Evaluating the Clinical Impact of Myofascial Treatment: Physiological Changes vs. Patient-Centered Outcomes

Nonspecific neck pain, common in various occupations, is pain in the neck without specific underlying causes or significant daily life interference. It’s often affecting muscles like the trapezius. Myofascial reorganization® (MR) is a treatment that uses manual pressure on the fascia to improve blood flow and reduce muscle tension. A past study showed MR increases oxyhemoglobin in nonspecific neck pain patients, suggesting benefits for muscle oxygenation, pain tolerance, and neck disability. Now a new study continues to investigate its physiological effects.

A double-blind randomized controlled trial was conducted in Brazil to explore the effects of myofascial reorganization® in the trapezius muscle. The study involved 75 participants, split equally into three groups: the myofascial treatment, the massage, and the control. The study was published in the Plos One journal.

The participants in the intervention groups were selected based on several criteria. They were either male or female, aged between 18 and 32 years, and had self-reported non-specific neck pain in the past three months without a definitive cause. Additionally, they exhibited at least “soft” pain during the first session of the neck disability index (NDI) and scored at least 1 on the Visual Analogue Scale (VAS). Conversely, the Control consisted of individuals with NDI and VAS scores of 0 at the time of recruitment.

Over the course of six weeks, the myofascial group underwent myofascial therapy sessions lasting 10 minutes each, once a week. Similarly, the massage group received classical massage for the same duration and frequency. The Control, having no pain, did not receive any intervention.

The effectiveness of these treatments was assessed using various tools. The NDI Questionnaire evaluated neck disability, while a pressure algometer was employed for pain evaluation. Near-infrared spectroscopy was utilized to measure muscle oxygenation levels.

The results, after six weeks of intervention, were telling. Both treatment groups showed a significant decrease in their NDI scores when compared to the Control.  Interestingly, the Control exhibited a lower basal tissue saturation (TSI) index than both treatment groups. Furthermore, the myofascial treatment group demonstrated higher oxyhemoglobin values compared to both the massage  and Control.

Post-intervention, the Control had higher pain tolerance than both treatment groups.

The findings indicate that after six weeks of myofascial therapy intervention, there was a notable increase in trapezius muscle oxygenation, suggesting potential therapeutic benefits for individuals suffering from nonspecific neck pain.

Nevertheless, the differences in self-reported pain and disability scores among the treatment groups did not reach the minimal clinically important difference  thresholds. This suggests that while myofascial reorganization can lead to measurable physiological changes, its impact on patient-centered outcomes, such as pain relief and reduced disability, remains uncertain in this particular study.