Journal of Anesthesiology and Pain

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 Aims and background: Muscle trigger points are one of the main sites of chronic pain in the musculoskeletal system. The activity of the trigger points of the quadrates lamborum muscles are a very common cause of low back pain. Therefore, the purpose of this study was to investigate the effect of Physical therapy with and without Positional Release Techniques on the pain, disability and range of motion of patients with chronic low back pain. Materials and methods: The target population was people who had chronic back pain in the trigger points in the lumbar muscles. Patients were randomly divided into two groups. The first group received Physical therapy with Positional Release Techniques and the second group, received only standard Physical therapy. Each group received 12 sessions of treatment over a period of three weeks. Pain was assessed before and after treatment by a Visual analogue scale (VAS) and the OSWESTRY disability questionnaire. Range of motion at the waist was evaluated by Schuber’s adjusted test both before and 48 hours after treatment. ANOVA with repeated measures was employed for data analyses and the results were considered significant if p<0.05. Findings: There was a significant difference in pain severity, the disability index and lumbar range of motion after intervention in both groups compared to pre-therapy levels. (P >0.005). Analysis of the two different treatment groups also showed there was a significant difference in the severity of pain, the disability index and lumbar range of motion (P >0.005), improvements that were achieved in the Physical therapy with Positional Release Technique group compared to the physical therapy alone group. Conclusion: Physical therapy in two situations with and without Positional Release Technique is effective in reducing pain and improving the lumbar motion in patients with chronic low back pain. Physical therapy combined with Positional Release Technique was more effective in reducing pain, the disability index and increasing the lumbar range of motion compared with the standard Physical therapy group.

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 Aims and background: Trigger points are sensitive points in the skeletal muscle and neck muscles that cause referral pain, decrease the range of motion and muscle soreness. Therefore, the purpose of this study was to compare the effect of the Positional Release Technique with and without strain-counter strain technique on the pain, neck range of motion in men with active trigger points in upper trapezius muscle. Materials and methods: The target community included the employees of the Mellat bank of Tehran city, which had trigger points in the upper trapezius muscle, ageing from 30 to 60 years old. Patients were randomly divided into two groups. The first group received a Positional Release Technique with strain-counter strain technique and the second group received only a Positional Release Technique. Each group received five treatment sessions. Pain was assessed on the basis of Visual analogue scale (VAS) and neck range of motion by goniometer before and 48 hours after treatment. The statistical methods used included two way ANOVA. Findings: There was a significant difference in pain severity and neck range of motion after intervention in both groups (P <0.005). Compared to the two groups after the treatment, there was a significant difference in the severity of pain as well as the neck range of motion (P <0.005), in the other words More improvements were achieved in Positional Release Technique with strain-counter strain technique group. Conclusion: Positional Release Technique in two situations with and without strain-counter strain technique is effective in reducing pain and improving the neck motion in people with trigger points of upper trapezius muscle. A Positional Release Technique combined with strain-counter strain technique was more effective in reducing pain and increasing the neck range of motion compared with the Positional Release Technique group.
 

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 Aims and background: Scapula and shoulder pain is one of the most common complaints in today’s society. Preventing of Shoulder disorders is important to avoid secondary damage to the shoulder, such as impingement and shoulder instability. Dyskinesia is used to describe the reduction of natural physiological control, mechanics, and scapular movement. The increase in the amount of surgical operations and costs associated that non-surgical treatment, such as exercise therapy, has made the need for prevention programs more effective. Therefore, the aim of this study was to evaluate the effect of six weak corrective exercises on pain and  disability in patients with dyskinesia scapula syndrome. Materials and methods: The statistical population of the present study were academic women with dyskinesia. At first, 30 patients with dyskinesia in scapula were diagnosed using wall functional tests and internal shoulder rotation and randomly divided into experimental and control groups. Subjects with inferior angle Prominence and scapular edges were selected as subjects with dyskinesia’s scapula.  Pain evaluation was performed using Visual Analogue Scale (VAS) and disability was assessed by hand shoulder disability questionnaire. Then six weeks of comprehensive corrective combined exercises including stability, strengthening and muscular strength training were performed for three sessions per week for the experimental group. Data were analyzed using Repeated Measures ANOVA and paired t-test.in SPSS software. Finding: There was a significant difference between the two groups in the pain and disability variable after the intervention, so that the intervention group improved more than the control group (P <0.005). Conclusion: With reliance on the findings of the research, the use of corrective exercise program is suggested to improve pain in people with scapular dyskinesia.

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Purpose: Neck pain is one of the most common problems in human societies. There are many factors involved in the etiology of neck pain, and cognitive problems related to pain are among the most important factors involved for non-specific neck pain. ‎The aim of this study was to investigate the effect of six weeks of functional cognitive training on the pain intensity, disability and Kinesiophobia in people with non-specific chronic neck pain.
Methods: The present study was a clinical trial study with one intervention group and one control group. In this clinical trial study, 24 patients with chronic neck pain were randomly divided into two ‎groups of Cognitive Functional Exercise (n=12) and Control (n=12). ‎‎ The variables of pain intensity, disability and Kinesiophobia ‎ were evaluated before and immediately after six weeks of cognitive exercises by Visual Analog Scale, neck disability questionnaire and Tampa Scale of Kinesiophobia, respectively. Data were analyzed using Repeated Measures ANOVA and paired t-test. ‎
Results: Comparing the two groups after treatment, there was a significant difference in pain intensity (P = 0.001), disability index (P = 0.001) and Tampa Scale of Kinesiophobia (P = 0.001) was observed, so that in the intervention group in all factors a significant decrease was observed. Also, the results of the T-pair test showed that there is a significant difference in the group of intervention before and after the test in all variables (P = 0.001). But there was no significant difference for the control group.
Conclusion: The findings showed that the intervention of functional cognitive exercises improves pain, disability and Kinesiophobia in people with chronic neck pain, so it is suggested that functional cognitive exercises can be used as a complementary method in improving individuals with non-specific chronic neck pain.