Effectiveness of hot herbal compress versus topical diclofenac in treating patients with myofascial pain syndrome

Myofascial pain syndrome (MPS) is a chronic pain disorder which causes musculoskeletal pain and inflammation in the body's soft tissues. Thai Traditional Medicine uses hot herbal compresses as analgesic and anti-inflammatory treatment. There are no scientifically validated follow-up studies after treatment using hot herbal compresses. Effects of hot herbal compresses as an alternative treatment for MPS in the upper trapezius muscle compared with the standard treatment (diclofenac) were examined. Sixty patients with myofascial pain syndrome in the upper trapezius muscle were randomly divided into two groups and assigned to receive either hot herbal compress or nonsteroidal anti-inflammatory drug (diclofenac) treatment for 2 weeks. Clinical assessments included visual analogue scale (VAS) for pain score, cervical range of motion (CROM) for the neck and pressure pain threshold (PPT) tolerability before and after treatment. Within the groups, all treatments caused significant improvement in VAS and marginally increased effectiveness in PPT; however, only hot herbal compress treatment improved CROM. Hot herbal compress was more effective than diclofenac in all tests. Results provided comparable clinical efficacy between hot herbal compress and diclofenac after 2 weeks of treatment. Hot herbal compress proved to be an effective complementary or alternative treatment for MPS in the upper trapezius muscle.