The Effect Of Myofascial Trigger Point On Primary Dysmenorrhea

Purpose Primary Dysmenorrhea(PDM)occurs in the case of non-pelvic organic disease,which has brought many negative effects on young women.Activated Myofascial Trigger Points(MTr Ps)in abdomen are one of the causes of dysmenorrhea.MTr Ps refers to the palpable nodules located on the involved muscles,not only causing local and vicinity pain in involved muscles but also causing distant involved pain beyond involved muscles.Long-term exercise therapy combined with inactivation of MTr Ps can alleviate women’s pain because of menstruation,but current studies have not separately explored the effect of inactivated MTr Ps on PDM.Therefore,this study aims to explore the immediate and short-term effects of inactivating MTr Ps and exercise therapy on PDM,and compares the differences between inactivation of MTr Ps and exercise on PDM from multiple aspects.Methods Part 1:Fifty-four PDM women who met the inclusion criteria were randomly divided into MTr Ps group(n=20),exercise group(n=18)and blank control group(n=16).In the MTr Ps group,inactivation of MTr Ps was operated the first day of the menstrual.The exercise group received 30 minutes of stretching exercises on the first day of the menstrual.The blank control group did not do any intervention during the menstrual.Pressure pain threshold(PPT),Mc Gill score and dysmenorrhea symptom score of the three groups were measured before and after treatment.Part 2:Twenty-five PDM women who met the inclusion criteria were randomly divided into MTr Ps group(n=13)and exercise group(n=12).The MTr Ps group performed inactivation of MTr Ps twice a week outside menstrual,and stopped the intervention when the next holiday comes.The exercise group performed twice a week stretching exercise outside menstrual for 4 weeks,and stopped the intervention when the next period comes.PPT,Mc Gill pain score,dysmenorrhea symptoms,sleep quality,and mental state of the two groups were measured before and after treatment.Statistical Analysis Repeated measures analysis of variance was used to analyze the immediate and short-term effects of different interventions.The inter-group variable is the group,the intra-group variable is time,and the post-hoc pairwise test is performed when there is an interaction effect;P<0.05 means significant difference.Results Part 1:(1)The PPT of whole body will decrease during menstruation.The PPT of the wrist and the trapezius muscle is significantly reduced(P<0.05),and the PPT of lumbar spine and lower rectus abdominis is significant Decrease(P<0.05);(2)Immediately inactivating MTr Ps can significantly increase the PPT of the whole body and the effect is better than exercise therapy(P<0.05);(3)Immediate stretching exercise may has a certain maintenance effect on external area,but it may reduces the PPT of internal area.the PPT of lumbar spine and lower rectus abdominis was significantly reduced(P<0.05);(4)Immediate effect on inactivation of MTr Ps and stretching exercises can significantly reduce the Mc Gill scores(P<0.05),but the effect of inactivating of MTr Ps on the Mc Gill score reducing was significantly greater than that of stretching exercises(P<0.05).Part 2:(1)Inactivating of MTr Ps and stretching exercise can increase the PPT of the whole body(P<0.05),and the effect of MTr Ps inactivation on the PPT raising is greater than stretching exercise(P<0.05);during follow-up,the PPT of wrist,calf,trapezius and waist continued to increase in MTr Ps group(P>0.05),and the PPT of calf and rectus abdominis showed a downward trend(P>0.05).In exercise group,after intervention and during follow-up,the PPT of each part showed an upward trend(P>0.05);(2)The CMSS score of the two groups showed a downward trend(P>0.05);(3)The short-term and maintenance effects of the MTr Ps group on the Mc Gill pain score reducing were better than stretching exercises(P<0.05);(4)The MTr Ps group had a better maintenance effect on reducing the ATQ score and PCQ score(P<0.05);The MTr Ps group was better than stretching exercise in the short-term effect on PSEQ score increasing and POMS score decreasing(P<0.05);(5)Both treatment methods both have significant difference on PSQI score decreasing(P<0.05).Conclusions Inactivating of MTr Ps immediately during menstruation may improve the pain intensity and negative emotion of women with dysmenorrhea.The immediate stretching exercise may aggravate the pain during menstruation,which may have a better relief effect on the negative emotion caused during menstruation.After short-term intervention outside menstruation,two methods both can reduce the pain sensitivity of whole body.Stretching exercise may have a better maintenance effect than inactivating of MTr Ps;two methods both can improve sleep quality in the short term;inactivate muscles Fascia trigger points may be better than.Inactivating of MTr Ps may have a better short effect than stretching exercise in alleviating bad mental state.