Effleurage, Petrissage, and Combined Manual Pressure Release Techniques for Trigger Points of Cervical Spine in Patients with Myofascial Pain Syndrome

Myofascial pain syndrome is a musculoskeletal disorder that arises due to the presence of taut knots in fascia surrounding the muscle. These hypercontracted skeletal muscles or soft tissues are termed myofascial trigger points. These taut knots cause sensory, motor, and autonomic (vasoconstriction, pilomotor response, hypersecretion) symptoms. Worldwide prevalence rate of myofascial pain syndrome is 85%. The etiology of myofascial pain syndrome is unknown, but factors contributing are overuse of the muscle, repetitive exercise, and postural stress. Patients facing significant sensorimotor impairments are treated by physiotherapists who suffer from problems caused by myofascial pain syndrome. The cervical spine provides a greater range of motion compared to other vertebrae. Mostly trigger points develop in the cervical spine, especially in the trapezius and levator scapulae muscles. Common clinical characteristics of myofascial trigger points are pain on compression, local twitch response, muscle tightness, and local myofascial pain. Worldwide, many rehabilitation centers provide services to indoor and outdoor patients for quality treatment. Effleurage technique (stroking) is a unidirectional (distal to proximal) rhythmical gliding stroking movement of hands (palms, thumbs, fingers), sliding continuously over a tight muscular region to increase pliability of muscles. Petrissage technique (kneading) is an alternative to deep squeezing and relaxation of the tight fascia of muscle from proximal to distal by hands, thumbs, and fingers to increase localized blood flow. The combined manual pressure release technique is a combination of four techniques. Direct pressure technique (I & II) for ischemic compression and local stretching on a taut knot. Other is fascial techniques (III & IV) for improvement of mobility of fascia, connective tissues, intermuscular and intramuscular mobility. This concludes that these treatments are effective for myofascial pain syndrome patients, for improving range of motion, decreasing pain, and releasing myofascial trigger points in these patients.