Myofascial trigger points are a muscular dysfunction at the level of the motor end-plate and the sarcoplasmic reticula that, in turn, cause a local contraction with ischemia -induced hypoxia. Along with the hypoxia, the resulting energy crisis leads to a sensation of the surrounding nociceptors . Extracorporeal shock wave therapy (ESWT) is recently considered an effective treatment for myofascial pain syndrome. It's been proved an effective in musculoskeletal disease fasciitis . It is significant since it is a non-invasive and simple treatment, easy to apply at a large surface, and has fewer side effects with low intensity even if it requires relatively high cost, ESWT has been proved to be more effective than conventional ultrasound on MTrPs in the upper trapezius muscle and showed that ESWT is more effective . It has been found that three sessions of ESWT significantly improved pain levels, neck disabilities, and the quality of life by reducing the number of MTrPs . ESWT could reduce the pain of myofascial pain syndrome by pain signal alteration, promoting angiogenesis and increasing perfusion in ischemic tissues induced by sensitization of nociceptors and muscle ischemia. Ultrasound with deep heat is used in treatment of myofascial trigger point due to the properties of achieving vasodilation, accelerating the metabolism, increasing viscoelasticity and reducing pain and muscle spasm High power pain threshold ultrasound found to be effective in many literatures in treatment of myofascial trigger point . Study was performed comparing effect of high power pain threshold ultrasound with conventional ultrasound proved that high power pain threshold is more effective in treating upper trapezius myofascial It was found in the treatment of MPS, HPPT US therapy could be considered as a reliable and more effective and has positive effect method than low-dose and conventional US therapies This study will be presented as a part of ongoing study. The ongoing study investigates the effect of different intensities of ultrasound on upper trapezius trigger points. The current study will investigate the myoelectric activities of trigger points after application of high power pain threshold ultrasound
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surface electromyography
Timeframe: before treatment and after 2 weeks of treatment
pressure algometer
Timeframe: before treatment and 2 weeks after treatment
Neck disability index
Timeframe: before treatment and 2 weeks after treatment