EFFECTIVENESS OF THE COURT-TYPE TRADITIONAL THAI MASSAGE VERSUS TOPICAL DICLOFENAC ON TREATING PATIENTS WITH MYOFASCIAL PAIN SYNDROME IN THE UPPER AND MIDDLE TRAPEZIUS

Abstract

Myofascial pain syndrome (MPS) commonly occurs among office workers. Pharmacological therapy is one of standard treatment; however adverse drug reaction is concerned. Court-type traditional Thai massage (CTTM) may be effective and safe for alternative treatment. This study aimed to investigate the effectiveness of CTTM compared to topical diclofenac among patients with myofascial pain in the upper and middle trapezius. The study was performed at the Faculty of Medicine Thammasart University during April 23, 2014 to April 23, 2015. MPS patients were randomly allocated by envelope. The treatment group received a session of 30-minute court-type traditional Thai massage twice a week for six weeks. The control group received 4 g of topical diclofenac gel three times a day for six weeks. The outcomes were investigated for pain intensity by visual analog scale (VAS); quality of life by the 36-item short form health survey (SF-36) ; cervical range of motion by cervical flexion, cervical extension, cervical left lateral flexion, cervical right lateral flexion (CROM); and tissue hardness by pressure pain threshold . There were 45 patients in CTTM group and 44 patients in diclofenac group (1 dropped out by accidental injury). Their age, gender, height, weight, pain period, and side of pain were no statistically significant different between two groups (p > 0.05) at baseline. After intervention, pain intensity significantly decreased (p < 0.05) in both treatment and control groups. There were statistically significant improvement in the quality of life scores which comprised of the physical component summary and the mental component summary scores (p < 0.001). All categories of the cervical range of motion as well as pressure pain threshold increased significantly (p < 0.05 and p < 0.005 respectively) in both groups. The results strongly suggested the capability of the court-type traditional Thai massage to be an effective treatment for patients with myofascial pain syndrome in the upper and middle trapezius.