Effects of electroacupuncture on pain, functional disability and ultrasonographic changes of gluteus maximus muscle in non-specific chronic low back pain patients with gluteus maximus muscle trigger points

authors:

avatar Fateme Moslemi , avatar Ziaeddin Safavi-Farokhi , *


how to cite: Moslemi F, Safavi-Farokhi Z. Effects of electroacupuncture on pain, functional disability and ultrasonographic changes of gluteus maximus muscle in non-specific chronic low back pain patients with gluteus maximus muscle trigger points. koomesh. 2020;22(4):e153220. 

Abstract

Introduction: Chronic low back pain is one of the major musculoskeletal problems. The presence of trigger points in the gluteus maximus muscle is a factor in increasing back pain. The aim of this study was to evaluate the effect of electro acupuncture on pain, functional disability and ultrasonographic changes of gluteus maximus muscle in patients with nonspecific chronic low back pain with trigger points of gluteus maximus muscle. Materials and Methods: This clinical trial study was performed on 38 non-specific chronic low back pain participants aged between 20-50 years. The participants were randomly assigned in 2 intervention and control groups. The scores of visual analogue scale of pain and disability questionnaire were recorded. The thickness of the gluteus maximus muscle was measured. Therefore, the control group performed 10 sessions routine physiotherapy (3 repetitions per week). The intervention group received 4 sessions’ electro acupuncture of gluteus maximus muscle (2 repetitions per week) and routine physiotherapy as mentioned above. At the end of intervention and two weeks after the last treatment session, the variables were assessed in both groups. Results: The results showed that there was no significant difference between the two groups in gluteus maximus thickness and lumbar pain but there was a significant reduction in gluteal pain (P = 0.000) and the score of disability questionnaire (P = 0.007) in the intervention group compared to control group. Conclusion: Electroacupuncture is an effective method in nonspecific chronic low back pain patients with trigger points of gluteus maximus muscle.The combination of electroacupuncture and routine physiotherapy compared to routine physiotherapy can help to decrease pain and functional disability significantly

References

  • 1.

    Hayden J, Van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of nonspecific low back pain. Cochrane Database Syst Rev 2005; 3: CD000335.

  • 2.

    Dunn K, Croft P. Epidemiology and natural history of low back pain. Eur J Phys Rehab Med 2004; 40: 9.

  • 3.

    Nordin M, Lis AM, Weiser SR, Halpern M, Campello MA. Nonspecific low back pain. Spine 2004; 1: 307.

  • 4.

    Kahrizi S. Stabilization exercises and their effect on fear-avoidance belief and disability in patients with recurrent nonspecific low back pain. Koomesh 2015; 17: 142-151. (Persian).

  • 5.

    Chapter 4 - Myofascial trigger point pain A2 - Baldry, P E. Myofascial Pain and Fibromyalgia Syndromes. Edinburgh: Churchill Livingstone; 2001; p: 57-79.

  • 6.

    Liu L, Huang QM, Liu QG, Thitham N, Li LH, Ma YT, et al. Evidence for dry needling in the management of myofascial trigger points associated with low back pain: a systematic review and meta-analysis. Arch Phys Med Rehab 2018; 99: 144-152.e2.

  • 7.

    Taghizadeh Dlkhoush C, Bakhshi S, Safavi Farokhi Z, MirmohammadKhani M. Comparison of dry needling and inhibitory kinesio taping on the pain and functional disability in females with myofascial pain syndrome in upper trapezius muscle. Koomesh 2019; 21: 610-618. (Persian).

  • 8.

    Hua NK, Van der Does E. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice. Pain 1994; 58: 317-323.

  • 9.

    Macintosh JE, Bogduk N, Gracovetsky S. The biomechanics of the thoracolumbar fascia. Clin Biomech 1987; 2: 78-83.

  • 10.

    Gracovetsky S. Is the lumbodorsal fascia necessary? J Bodyw Mov Ther 2008; 12: 194-197.

  • 11.

    Aranha MF, Alves MC, Brzin F, Gavio MB. Efficacy of electroacupuncture for myofascial pain in the upper trapezius muscle: a case series. Braz J Phys Ther 2011; 15: 371-379.

  • 12.

    Ulett GA, Han S, Han JS. Electroacupuncture: mechanisms and clinical application. Biol Psychiatry 1998; 44: 129-138.

  • 13.

    Aranha MF, Mller CE, Gavio MB. Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial. Braz J Phys Ther 2015; 19: 34-43.

  • 14.

    Mller CE, Aranha MF, Gavio MB. Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study. Ultrason Imaging 2015; 37: 152-167.

  • 15.

    Comachio J, Magalhes MO, Burke TN, Ramos LA, Almeida GP, Silva AP, et al. Efficacy of acupuncture and electroacupuncture in patients with nonspecific low back pain: study protocol for a randomized controlled trial. Trials 2015; 16: 469.

  • 16.

    Koppenhaver SL, Hebert JJ, Fritz JM, Parent EC, Teyhen DS, Magel JS. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. Arch Phys Med Rehabil 2009; 90: 87-94.

  • 17.

    Jeong JR, Lee SJ, Lee WH. Reliability of rehabilitative ultrasound imaging for measuring the gluteus maximus muscle at rest and during contraction. Phys Ther Rehab Sci 2017; 6: 7-13.

  • 18.

    Baxter GD, McDonough SM. Principles of electrotherapy in veterinary physiotherapy. Animal Physiotherapy: Assessment, Treatment and Rehabilitation of Animals Oxford: Blackwell. 2007; 177-186.

  • 19.

    Kamali F, Panahi F, Ebrahimi S, Abbasi L. Comparison between massage and routine physical therapy in women with sub acute and chronic nonspecific low back pain. J Back Musculoskelet Rehabil 2014; 27: 475-480.

  • 20.

    Lehmann TR, Russell DW, Spratt KF, Colby H, Liu YK, Fairchild ML, et al. Efficacy of electroacupuncture and TENS in the rehabilitation of chronic low back pain patients. Pain 1986; 26: 277-290.

  • 21.

    Xue CC, Helme RD, Gibson S, Hogg M, Arnold C, Somogyi AA, et al. Effect of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: protocol of a randomised controlled trial. Trials 2012; 13: 169.

  • 22.

    Pei J, Sun L, Chen R, Zhu T, Qian Y, Yuan D. The effect of electro-acupuncture on motor function recovery in patients with acute cerebral infarction: a randomly controlled trial. J Tradit Chin Med 2001; 21: 270-272.

  • 23.

    Cintron A, Morrison RS. Pain and ethnicity in the United States: A systematic review. J Palliat Med 2006; 9: 1454-1473.

  • 24.

    Kahana B, Kahana E, Namazi K, Kercher K, Stange K. The role of pain in the cascade from chronic illness to social disability and psychological distress in late life. Handbook Pain Aging 1997; p: 185-206.

  • 25.

    Huang LP, Zhou S, Lu Z, Tian Q, Li X, Cao LJ, et al. Bilateral effect of unilateral electroacupuncture on muscle strength. J Altern Complement Med 2007; 13: 539-546.##.