. The authors concluded that “…low-dose ultrasound evokes short-term segmental antinociceptive effects on trigger points which may have applications in the management of musculoskeletal pain.” They are not necessarily proposing that ultrasound is a useful treatment for myofascial pain syndrome, but producing evidence of an interesting effect that may prove to be clinically significant in time.

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Follow up:

Agri. 2015;27(4):190-6. doi: 10.5505/agri.2015.48569.
Efficacy of conventional ultrasound therapy on myofascial pain syndrome: a placebo controlled study.
Kavadar G1, Çağlar N2, Özen Ş3, Tütün Ş2, Demircioğlu D4.

Abstract

OBJECTIVES: Myofascial pain syndrome (MPS) is a complex pain syndrome characterized with trigger points (TP) in skeletal muscles. We aimed to assess the efficacy of ultrasound (US) therapy, which is one of the main devices used in physical medicine and rehabilitation, for the treatment of TP in MPS.

METHODS: Fifty nine patients (49 females, 10 males) with active TP on the upper trapezius fibers were randomized into the treatment (n=30) and the control groups (n=29). The treatment group received conventional US therapy for 6 minutes, on 1.5 Watt/cm2 dose with 1 MHz frequency for 15 days whereas a placebo US therapy was administered to the control group. Prior to the treatment, immediately and 3 months later pain severity during rest and physical activity was assessed with visual analog scale (VAS), TP tenderness was measured with 0-5 scale, pressure pain threshold (PPT) was analyzed with algometer and the depression level was evaluated with Beck's depression questionnaire (BDP) by a clinician blinded to the groups.

RESULTS: The mean age of the patients were 37.43±9.07 and 35.83±5.68 years, in the treatment and control groups, respectively. Compared to the pre-treatment values VAS, 0-5 scale and BDP scores decreased (p<0.01) along with an increase in PPT (p<0.01) in both groups at the follow-up visits. 0-5 scales and BDP scores were significantly lower and PPT was significantly higher in the treatment group, compared to the control group (p<0.001).

CONCLUSION: Our results revealed that US treatment is effective on MPS.

PMID: 26860492

Full text here:
http://www.journalagent.com/agri/pdfs/A ... 90_196.pdf