Blood Flow Within Active Myofascial Trigger Points Following Massage

The physiological response at the myofascial trigger point (MTrP) to massage is not known,
yet would provide important objective evidence for a treatment effect and clarify the
resolution process of a MTrP. The long-term goal is to understand how therapeutic
intervention affects the physiology of the MTrP. The objective of the proposed research is
to assess, in a placebo controlled trial, the effectiveness of trigger point release massage
(also known as ischemic compression) on blood flow at an active MTrP. The central hypothesis
is that the contraction nodule of an active MTrP is characterized by an ischemic state
comprised of reduced blood flow and subsequent dysregulation in carbohydrate metabolism. The
investigators hypothesize that trigger point release (TPR) can positively impact blood flow
leading to a change in high energy carbohydrate tension. The present study has been
formulated, in part, from a preliminary study conducted by the investigators, which supports
reduced blood flow and physiological disruption at active MTrPs. The proposed research will
provide a physiological basis for massage to corroborate subjective reports of reduced pain
sensitivity, impart credibility to treatment techniques, and provide insight into a
mechanism of action for healing the MTrP.

Inclusion Criteria:

- Chronic or episodic tension-type headache

- active MTrP in upper trapezius

- age 21-49

- BMI between 18.5-24.9

- either gender

- any race or ethnicity

Exclusion Criteria:

- No or latent MTrP in the upper trapezius

- migraine 4+/month

- cluster headache

- fibromyalgia

- neurological disease (e.g. Alzheimer's disease, Parkinson's disease, muscular
dystrophy, multiple sclerosis)

- cardiovascular disease (e.g. prior heart attack or stroke)

- diabetes

- pregnancy

- a bleeding disorder (Self-report of hemophilia, known lack/deficiency of clotting
factors, or presently °taking anti-coagulants (e.g. warfarin, Coumadin))

- narcotic use

- currently receiving massage

- prior trigger point injection or needling therapies

- allergy to lidocaine-type anesthetics such as lidocaine and prilocaine