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.
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