INTRODUCTION
Myofascial pain syndrome (MPS) is characterized by the development of irritability within small areas of taut bands of skeletal muscle or fascia referred to as trigger points (TrPs). Locally tender and painful when active, TrPs can lead to characteristic referred pain and tenderness, including specific patterns of autonomic reaction to other body areas upon compression [1-6]. A literature review of studies conducted in Thailand and other countries demonstrate that MPS is a major problem adversely affecting the patients’ quality of life and their ability to perform daily activities. For instance, the prevalence of MPS is as high as 36% with the patients suffering mainly from skeletal and muscle abnormalities [1, 4, 5].
The treatment of MPS involves relaxing TrPs by, for instance, stretching exercise or massage, or dealing with the factors causing MPS [4-8]. The pharmacological approach is also applied, using medications such as analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs); however, these medications have several side effects, including irritation of the stomach or the intestine. Currently, traditional Thai massage is becoming more widely accepted in health care as an alternative to the use of medications, especially in alleviating muscle pain and enhancing physical motion due to its effectiveness in healing muscle fatigue, stress, ache, and pain, including neck pain.
Court - type traditional Thai massage is based on the flow of the life energy known in Thai as Sen which consists of ten major channels called Sen Sib (ten lines). The ailments are caused by the obstruction of these channels resulting in the imbalance of the life energy. The main actions are pressing along the lines and specific points of the body using both thumbs and hands to restore various systems of the body, enhance, prevent and rehabilitate health [9].
The objective of this randomized controlled trial is, therefore, to assess the effectiveness of the court-type traditional Thai massage in reducing MPS in the upper and middle trapezius compared to topical diclofenac. The research findings will cast light on the administration of alternative medicine in treating MPS patients.