Efficacy of Immediate Rewarming with Moist Heat After Conventional Vapocoolant Spray Therapy in Myofascial Pain Syndrome

ABSTRACT

Objectives: Spray with stretch therapy is frequently used in the treatment of myofascial pain syndrome [MPS]. Although rewarming is suggested after vapocoolant spray therapy, there have been no reports of its efficacy. We investigated the clinical efficacy of immediate rewarming after application of vapocoolant spray in patients with MPS.

Method: Female patients presenting with MPS in their upper trapezius muscle were included in the study. Initial, pain intensity, lateral bending of the cervical spine, and pressure pain threshold [PPT] of the trigger points were assessed using a visual analog scale [VAS], measuring contralateral acromion–tragus distance, and a pressure algometer. Patients in the group one were treated with conventional spray with stretch; patients in the group two were treated with spray and stretch and rewarming with a moist hot pack. Therapies were carried out thrice each on three consecutive days in both the groups.

Results: Eighty patients participated in the study. Both the groups showed statistically significant improvement in terms of pain, cervical range of motion [ROM], and PPT [p < 0.001]. Improvements in VAS score and cervical ROM were significantly higher in the spray with stretch hot pack group than in the spray with stretch group. There was no significant difference between the groups in terms of PPT [p < 0.05].

Conclusions: Adding rewarming to the spray with stretch therapy was more effective than spray–stretch alone in reducing MPS symptoms. Rewarming using a moist hot pack should be included in conventional spray–stretch procedure in MPS treatment.

KEYWORDS. :

• Myofascial pain syndrome
• pain-pressure threshold
• rewarming
• spray with stretch
• trapezius