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8 active trials for Myofascial Pain Syndrome

Shockwave Effectiveness in Myofascial Pain of the Upper Trapezius Muscle

Focused shockwaves are generated electrically, either within the applicator (electrohydraulic technique), or externally to it in the focal zone (electromagnetic or piezoelectric techniques), and then propagate to a designated focal point in order to treat it. Most research in shockwave therapy has focused on understanding the mechanism which results in the establishment of a mechano-sensitive feedback loop between the acoustic impulse and the stimulated cells, and involves specific transduction pathways and gene expression. Taking as valid the current physiopathological hypothesis of myofascial pain (MPS) and considering the mechanotransduction effect of ESWT in other diseases, it could be posited that ESWT in MPS may increase perfusion, promote angiogenesis and alter the pain signaling in ischaemic tissues caused by the influx of calcium. On the other hand, recent articles have demonstrated that free nerve endings degenerate after the application of ESWT, and that ESWT produces a transient dysfunction of nerve excitability at the neuromuscular junction, by bringing about the degeneration of AChR. Finally, following a pure mechanistic approach, shockwaves might be able to break-up the Actine-myosin links, as they are propagating perpendicularly to the sarcomere contractions. Study Hypothesis: To obtain pain relief and improvement in functional and quality of life scales, by performing 3 ESWT sessions, 1 per week (0,10 mJ/mm2; 2000 impulses; 5 Hz) in the most painful tender and/or trigger points of the upper trapezius muscle. Primary objective: To analyze the effectiveness of Focused Shockwave Treatment in myofascial pain of the upper trapezius muscle.

Start: February 2019