The Efficacy of Ultrasound-facilitated Electrical Stimulation as an Adjunct to Exercise in Treating Chronic Neck and Shoulder Pain

Objective: To evaluate the effectiveness of ultrasound [US]-facilitated electrical stimulation [US/ES] of thoracic spine area trigger points [TrPs] as an adjunct to exercise/electrical stimulation therapy alone in patients with chronic neck and shoulders pain. Methods: Subjects were randomly allocated into two treatment groups; one group to receive classic treatment [exercise plus ES] and the second group in which the classic treatment was supplemented with US/ES treatment of TrPs in the upper trunk area on the painful side. Participants were tested for pain intensity using a visual analog scale [VAS] for pain, Box plots [Box], Margolis' scoring system [size of pain area], and pain self-efficacy questionnaire [PSEQ]. Results: Forty two male and female patients, aged 27 and 76 years, entered the study and 39 patients [34 women and five men; aged 51.8 +/- 10 years] completed the study. The group that received the additional US/ES treatment exhibited greater improvements in pain intensity [Box, p = 0.05; VAS, p = 0.02] and size of the pain area, as measured with the Margolis scoring system [p=0.019]. There were no differences between the treatment groups with respect to functional status, as measured by the PSEQ [p=0.094]. Conclusion: The results showed that US/ES of TrPs as an adjunct to classical exercise/ES therapy can reduce the pain intensity in patients with chronic neck and shoulder pain.