In accordance with the
method of following Travell and Simon1), the diagnosis
involved the presence of 1) a palpable taut band, 2) palpable
nodule, and 3) palpable spot tenderness. At the time of the
research, they had stopped using painkillers, NSAIDs, and/
or other forms of treatment for at least 2 days. Patients were
excluded from the study based on any history of disease
or disorder that may be contraindicated for TTM such as
contagious skin disease, injury or inflammation of muscle,
bone fracture and/or joint dislocation, open wounds, and
cervical radiculopathy, as were pregnant or breastfeeding
women. Patients who expressed unwillingness to continue
their participation in the research; suffered from severe side
effects of the administration of ibuprofen or massage with
the Wilai massage stickTM, such as gastrointestinal bleeding
or greater pain intensity; received other types of treatment
other than those prescribed by the doctor during their participation,
such as acupuncture and medical injection; and
failed to follow the conditions of the research or missed
appointments were also excluded. Sixty subjects passing the
inclusion criteria were randomly allocated to treatment with
self-massage using a Wilai massage stickTM (TTMW) or
treatment with ibuprofen (control), which was accomplished
using a simple random sampling approach. There were 30
subjects in each group. The subjects were examined by a
licensed physiotherapist who was not informed of their
group before the beginning of the treatment, at day 1, at day
2, and at day 5 after the last treatment. In the Wilai massage
stickTM group (TTMW group), the patients were provided
instructions regarding self-massage according to TTM principles
as follows (Fig. 2). The upper back was to be divided
into the left side and the right side using the spinal processes
as the point of reference (Fig. 3). For each side, there were
two massage lines. The first one was about the width of a
finger from the spinous processes, and the second line was
about the width of three fingers from the spinous processes.
Each line was further comprised of eight points on the upper
back region. The self-massage was performed in a sitting
or standing posture, starting from the first point along the
massage line on the left side of the back. The pressure was
gradually increased until mild pain was felt, maintained for
5 seconds, and then released. This was performed for all the
eight points and then repeated 5 times. The procedures were
performed for all the massage lines of both sides of the back,
lasting approximately 10 minutes and follow stretching exercise
2 minutes. Thus, the total duration of each treatment
was 12 minutes, and the treatment was continued for 5 days.