Effectiveness of Low-Level Laser Therapy Versus Ischemic Compression on Pressure Pain Threshold Using Algometry in Upper Trapezius Myofascial Pain Syndrome: A Randomized Controlled Trial
Main Article Content
Abstract
Background: Upper-trapezius myofascial pain syndrome is characterized by trigger-point tenderness and reduced pressure pain threshold. Low-level laser therapy and ischemic compression are commonly used interventions, but their comparative effects remain uncertain. Objective: To compare the effects of low-level laser therapy and ischemic compression on pressure pain threshold in individuals with upper-trapezius myofascial pain syndrome. Methods: This randomized controlled trial included 40 adults allocated equally to low-level laser therapy or ischemic compression. Both interventions were administered three times weekly for four weeks. Pressure pain threshold was measured using a pressure algometer at baseline and after treatment. Within-group changes were assessed using paired-samples t tests, and changes between groups were compared using an independent-samples t test. Results: Pressure pain threshold increased from 2.15 ± 0.42 to 3.85 ± 0.55 kg/cm² in the low-level laser therapy group and from 2.20 ± 0.45 to 3.40 ± 0.60 kg/cm² in the ischemic-compression group. Mean improvements were 1.70 ± 0.48 and 1.20 ± 0.52 kg/cm², respectively. The between-group difference was 0.50 kg/cm² (95% CI: 0.18–0.82; p=0.003; Hedges’ g=0.98). Conclusion: Both interventions improved pressure pain threshold, but low-level laser therapy produced a greater short-term increase in mechanical pain tolerance. Keywords: Algometry; Ischemic compression; Low-level laser therapy
Article Details
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Liu C, Wang Y, Yu W, Xiang J, Ding G, Liu W. Comparative effectiveness of noninvasive therapeutic interventions for myofascial pain syndrome: a network meta-analysis of randomized controlled trials. Int J Surg. 2023;110(2):1099.
2. Rezaei S, Shadmehr A, Tajali SB, Moghadam BA, Jalaei S. Application of combined laser and compression therapy on the pain and level of disability associated with trigger points in the upper trapezius muscle. J Mod Rehabil. 2020;14(2):97-104.
3. Anwar K, Arshad H, Taj S, Khalid M, Sajjad AG, Malik R. Effects of neuromuscular reeducation with ischemic compression on myofascial trigger points in patients with neck pain: a randomized controlled trial. Pak J Med Health Sci. 2021;15(12):3673-7.
4. Alayat MS, Battecha KH, Elsodany AM, Ali MI. Pulsed Nd:YAG laser combined with progressive pressure release in the treatment of cervical myofascial pain syndrome: a randomized controlled trial. J Phys Ther Sci. 2020;32(7):422-7.
5. Alayat MSM, Battecha KH, Elsodany AM, Alzahrani OA, Alqurashi AKA, Jawa AT, et al. Effectiveness of photobiomodulation therapy in the treatment of myofascial pain syndrome of the upper trapezius muscle: a systematic review and meta-analysis. Photobiomodul Photomed Laser Surg. 2022;40(10):661-74.
6. Mammen AA. Effects of low-level laser therapy versus ultrasound therapy in the management of active trapezius trigger points. J Pharm Res Int. 2022.
7. Iqbal SA, Arooj A, Noor S, Raza Q, Naz F. Determine and compare the effects of ultrasound therapy versus laser therapy for the treatment of myofascial trigger points in the upper trapezius muscle. Era Physiother Rehabil J. 2022;1(1):13-21.
8. Taleb EA, Ahmed HM, Ameen FH, Lasheen YR, Albalawi HF, Eldesoky MT. Effect of high-intensity laser on upper trapezius myofascial pain syndrome: a single-blinded randomized controlled trial. Int J Health Sci. 2022;6(3):1227-39.
9. Seifolahi A, Rezaeian T, Mosallanezhad Z, Naimi SS. Comparison of the effects of dry needling and low-level laser on latent trigger points of the upper trapezius. 2021.
10. Ahmed H, Jarrar M, Ahmed R, Alqhtani R, Alshahrani A. Effect of post-isometric relaxation and laser on upper trapezius trigger-point pain in patients with mechanical neck pain. Niger J Clin Pract. 2020;23(12):1660-6.
11. Ebtesam A, Ragia MK, Elrefaey AM. High-intensity laser versus ischemic compression on myofascial trigger points in the upper trapezius: a randomized controlled trial. Med J Cairo Univ. 2025;93(6):681-7.
12. Akgül Kocabal Al, Gündüz OH. Examining the Effectiveness of Low-Level Laser Treatment Applied to the Upper Back Region in Individuals with Myofascial Pain Syndrome. Cyprus Journal of Medical Sciences. 2024;9(2):93-100.
13. Alayat MSM, Battecha KH, Elsodany AM, Alzahrani OA, Alqurashi AKA, Jawa AT, et al. Effectiveness of Photobiomodulation Therapy in the Treatment of Myofascial Pain Syndrome of the Upper Trapezius Muscle: A Systematic Review and Meta-Analysis. Photobiomodulation, Photomedicine, and Laser Surgery. 2022;40(10):661-74.
14. Albaker AB. Ischemic pressure vs. post-isometric relaxation for treatment of rhomboid latent myofascial trigger point: a systemic review. European Review for Medical and Pharmacological Sciences. 2023;27(11):5031-8.
15. Geri T, Botticchio A, Rossettini G, Pournajaf S, Pellicciari L, Di Antonio S, et al. Pressure Pain Threshold of the Upper Trapezius Trigger Point: A Systematic Review with Meta-Analysis of Baseline Values and Their Modification after Physical Therapy. Journal of Clinical Medicine. 2022;11(23):7243.
16. Lu W, Li J, Tian Y, Lu X. Effect of ischemic compression on myofascial pain syndrome: a systematic review and meta-analysis. Chiropr Man Therap. 2022;30(1).
17. Oliveira AKd, Dibai-Filho AV, Soleira G, Machado ACF, Guirro RRdJ. Reliability of pressure pain threshold on myofascial trigger points in the trapezius muscle of women with chronic neck pain. Revista da Associação Médica Brasileira. 2021;67(5):708-12.
18. Saleh MS, Shahien M, Mortada H, Elaraby A, Hammad YS, Hamed M, et al. High-intensity versus low-level laser in musculoskeletal disorders. Lasers in Medical Science. 2024;39(1).
19. Tehrani MR, Nazary-Moghadam S, Zeinalzadeh A, Moradi A, Mehrad-Majd H, Sahebalam M. Efficacy of low-level laser therapy on pain, disability, pressure pain threshold, and range of motion in patients with myofascial neck pain syndrome: a systematic review and meta-analysis of randomized controlled trials. Lasers in Medical Science. 2022;37(9):3333-41.
20. Tsabita R, Aktifah N, Sunyiwara AS. Pengaruh Kombinasi Ischemic Compression Dan Stretching Pada Myofascial Pain Syndrome Otot Upper Trapezius. FisioMu. 2021;2(1):47-53.
21. Xu A, Huang Q, Rong J, Wu X, Deng M, Ji L. Effectiveness of ischemic compression on myofascial trigger points in relieving neck pain: A systematic review and meta-analysis. Journal of Back and Musculoskeletal Rehabilitation. 2023;36(4):783-98.